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Central Venous Pressure

David J Goldberg, Victor Zak, Bryan H Goldstein, Brian W McCrindle, Shaji C Menon, Kurt R Schumacher, R Mark Payne, Jonathan Rhodes, Kimberly E McHugh, Daniel J Penny, Felicia Trachtenberg, Michelle S Hamstra, Marc E Richmond, Peter C Frommelt, Matthew D Files, James L Yeager, Victoria L Pemberton, Mario P Stylianou, Gail D Pearson, Stephen M Paridon
The Fontan operation creates a circulation characterized by elevated central venous pressure and low cardiac output. Over time, these characteristics result in a predictable and persistent decline in exercise performance that is associated with an increase in morbidity and mortality. A medical therapy that targets the abnormalities of the Fontan circulation might, therefore, be associated with improved outcomes. Udenafil, a phosphodiesterase type 5 inhibitor, has undergone phase I/II testing in adolescents who have had the Fontan operation and has been shown to be safe and well tolerated in the short term...
July 2018: American Heart Journal
Raphaëlle Huguet, Damien Fard, Thomas d'Humieres, Ophelie Brault-Meslin, Laureline Faivre, Louis Nahory, Jean-Luc Dubois-Randé, Julien Ternacle, Leopold Oliver, Pascal Lim
BACKGROUND: The inferior vena cava (IVC) has a complex three-dimensional (3D) shape, but measurements used to estimate central venous pressure (CVP) remain based on two-dimensional (2D) echocardiographic imaging. The aim of this study was to investigate the accuracy of IVC size and collapsibility index obtained by 3D echocardiography for assessing CVP in patients with cardiogenic shock. METHODS: Eighty consecutive echocardiographic examinations performed in 33 patients (mean age, 72 ± 15 years; mean left ventricular ejection fraction, 19 ± 10%) admitted for cardiogenic shock were prospectively included...
June 13, 2018: Journal of the American Society of Echocardiography
Gill Norman, Maggie J Westby, Amber D Rithalia, Nikki Stubbs, Marta O Soares, Jo C Dumville
BACKGROUND: Venous leg ulcers are open skin wounds on the lower leg which can be slow to heal, and are both painful and costly. The point prevalence of open venous leg ulcers in the UK is about 3 cases per 10,000 people, and many people experience recurrent episodes of prolonged ulceration. First-line treatment for venous leg ulcers is compression therapy, but a wide range of dressings and topical treatments are also used. This diversity of treatments makes evidence-based decision-making challenging, and a clear and current overview of all the evidence is required...
June 15, 2018: Cochrane Database of Systematic Reviews
Heath D White, Alfredo Vazquez-Sandoval, Pedro F Quiroga, Juhee Song, Shirley F Jones, Alejandro C Arroliga
Acid-base status is frequently assessed in severe sepsis and septic shock. Venous blood gas sampling is proposed as a less-invasive modality but lacks evidence within this population. The objective of this study was to evaluate the correlation and agreement between arterial blood gas (ABG), peripheral venous blood gas (pVBG), and central venous blood gas (cVBG) in severe sepsis and septic shock. We conducted a prospective, observational cohort study in subjects admitted to the medical intensive care unit. Simultaneous blood gas samples, including ABG, pVBG, and cVBG, were analyzed for correlation and agreement...
July 2018: Proceedings of the Baylor University Medical Center
Hiroki Sano, Joonbum Seo, Paul Wightman, Nick J Cave, Mike A Gieseg, Craig B Johnson, Paul Chambers
OBJECTIVE: To evaluate whether pulse pressure variation (PPV) and pleth variability index (PVI) are more accurate than central venous pressure (CVP) for predicting fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs after premedication with acepromazine. DESIGN: Prospective experimental trial. SETTING: University teaching hospital. ANIMALS: Twelve Harrier hound dogs. INTERVENTIONS: Each dog was anesthetized and had a fluid challenge performed...
June 13, 2018: Journal of Veterinary Emergency and Critical Care
Kevin M Veen, Rahatullah Muslem, Osama I Soliman, Kadir Caliskan, Marit E A Kolff, Dagmar Dousma, Olivier C Manintveld, Ozcan Birim, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: Moderate-to-severe tricuspid regurgitation is common in end-stage heart disease and is associated with an impaired survival after left ventricular assist device (LVAD) surgery. Controversy remains whether concomitant tricuspid valve surgery (TVS) during LVAD implantation is beneficial. We aimed to provide a contemporary overview of outcomes in patients who underwent LVAD surgery with or without concomitant TVS. METHODS: A systematic literature search was performed for articles published between January 2005 and March 2017...
