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Central Venous Pressure

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https://www.readbyqxmd.com/read/29028731/when-who-and-how-is-elevated-mean-airway-pressure-and-central-venous-pressure-in-the-first-day-of-mechanical-ventilation-a-sign
#1
Guniz M Koksal, Emre Erbabacan, Antonio M Esquinas
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29027656/pulmonary-complications-after-non-cardiac-surgeries-temporal-patterns-and-risk-factors
#2
Cássia Toledo, Flávio Eduardo Nácul, Marcos Freitas Knibel, Nilton Brandão Silva, Ederlon Rezende, Cintia Magalhães Carvalho Grion, Murillo Assunção, Fernando Gutierrez, Joelma Villafanha Gandolfi, Suzana Margareth Lobo
BACKGROUND: Postoperative complications are the primary determinants of survival following major surgery. We aimed to characterize the early perioperative risk factors for postoperative pulmonary complications (POPCs) in patients undergoing major non-cardiac surgeries. METHODS: This study utilized a multicenter prospective observational cohort design. Adult patients undergoing non-cardiac surgeries and admitted to 21 Brazilian ICUs were screened for inclusion in the study...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29027577/assessment-of-renal-perfusion-impairment-in-a-rat-model-of-acute-renal-congestion-using-contrast-enhanced-ultrasonography
#3
Kaoru Komuro, Yoshihiro Seo, Masayoshi Yamamoto, Seika Sai, Tomoko Ishizu, Kyo Shimazu, Yumi Takahashi, Shogo Imagawa, Teisuke Anzai, Kazuya Yonezawa, Kazutaka Aonuma
Renal congestion is caused by elevated central venous pressure (CVP), and decreases glomerular filtration in patients with congestive heart failure. Since real-time contrast-enhanced ultrasonography (CEUS) using microbubble-based contrast agents can visualize the perfused microvascular bed, we sought to evaluate the impairment of renal perfusion during acute renal congestion with CEUS. In Wister rats, CEUS of kidney was performed with the direct monitoring of CVP and intra-renal pressure (IRP). When CVP was elevated to 10 and 15 mmHg after the bolus injection of normal saline via the femoral vein, peak intensity (PI, dB) and time to PI (TTP) in the renal cortex and medulla were compared with control rats...
October 13, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#4
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29024133/plasma-natriuretic-peptide-levels-in-fetuses-with-congenital-heart-defect-and-arrhythmia-a-single-center-prospective-study
#5
Takekazu Miyoshi, Takashi Umekawa, Hiroshi Hosoda, Takashi Asada, Akihiro Fujiwara, Ken-Ichi Kurosaki, Isao Shiraishi, Michikazu Nakai, Kunihiro Nishimura, Mikiya Miyazato, Kenji Kangawa, Tomoaki Ikeda, Jun Yoshimatsu, Naoto Minamino
OBJECTIVES: Diagnosing fetal heart failure remains challenging because it is difficult to know how well the fetal myocardium will perform as loading conditions change. In adult cardiology, natriuretic peptides (NPs) are established marker of heart failure. However, the number of studies investigating NP levels in fetuses is quite limited. The aim of this study was to evaluate the significance of plasma NP levels in the assessment of heart failure in fetuses with congenital heart defect (CHD) and arrhythmia...
October 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29023316/septic-shock-resuscitation-in-the-first-hour
#6
Nicholas Simpson, Francois Lamontagne, Manu Shankar-Hari
PURPOSE OF REVIEW: We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients. RECENT FINDINGS: Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination...
