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https://www.readbyqxmd.com/read/28641796/cardiac-sympathetic-denervation-for-refractory-ventricular-arrhythmias
#1
Marmar Vaseghi, Parag Barwad, Federico J Malavassi Corrales, Harikrishna Tandri, Nilesh Mathuria, Rushil Shah, Julie M Sorg, Jean Gima, Kaushik Mandal, Luis C Sàenz Morales, Yash Lokhandwala, Kalyanam Shivkumar
BACKGROUND: Cardiac sympathetic denervation (CSD) has been shown to reduce the burden of implantable cardioverter-defibrillator (ICD) shocks in small series of patients with structural heart disease (SHD) and recurrent ventricular tachyarrhythmias (VT). OBJECTIVES: This study assessed the value of CSD and the characteristics associated with outcomes in this population. METHODS: Patients with SHD who underwent CSD for refractory VT or VT storm at 5 international centers were analyzed by the International Cardiac Sympathetic Denervation Collaborative Group...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28640785/physiologic-considerations-in-trauma-patients-undergoing-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#2
Zaffer A Qasim, Robert A Sikorski
Resuscitative endovascular balloon occlusion of the aorta is a new procedure for adjunctive management of critically injured patients with noncompressible torso or pelvic hemorrhage who are in refractory hemorrhagic shock, ie, bleeding to death. The anesthesiologist plays a critical role in management of these patients, from initial evaluation in the trauma bay to definitive care in the operating room and the critical care unit. A comprehensive understanding of the effects of resuscitative endovascular balloon occlusion of the aorta is essential to making it an effective component of hemostatic resuscitation...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28638723/low-dose-methotrexate-in-sickle-cell-disease-a-pilot-study-with-rationale-borrowed-from-rheumatoid-arthritis
#3
Silvia R Brandalise, Rosemary Assis, Angelo B A Laranjeira, José Andrés Yunes, Pedro O de Campos-Lima
BACKGROUND: Inflammation is a major feature of sickle cell disease (SCD). Low-dose methotrexate (MTX) has long been used in chronic inflammatory diseases. This pilot study examined the MTX effect on acute vaso-occlusive pain crises (VOC) in SCD patients. METHODS: Fourteen adults on hydroxyurea with severe and refractory VOC received one intramuscular injection of 10 mg of MTX per week for 12 weeks. A single weekly dose of 5 mg of leucovorin was administered orally 48 h after each MTX injection...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28626745/investigating-the-effect-of-extracorporeal-shock-wave-therapy-on-reducing-chronic-pain-in-patients-with-pes-anserine-bursitis-a-randomized-clinical-controlled-trial
#4
Saeid Khosrawi, Parisa Taheri, Marziyeh Ketabi
BACKGROUND: Knee pain, is one of the most common causes of patients' referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. MATERIALS AND METHODS: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28624593/double-sequential-defibrillation-therapy-for-out-of-hospital-cardiac-arrests-the-london-experience
#5
Amber C Emmerson, Mark Whitbread, Rachael T Fothergill
BACKGROUND: Despite advances in treatment for out-of-hospital cardiac arrest (OHCA), a subgroup of patients remain in refractory ventricular fibrillation (RVF) during resuscitation. Recent evidence suggests that double sequential defibrillation (DSD), where two shocks are delivered to the patient in quick succession, may provide an effective therapy for RVF. This study describes the characteristics and survival outcomes of OHCA patients treated by ambulance clinicians using a local DSD protocol in an attempt to resolve RVF...
June 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28622968/the-beneficial-effect-of-extracorporeal-shockwave-myocardial-revascularization-two-years-of-follow-up
#6
Gianluca Alunni, Umberto Barbero, Alessandro Vairo, Salvo D'Amico, Martina Pianelli, Domenica Zema, Federica Bongiovanni, Fiorenzo Gaita
OBJECTIVES: Despite the advancements achieved by revascularization technique and pharmacological therapies, the number of patients with refractory angina (RA) is still high, carrying together a poor prognosis. Experimental data and small clinical studies suggest that the use of extracorporeal shockwave myocardial revascularization (ESMR) might improve symptoms of angina in patients with RA. The aim of our study is to evaluate the efficacy of cardiac shock wave therapy in a long term follow-up of patients with coronary artery disease (CAD) otherwise not suitable for revascularization...