April 20, 2018: European Journal of Cardio-thoracic Surgery
Liwen Bao, Jiechun Huang, Fangrui Wang, Liewen Pang, Yiqing Wang, Haiming Shi
Constrictive pericarditis (CP) is defined as impaired diastolic cardiac function caused by a calcified and thickened pericardium. We assessed the clinical characteristics and time to diagnosis, as well as patient prognosis after pericardiectomy. Methods: We analyzed the records of 36 CP patients who underwent pericardiectomy at Huashan Hospital, China, between 2012 and 2015. Clinical manifestations, length of time to diagnosis, laboratory parameters, and diagnostic imaging results were examined. All patients underwent pericardiectomy, and were assessed post-operatively for quality of life and improvement of cardiac function using the Minnesota Living with Heart Failure Questionnaire (MLHFQ)...
May 24, 2018: Heart Surgery Forum
Taiki Sakaguchi, Akio Hirata, Kazunori Kashiwase, Yoshiharu Higuchi, Tomohito Ohtani, Yasushi Sakata, Yoshio Yasumura
BACKGROUND: Although central venous pressure (CVP) is a surrogate measure of preload in patients with acute decompensated heart failure (ADHF), it is a multifactorial index influenced not only by fluid volume status, but also by cardiac pump function and other factors. We aimed to elucidate the individual pathophysiologic factors of CVP elevation in ADHF patients by assessing the relationship between CVP and extracellular fluid volume status (EVS). METHODS AND RESULTS: We quantified EVS in 100 ADHF patients using bioelectrical impedance analysis...
June 8, 2018: Journal of Cardiac Failure
C Zhang, Y Zhu, Q Q Li, H Gu
Objective: To investigate the risk factors, clinical features, treatments, and prevention of pulmonary hypertensive crisis (PHC) in children with idiopathic pulmonary arterial hypertension (IPAH) undergoing cardiac catheterization. Methods: This retrospective study included 67 children who were diagnosed with IPAH and underwent cardiac catheterization between April 2009 and June 2017 in Beijing Anzhen Hospital. The medical histories, clinical manifestations, treatments, and outcomes were characterized. Statistical analyses were performed using t test, χ(2) test and a multiple Logistic regression analysis...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Ashraf M Eskandr, Ahmed A Metwally, Montasser S Abu Elkassem, Sadik A Sadik, Ashraf E Elmiligy, Mohamed Mourad, Lamiaa Hussein
OBJECTIVE: To compare the effects of dobutamine and nitroglycerin to milrinone in young patients with severe pulmonary hypertension undergoing mitral valve replacement. DESIGN: A prospective randomized, double-blinded, controlled study. SETTING: Single university hospital. PARTICIPANTS: Forty patients had systolic pulmonary arterial pressure ≥60 mmHg and were scheduled for elective mitral valve replacement. The patients were divided randomly into 2 equal groups according to the drugs given during the study...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Michael D Gudejko, Brian R Gebhardt, Farhad Zahedi, Ankit Jain, Janis L Breeze, Matthew R Lawrence, Stanton K Shernan, Navin K Kapur, Michael S Kiernan, Greg Couper, Frederick C Cobey
BACKGROUND: Severe right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation increases morbidity and mortality. We investigated the association between intraoperative right heart hemodynamic data, echocardiographic parameters, and severe versus nonsevere RVF. METHODS: A review of LVAD patients between March 2013 and March 2016 was performed. Severe RVF was defined by the need for a right ventricular mechanical support device, inotropic, and/or inhaled pulmonary vasodilator requirements for >14 days...
June 5, 2018: Anesthesia and Analgesia
Per W Moller, Anisa Hana, Paul Philipp Heinisch, Shengchen Liu, Siamak Djafarzadeh, Matthias Haenggi, Andreas Bloch, Jukka Takala, Stephan M Jakob, David Berger
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is gaining widespread use in the treatment of severe cardiorespiratory failure. Blood volume expansion is commonly used to increase ECMO flow (QECMO), with risk of positive fluid balance and worsening prognosis. We studied the effects of vasoconstriction on recruitment of blood volume as an alternative for increasing QECMO, based on the concepts of venous return. METHODS: In a closed chest, centrally cannulated porcine preparation (n = 9) in ventricular fibrillation and VA-ECMO with vented left atrium, mean systemic filling pressure (MSFP) and venous return driving pressure (VRdP) were determined in Euvolemia, during Vasoconstriction (norepinephrine 0...
June 5, 2018: Shock
Farid Yaghouby, Chathuri Daluwatte, Nicole R Marques, Muzna Khan, Michael Salter, Jordan Wolf, Christina Nelson, John Salsbury, Perenlei Enkhbaatar, Michael Kinsky, David G Strauss, George C Kramer, Christopher G Scully
In this paper we describe a data set of multivariate physiological measurements recorded from conscious sheep ( N = 8; 37.4 ± 1.1 kg) during hemorrhage. Hemorrhage was experimentally induced in each animal by withdrawing blood from a femoral artery at two different rates (fast: 1.25 mL/kg/min; and slow: 0.25 mL/kg/min). Data, including physiological waveforms and continuous/intermittent measurements, were transformed to digital file formats (European Data Format [EDF] for waveforms and Comma-Separated Values [CSV] for continuous and intermittent measurements) as a comprehensive data set and stored and publicly shared here (Appendix A)...