October 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29019905/bezold-jarisch-reflex-occurred-in-a-pediatric-patient-with-giant-intra-abdominal-teratoma-during-induction-of-anesthesia-a-case-report
#7
Kai-Ming Yuan, Shu-Ying Fu, Jun Li, Wang-Ning Shangguan, Qing-Quan Lian
RATIONALE: Bezold-Jarisch reflex (BJR) occurs when the cardioinhibitory receptors in the walls of ventricles are activated by various stimuli, with typical features of bradycardia, vasorelaxation, and hypotension. This reflex usually happens in parturient intrathecal anesthesia, as a result of decreased venous return by compression of inferior vena cava, but it is only rarely reported during general anesthesia. PATIENT CONCERNS: Severe bradycardia and hypotension, indicating BJR, occurred during the induction of general anesthesia in a 3-month-old female child with giant intra-abdominal teratoma...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28994680/rising-central-venous-pressure-impending-right-sided-failure
#8
Monish S Raut, Arun Maheshwari, Vinayak Desurkar, Rajesh Bhavsar
Central venous pressure generally indicates right sided cardiac filling pressure. Although it is a static hemodynamic parameter, however trend of CVP gives important information regarding the patient's management. Patient with left ventricular assist device is prone to develop right ventricular dysfunction which can easily be suspected by trend of CVP. However rising CVP does not always imply right heart dysfunction.
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28985844/assessment-of-hemodynamic-response-to-fluid-resuscitation-of-patients-with-intra-abdominal-sepsis-in-low-and-middle-income-countries
#9
Egide Abahuje, Robert Munyaneza, Robert Riviello, Faustin Ntirenganya
BACKGROUND: Patients with intra-abdominal infections need to achieve adequate hemodynamic status before being taken to the operating room. Multiple parameters (urinary output [UOP], vital signs, inferior vena cava collapsibility index, and central venous pressure) may be used to assess hemodynamic response to fluid resuscitation, but the options are few in limited-resource settings. This study aimed at assessing if a bedside-performed ultrasound to assess the inferior vena cava collapsibility index is superior to UOP in assessing hemodynamic response to fluid resuscitation...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984662/rapid-cardiothoracic-ultrasound-protocol-for-diagnosis-of-acute-heart-failure-in-the-emergency-department
#10
Jonas Öhman, Veli-Pekka Harjola, Pasi Karjalainen, Johan Lassus
OBJECTIVES: The aim of this study was to evaluate the performance of a rapid cardiothoracic ultrasound protocol (CaTUS), combining echocardiographically derived E/e' and lung ultrasound (LUS), for diagnosing acute heart failure (AHF) in patients with undifferentiated dyspnea in an emergency department (ED). PATIENTS AND RESULTS: We enrolled 100 patients with undifferentiated dyspnea from a tertiary care ED, who all had CaTUS done immediately upon arrival in the ED...
October 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28977264/recent-advances-in-bedside-microcirculation-assessment-in-critically-ill-patients
#11
Philipe Franco do Amaral Tafner, Felipe Ko Chen, Roberto Rabello, Thiago Domingos Corrêa, Renato Carneiro de Freitas Chaves, Ary Serpa
Parameters related to macrocirculation, such as the mean arterial pressure, central venous pressure, cardiac output, mixed venous saturation and central oxygen saturation, are commonly used in the hemodynamic assessment of critically ill patients. However, several studies have shown that there is a dissociation between these parameters and the state of microcirculation in this group of patients. Techniques that allow direct viewing of the microcirculation are not completely disseminated, nor are they incorporated into the clinical management of patients in shock...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28971030/data-availability-and-feasibility-of-various-techniques-to-predict-response-to-volume-expansion-in-critically-ill-patients
#12
Michael J Lanspa, Benjamin J Briggs, Eliotte L Hirshberg, Cristina M Pratt, Colin K Grissom, Samuel M Brown
OBJECTIVE: The accuracy of various techniques to predict response to volume expansion in shock has been studied, but less well known is how feasible these techniques are in the ICU. METHODS: This is a prospective observation single-center study of inpatients from a mixed profile ICU who received volume expansion. At time of volume expansion, we determined whether a particular technique to predict response was feasible, according to rules developed from available literature and nurse assessment...