May 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#7
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28618416/shock-wave-therapy-promotes-cardiomyocyte-autophagy-and-survival-during-hypoxia
#8
Ling Du, Tao Shen, Bing Liu, Yunhe Zhang, Cong Zhao, Na Jia, Que Wang, Qing He
BACKGROUND: Autophagy plays an important role in cardiovascular disease. Controversy still exists regarding the effect of autophagy on ischemic/hypoxic myocardium. Cardiac shock wave therapy (CSWT) is an effective alternative treatment for refractory ischemic heart disease. Whether CSWT can regulate cardiomyocyte autophagy under hypoxic conditions is not clear. We established a myocardial hypoxia model using the H9c2 cell line and performed shock waves (SWs) treatment to evaluate the effect of SW on autophagy...
June 15, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#9
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28600090/hemodynamics-of-cardiogenic-shock
#10
REVIEW
Ariel Furer, Jeffrey Wessler, Daniel Burkhoff
Cardiogenic shock (CS) represents an advanced state of morbidity along the pathophysiologic pathway of end-organ hypoperfusion caused by reduced cardiac output and blood pressure. Acute coronary syndromes remain the most common cause of CS. The spectrum of hypoperfusion states caused by low cardiac output ranges from pre-CS to refractory CS and can be characterized by an array of hemodynamic parameters. This review provides the foundation for a hemodynamic understanding of CS including the use of hemodynamic monitoring for diagnosis and treatment, the cardiac and vascular determinants of CS, and a hemodynamic approach to risk stratification and management of CS...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28589286/extracorporeal-cytokine-elimination-as-rescue-therapy-in-refractory-septic-shock-a-prospective-single-center-study
#11
Sigrun Friesecke, Stephanie-Susanne Stecher, Stefan Gross, Stephan B Felix, Axel Nierhaus
Sepsis is the most common cause of death in medical intensive care units (ICU). If sepsis progresses to refractory septic shock, mortality may reach 90-100% despite optimum current therapy. Extracorporeal cytokine adsorption in addition to regular therapy was studied prospectively in refractory septic shock patients on a medical ICU. Refractory shock was defined as increasing vasopressor dose required to maintain mean arterial blood pressure above 65 mmHg or increasing lactate levels despite protocol-guided shock therapy for 6 h...
June 6, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28583555/veno-arterial-venous-hybrid-mode-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-combined-with-septic-shock-in-a-liver-transplant-patient-a-case-report
#12
J-I Park, B-H Jung, S-G Lee
BACKGROUND: Post-operative respiratory failure is common in liver transplant patients, with a direct effect on graft and recipient outcomes. We present a case of successful treatment for a patient who had acute respiratory distress syndrome combined with septic shock after living-donor liver transplantation with veno-arterial-venous hybrid mode of extracorporeal membrane oxygenation (ECMO) support. METHODS: A 49-year-old male patient underwent successful emergency living-donor liver transplantation for acute-on-chronic liver failure associated with alcoholic liver cirrhosis...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28580075/role-of-vasopressin-in-current-anesthetic-practice
#13
REVIEW
Keun Suk Park, Kyung Yeon Yoo
Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe sepsis, cardiogenic or vasodilatory shock, or cardiopulmonary bypass have inappropriately low plasma levels of AVP ('relative vasopressin deficiency') and supersensitivity to exogenously-administered AVP...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28578440/adherence-to-surviving-sepsis-guidelines-among-pediatric-intensivists-a-national-survey
#14
Farah C Thabet, Jihad N Zahraa, May S Chehab
