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echocardiography in intensive care

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https://www.readbyqxmd.com/read/29352701/bailout-surgical-explantation-of-a-transcatheter-valve-in-valve-for-subacute-thrombosis-when-there-is-no-time-for-anticoagulation-case-report-and-literature-review
#1
Francesco Notaristefano, Matteo Rocco Reccia, Salvatore Notaristefano, Roberto Annunziata, Rocco Sclafani, Giuseppe Ambrosio, Claudio Cavallini
Trancatheter heart valve (THV) thrombosis is effectively treated with anticoagulation but alternative therapies are required when a faster gradient reduction is needed. Open heart surgery has been rarely performed due to the high perioperative mortality and only five cases have been described so far. Here we describe a case of emergent surgical explantation for THV thrombosis after a valve-in-valve. A 67years old man underwent transcatheter aortic valve implantation for a failed surgical bioprosthesis Epic 21mm (St...
December 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#2
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#3
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29283917/anesthetic-management-and-procedural-outcomes-of-patients-undergoing-off-pump-transapical-implantation-of-artificial-chordae-to-correct-mitral-regurgitation-case-series-of-76-patients
#4
Robertas Stasys Samalavicius, Ieva Norkiene, Agne Drasutiene, Arturas Lipnevicius, Vilius Janusauskas, Karolis Urbonas, Diana Zakarkaite, Audrius Aidietis, Kestutis Rucinskas
BACKGROUND: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure. METHODS: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29274919/use-of-lung-ultrasound-for-the-assessment-of-volume-status-in-ckd
#5
REVIEW
Adrian Covic, Dimitrie Siriopol, Luminita Voroneanu
Adequate assessment of fluid status is an imperative objective in the management of all types of patients in cardiology, intensive care, and especially nephrology. Fluid overload is one of the most common modifiable risk factors directly associated with hypertension, heart failure, left ventricular hypertrophy, and eventually, higher morbidity and mortality risk in these categories of patients. Different methods are commonly used to determine fluid status (eg, clinical assessment, natriuretic peptide concentrations, echocardiography, inferior vena cava measurements, or bioimpedance analysis)...
December 20, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29260440/frequency-and-prognostic-impact-of-basic-critical-care-echocardiography-abnormalities-in-patients-with-acute-respiratory-distress-syndrome
#6
Kay Choong See, Jeffrey Ng, Wen Ting Siow, Venetia Ong, Jason Phua
BACKGROUND: Among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS), apart from acute cor pulmonale (ACP), the frequency and prognostic impact of basic critical care echocardiography (BCCE) abnormalities are not well defined. METHODS: Observational study of patients with ARDS, admitted from September 2012 to May 2014, who underwent BCCE within 48 h of admission to a 20-bed medical ICU. We examined the association of two major BCCE-detected abnormalities (left ventricular ejection fraction < 40% and severe ACP) with ICU/hospital mortality and ICU/hospital length of stay...
December 19, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29250515/basics-of-functional-echocardiography-in-children-and-neonates
#7
REVIEW
Cécile Tissot, Vincent Muehlethaler, Nicole Sekarski
Functional echocardiography has become an invaluable tool in the pediatric and neonatal intensive care unit. "Point-of-care," "target," or "focus" echocardiography allows bedside cardiac ultrasound evaluation of the hemodynamic status of the patient, helps in directing treatment, thus improves patients care. In order to be able to perform functional echocardiography, it is essential to understand the principles of ultrasound, to know the echocardiographic equipment and settings necessary to acquire the images...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29249790/-ascending-aorta-replacement-and-extended-myectomy-for-acute-aortic-dissection-and-coexistent-hypertrophic-obstructive-cardiomyopathy-report-of-a-case
#8
Tomoyuki Suzuki, Masaki Hata, Kazuhiro Yamaya, Takeshi Saitou, Fumiya Haba, Masahiro Matsuno
Emergent ascending aortic replacement and extended myectomy were performed in a woman with acute aortic dissection who was aged 63 years. Preoperative transthoracic echocardiography performed in the intensive care unit showed only slight left ventricular outflow tract (LVOT) obstruction, but intraoperative transesophageal echocardiography after induction of anesthesia revealed pericardial effusion, systolic anterior motion(SAM), and associated mitral regurgitation(MR). Perioperative SAM and MR are sometimes facilitated under various hemodynamic conditions, but in this case, the left ventricular wall was thick and LVOT appeared to be obstructive by a hypertrophied septum...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29248289/is-hemodynamic-transesophageal-echocardiography-needed-for-patients-with-left-ventricular-assist-device
#9
Nataliya Bahatyrevich, Qiong Yang, Nicholas C Cavarocchi, Hitoshi Hirose
BACKGROUND: Interventions in patients with a left ventricular assist device (LVAD) in the intensive care unit (ICU) are typically performed based on the results of conventional monitoring, such as vital signs and Swan-Ganz catheter (SGC) and LVAD parameters. These variables might not always accurately reflect a patient's cardiac function, volume status, and interventricular septal configuration, however. To assess the accuracy of standard monitoring, we performed routine continuous hemodynamic transesophageal echocardiography (hTEE) to evaluate cardiac function, volume status, and septal position...