July 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28970711/is-portal-venous-pressure-or-porto-systemic-gradient-really-a-harbinger-of-poor-outcomes-after-living-donor-liver-transplantation
#13
Amol Vijay Kanetkar, Dinesh Balakrishnan, Sudhindran Sudhindran, Puneet Dhar, Unnikrishnan Gopalakrishnan, Ramachandran Menon, Othiyil Vayoth Sudheer
BACKGROUND: Portal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP). METHODS: In 42 adult cirrhotics undergoing elective LDLT, PVP was measured by direct canulation of portal vein and porto systemic gradient (PSG) was obtained after subtracting CVP from PVP. None underwent portal inflow modulation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970659/prognostic-value-of-venous-to-arterial-carbon-dioxide-difference-during-early-resuscitation-in-critically-ill-patients-with-septic-shock
#14
Tamer Abdallah Helmy, Ehab Mahmoud El-Reweny, Farahat Gomaa Ghazy
CONTEXT: The partial pressure of venous to arterial carbon dioxide gradient (PCO2 gap) is considered as an alternative marker of tissue hypoperfusion and has been used to guide treatment for shock. AIMS: The aim of this study was to investigate the prognostic value of venous-to-arterial carbon dioxide difference during early resuscitation of patients with septic shock and compared it with that of lactate clearance and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28959487/current-management-of-spontaneous-intracerebral-haemorrhage
#15
REVIEW
Cyrus K Dastur, Wengui Yu
Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant HTN, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Intensive lowering of systolic blood pressure to <140 mm Hg is proven safe by two recent randomised trials...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28955029/effects-of-abcde-bundle-on-hemodynamics-in-patients-on-mechanical-ventilation
#16
Xiao-Li Ren, Jian-Hua Li, Chong Peng, Hong Chen, Hai-Xia Wang, Xue-Ling Wei, Qing-Hong Cheng
BACKGROUND Mechanical ventilation is an important part of advanced life support in the intensive care unit (ICU). This study aimed to investigate the effects of ABCDE bundle on hemodynamics in patients on mechanical ventilation (MV). MATERIAL AND METHODS This study used a cross-sectional overall controlled approach in which 143 patients on mechanical ventilation were divided into 2 groups. In the pre-ABCDE bundle group (n=70), conventional sedation and analgesia strategy were used. In the post-ABCDE bundle group (n=73), ABCDE bundle was used...
September 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28949052/resting-and-exercise-haemodynamics-in-relation-to-six-minute-walk-test-in-patients-with-heart-failure-and-preserved-ejection-fraction
#17
Emil Wolsk, David Kaye, Barry A Borlaug, Daniel Burkhoff, Dalane W Kitzman, Jan Komtebedde, Carolyn S P Lam, Piotr Ponikowski, Sanjiv J Shah, Finn Gustafsson
AIMS: Patients with heart failure and preserved ejection fraction (HFpEF) are characterized by functional impairment and an abnormal haemodynamic response to exercise. The six-minute walk test (6MWT) serves as a standardized test for functional capacity quantification in heart failure patients, and is associated with cardiovascular outcomes. However, as the association between 6MWT and haemodynamic parameters during rest and exercise in HFpEF patients is unknown, we sought to elucidate this relationship...
September 26, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28938306/different-clinical-course-and-complications-in-interagency-registry-for-mechanically-assisted-circulatory-support-1-patients-managed-with-or-without-extracorporeal-membrane-oxygenation
#18
Jason J Han, Jennifer Chung, Carol W Chen, Ann C Gaffey, Alex Sotolongo, Christyna Justice, Alyse E Ameer, J Eduardo Rame, Christian Bermudez, Michael A Acker, Pavan Atluri
Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28932498/hemodynamic-effect-of-intravenous-lidocaine-during-aortic-cannulation-in-cardiac-surgery
#19
Ziya Totonchi, Shirin Salajegheh, Mahmoud Reza Mohaghegh, Mehrdad Mesbah Kiaei, Mohammad Shirvani, Masoud Ghorbanlo
BACKGROUND: Dissection of aorta is a rare, but fatal complication of aortic cannulation in cardiac surgery can be caused by the sudden rise in blood pressure and hemodynamic variations. METHODS: In this study, 90 patients aged 18 years or older undergoing cardiac surgery were divided into two equal groups. Under similar conditions, trial group received 1.5 mg/kg of lidocaine for 90 s before cannulation and control group received normal saline. Hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and central venous pressure before cannulation and 1, 3, and 5 min after cannulation were recorded in a form...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#20
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
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