April 2018: Data in Brief
Xiaohua Huang, Shereen M Hamza, Wenqing Zhuang, William A Cupples, Branko Braam
Increased central venous pressure and renal venous pressure (RVP) is associated with worsening of renal function in acute exacerbation of congestive heart failure. We tested whether an acute, isolated elevation of RVP in one kidney leads to ipsilateral renal vasoconstriction and decreased GFR and whether this depends on dietary salt intake or activation of renal nerves. Male Lewis rats received a normal (1% NaCl, NS) or high salt diet (6% NaCl, HS) for {greater than or equal to}14 days before the acute experiment...
June 6, 2018: American Journal of Physiology. Renal Physiology
Andrea Olivia Ciobanu, Leonida Gherasim
Ischemic hepatitis is an important, yet underdiagnosed pathological condition seen in either cardiology or hepatology clinics or intensive care units. The main causes are severe heart failure, circulatory and septic shock. Close monitoring of biological tests (AST, ALT, LDH) together with hemodynamic parameters (blood pressure, cardiac output and central venous pressure) allow for rapid and accurate diagnosis. Correction of hemodynamic parameters, hypoxemia, hepatic and/or renal dysfunction leads to a more favorable outcome of these patients...
March 2018: Mædica
Carl Sjödin, Soren Sondergaard, Lotta Johansson
BACKGROUND: The phlebostatic axis is the most commonly used anatomical external reference point for central venous pressure measurements. Deviation in the central venous pressure transducer alignment from the phlebostatic axis causes inadequate pressure readings, which may affect treatment decisions for critically ill patients in intensive care units. AIM: The primary aim of the study was to assess the variability in central venous pressure transducer levelling in the intensive care unit...
June 1, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Robert Frithiof, Anna Bandert, Anders Larsson, Miklos Lipcsey, David Smekal
In intensive care, drugs are commonly administered through central venous catheters (CVC). These catheters and central venous dialysis catheters (CVDC) are often placed in the same vessel for practical reasons. The aim of this experimental study was to investigate if the position of CVC and CVDC influences the elimination of infused drugs, during continuous renal replacement therapy (CRRT). In a randomized, cross-over model, anesthetized piglets received both a CVC and a CVDC in a jugular vein. Another CVDC was placed in a femoral vein for comparison...
May 29, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
H Suresh, B S Arun, V Moger, P B Vijayalaxmi, K T K Murali Mohan
Pulmonary hypertension (PH) is a recently recognized complication of chronic kidney disease (CKD), especially in end-stage renal disease. It has prevalence estimates of 30%-50% and is an independent predictor of increased mortality in CKD patients. The aim of this study is to analyze the prevalence of PH in patients with CKD, its severity in different stages of CKD, and risk factors for it. One hundred and eight patients with CKD treated at Karnataka Institute of Medical Sciences, Hubli, Karnataka, between January 1, 2014, and June 30, 2015, were selected...
March 2018: Indian Journal of Nephrology
Friso M Rijnberg, Mark G Hazekamp, Jolanda J Wentzel, Patrick J H de Koning, Jos J M Westenberg, Monique R M Jongbloed, Nico A Blom, Arno A W Roest
Visualization and quantification of the adverse effects of distorted blood flow are important emerging fields in cardiology. Abnormal blood flow patterns can be seen in various cardiovascular diseases and are associated with increased energy loss. These adverse energetics can be measured and quantified using 3-dimensional blood flow data, derived from computational fluid dynamics and 4-dimensional flow magnetic resonance imaging, and provide new, promising hemodynamic markers. In patients with palliated single-ventricular heart defects, the Fontan circulation passively directs systemic venous return to the pulmonary circulation in the absence of a functional subpulmonary ventricle...
May 29, 2018: Circulation
Kazuyuki Mizunoya, Hitoshi Saito, Yuji Morimoto
PURPOSE: A proper reference level is important for measuring intracardiac pressures, especially for parameters with small normal values such as central venous pressure (CVP). Although several external zero reference levels (eZRLs) have been proposed for non-obese patients, none has been reported for severely obese patients. The aim of this study was to investigate an appropriate eZRL for CVP measurements of severely obese patients. METHODS: Chest computed tomography images of 65 patients with body mass index (BMI) ≥ 35 kg/m2 were retrospectively reviewed...
May 28, 2018: Journal of Anesthesia
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