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29247912/a-small-pericardial-effusion-is-a-marker-of-complicated-hospitalization-in-patients-with-community-acquired-pneumonia
#10
Funda Sungur Biteker, Murat Biteker, Özcan Başaran, Volkan Doğan, Bülent Özlek, Birdal Yıldırım, Eda Özlek, Oğuzhan Çelik
OBJECTIVE: Although often asymptomatic, presence of small pericardial effusion (SPE) is shown to be associated with adverse events and increased mortality in various conditions. This study aimed to evaluate the frequency and prognostic importance of SPE in a cohort of patients hospitalized for community-acquired pneumonia (CAP). METHODS: We prospectively followed 154 consecutive adult patients hospitalized with CAP. The severity of CAP was evaluated with the pneumonia severity index (PSI) and the CURB-65 (confusion, urea, respiratory rate, arterial blood pressure and age) score...
November 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29229143/myocardial-functional-changes-in-transfemoral-versus-transapical-aortic-valve-replacement
#11
Niraj Asthana, Aditya Mantha, Eric H Yang, William Suh, Olcay Aksoy, Richard J Shemin, Gabriel Vorobiof, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has greatly expanded the treatment options available for patients with severe aortic stenosis at high surgical risk. MATERIALS AND METHODS: We compared changes in myocardial function in TAVR with a transfemoral (TF) versus a transapical (TA) approach at a major tertiary hospital from 2012-2016. Traditional echocardiographic measures of cardiac structure and function were tracked, alongside the use of two-dimensional speckle tracking echocardiography to measure myocardial strain and strain rates...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29200072/tailored-holder-for-continuous-echocardiographic-monitoring
#12
Haibo Song, Shen Kou Tsai, Jin Liu
Hemodynamic monitoring is essential for prompt and effective interventions in intensive care unit patients. We developed a custom-made transthoracic echocardiography transducer holder consisting of transducer holder and skin patch attachment. This holder allowed continuous transthoracic echocardiography monitoring in 5 adult patients with circulatory failure due to shock, and 6 pediatric patients after successful percutaneous closure of a ventricular septal defect. One case of an unexpected hemopericardium was promptly diagnosed and pericardiocentesis was performed, and 1 patient required extracorporeal membrane oxygenation support...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29193877/effects-of-probiotics-on-ghrelin-and-lungs-in-children-with-acute-lung-injury-a-double-blind-randomized-controlled-trial
#13
Yu Wang, Li Gao, Zhongwen Yang, Fengmin Chen, Yuhua Zhang
AIM: To assess the effects of probiotics on serum ghrelin levels and protection for lungs in children with acute lung injury (ALI). METHODS: This study was performed as a double-blind, randomized, and controlled trial in a pediatric intensive care unit (PICU). The eligible children with ALI were assigned to either probiotic treatment or an identical placebo for 10 days. Serum ghrelin, SP-A(surfactant protein-A), TNF-α, and IL-6 concentrations were assessed at baseline and at the end of trial...