To assess the compliance with the 2006 American College of Critical Care-Pediatric Advanced Life Support (ACCM-PALS) guidelines for sepsis management, and the 2012 surviving sepsis campaign (SSC), for the management of pediatric patients with sepsis and to identify the main barriers to adherence to these guidelines. Methods: In November 2015, a prospective cohort study in which a web based electronic survey using a case scenario to explore the usual management of a child with severe sepsis was designed and sent to all consultant pediatric intensivists practicing in Kingdom of Saudi Arabia (KSA)...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28575211/clinical-outcomes-in-patients-after-extracorporeal-membrane-oxygenation-support-for-post-cardiotomy-cardiogenic-shock-a-single-centre-experience-of-92-cases%C3%A2
#15
Julien Guihaire, Simon Dang Van, Simon Rouze, Sébastien Rosier, Antoine Roisne, Thierry Langanay, Hervé Corbineau, Jean-Philippe Verhoye, Erwan Flécher
OBJECTIVES: Post-cardiotomy cardiogenic shock is a major concern in cardiac surgery. We reviewed our experience of extracorporeal membrane oxygenation (ECMO) as temporary circulatory support in post-cardiotomy cardiogenic shock. METHODS: Between January 2005 and December 2014, adult patients implanted with ECMO after cardiac surgical procedures were included. Indications for ECMO were failure to be withdrawn from cardiopulmonary bypass or refractory cardiogenic shock occurring during postoperative Days 1 and 2...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28570152/shockingly-deficient-an-elderly-woman-with-refractory-hypotension-and-acidosis
#16
Harin Patel, Pranav Kidambi, Gautam George, Peter F Clardy, Carey C Thomson
No abstract text is available yet for this article.
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28567214/surgical-treatment-of-piriformis-syndrome
#17
Suk Ku Han, Yong Sik Kim, Tae Hyeon Kim, Soo Hwan Kang
BACKGROUND: Piriformis syndrome (PS) is an uncommon disease characterized by symptoms resulting from compression/irritation of the sciatic nerve by the piriformis muscle. Uncertainty and controversy remain regarding the proper diagnosis and most effective form of treatment for PS. This study analyzes the diagnostic methods and efficacy of conservative and surgical treatments for PS. METHODS: From March 2006 to February 2013, we retrospectively reviewed 239 patients who were diagnosed with PS and screened them for eligibility according to our inclusion/exclusion criteria...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28561960/acute-respiratory-distress-syndrome-and-septic-shock-in-a-cat-with-disseminated-toxoplasmosis
#18
Natashia A Evans, Julie M Walker, Alison C Manchester, Jonathan F Bach
OBJECTIVE: To describe acute respiratory distress syndrome (ARDS) and septic shock in a cat with disseminated toxoplasmosis. CASE SUMMARY: A 2-year-old neutered male domestic shorthair cat was presented for acute respiratory distress. At the time of presentation it had been receiving cyclosporine for treatment of eosinophilic dermatitis. Thoracic radiographs revealed severe mixed nodular interstitial and alveolar patterns. An endotracheal wash was performed, which confirmed a diagnosis of pulmonary toxoplasmosis...
May 31, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28553783/a-retrospective-cohort-analysis-of-percutaneous-versus-side-graft-perfusion-techniques-for-veno-arterial-extracorporeal-membrane-oxygenation-in-patients-with-refractory-cardiogenic-shock
#19
Mehmet Cakici, Evren Ozcinar, Cagdas Baran, Ahmet Onat Bermede, Mehmet Cahit Sarıcaoglu, Mustafa Bahadır Inan, Mustafa Serkan Durdu, Atilla Aral, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: This study was designed to compare vascular complications and the outcomes of ultrasound (US)-guided percutaneous cannulation with distal perfusion catheter (PC-DP) and arterial side-graft perfusion (SGP) techniques in patients who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock (RCS). METHODS: We conducted a retrospective, observational cohort study of consequtive patients with RCS treated with VA-ECMO at a single transplant center from March 2010 until August 2015...
July 2017: Perfusion
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#20
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
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