November 29, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29192422/executive-summary-on-the-use-of-ultrasound-in-the-critically-ill-consensus-report-from-the-3rd-course-on-acute-care-ultrasound-cacu
#14
Manu L N G Malbrain, Brecht De Tavernier, Sandrine Haverals, Michel Slama, Antoine Vieillard-Baron, Adrian Wong, Jan Poelaert, Xavier Monnet, Willem Stockman, Paul Elbers, Daniel Lichtenstein
Over the past decades, ultrasound (US) has gained its place in the armamentarium of monitoring tools in the intensive care unit (ICU). Critical care ultrasonography (CCUS) is the combination of general CCUS (lung and pleural, abdominal, vascular) and CC echocardiography, allowing prompt assessment and diagnosis in combination with vascular access and therapeutic intervention. This review summarises the findings, challenges lessons from the 3rd Course on Acute Care Ultrasound (CACU) held in November 2015, Antwerp, Belgium...
December 1, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29192421/the-state-of-critical-care-ultrasound-training-in-europe-a-survey-of-trainers-and-a-comparison-of-available-accreditation-programmes
#15
Laura Galarza, Adrian Wong, Manu L N G Malbrain
BACKGROUND: Although critical care ultrasound (CCUS) in the Intensive Care Unit has been increasing exponentially for diagnostic and therapeutic purposes, the lack of a uniform formal training structure and programme has posed the question of whether scans have been appropriately performed or reported, and whether there exists proper clinical governance to ensure a high standard of care. METHODS: An online survey was sent to the representatives of various national intensive care societies via the European Society of Intensive Care Medicine CoBaTrICE committee...
December 1, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29180214/thioredoxin-1-attenuates-sepsis-induced-cardiomyopathy-after-cecal-ligation-and-puncture-in-mice
#16
Rickesha L Wilson, Vaithinathan Selvaraju, Rajesh Lakshmanan, Mahesh Thirunavukkarasu, Jacob Campbell, David W McFadden, Nilanjana Maulik
BACKGROUND: Sepsis is a leading cause of mortality among patients in intensive care units across the USA. Thioredoxin-1 (Trx-1) is an essential 12 kDa cytosolic protein that, apart from maintaining the cellular redox state, possesses multifunctional properties. In this study, we explored the possibility of controlling adverse myocardial depression by overexpression of Trx-1 in a mouse model of severe sepsis. METHODS: Adult C57BL/6J and Trx-1Tg/+ mice were divided into wild-type sham (WTS), wild-type cecal ligation and puncture (WTCLP), Trx-1Tg/+sham (Trx-1Tg/+S), and Trx-1Tg/+CLP groups...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29174659/impact-of-a-monoplane-hemodynamic-tee-htee-monitoring-device-on-decision-making-in-a-heterogeneous-hemodynamically-unstable-intensive-care-unit-population-a-prospective-observational-study
#17
Maung Hlaing, Jianghua He, Nicholas Haglund, Hiroo Takayama, Brigid C Flynn
OBJECTIVE: This prospective observational study was undertaken to evaluate the utility of a miniature transesophageal echocardiography probe (ImaCor hemodynamic [hTEE]) in the management of hemodynamically unstable intensive care unit patients with and without various forms of mechanical circulatory support. DESIGN: A prospective observational study. SETTING: A single tertiary care cardiothoracic and surgical intensive care unit. PARTICIPANTS: Fifty-three cardiothoracic and surgical intensive care unit patients undergoing miniature transesophageal echocardiography examinations...
October 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#18
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29158684/right-and-left-ventricular-function-in-hospitalized-children-with-respiratory-syncytial-virus-infection
#19
Thorsten Horter, Britt Nakstad, Omid Ashtari, Anne Lee Solevåg
Background: Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward. Methods: We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29142568/echocardiographic-evaluation-of-cardiovascular-complications-after-birth-asphyxia-in-term-neonates
#20
Mohsen Shahidi, Ghodratollah Evazi, Abdorrahim Afkhamzadeh
Objectives: After birth asphyxia, a variety of hemodynamic disorders may be noted in the neonatal intensive care unit; these require appropriate recognition and management. The present study was designed to demonstrate the prevalence of heart complications amongst asphyxiated newborns. Methods: Through a cohort study, 29 asphyxiated term neonates were followed since birth until amelioration of pulmonary hypertension and compared with 31 well born neonates. Both groups were evaluated for their heart anatomy and hemodynamic with meticulous assessment through echocardiography...
September 2017: Pakistan Journal of Medical Sciences Quarterly
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