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https://www.readbyqxmd.com/read/29127685/the-first-case-of-ischemia-free-organ-transplantation-in-humans-a-proof-of-concept
#1
Xiaoshun He, Zhiyong Guo, Qiang Zhao, Weiqiang Ju, Dongping Wang, Linwei Wu, Lu Yang, Fei Ji, Yunhua Tang, Zhiheng Zhang, Shanzhou Huang, Linhe Wang, Zebin Zhu, Kunpeng Liu, Yanling Zhu, Yifang Gao, Wei Xiong, Ming Han, Bing Liao, Maogen Chen, Yi Ma, Xiaofeng Zhu, Wenqi Huang, Changjie Cai, Xiangdong Guan, Xian Chang Li, Jiefu Huang
Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man...
November 10, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29105303/myocarditis-and-kawasaki-disease
#2
Audrey Dionne, Nagib Dahdah
Kawasaki disease (KD) is the most common vasculitis of childhood. Coronary artery aneurysms and myocarditis are common cardiovascular complications of KD. While evidence of myocarditis can be found in all patients with KD on histology specimens, only a minority of patients are clinically symptomatic. Occasionally children can present with KD shock syndrome and hemodynamic instability as a result of decreased systolic function and vasoplegia. Several children with KD have depressed shortening fraction on echocardiography...
November 3, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28994688/the-use-of-intravenous-hydroxocobalamin-as-a-rescue-in-methylene-blue-resistant-vasoplegic-syndrome-in-cardiac-surgery
#3
Yi Cai, Anwar Mack, Beth L Ladlie, Archer Kilbourne Martin
Vasoplegic syndrome is a well-recognized complication during cardiopulmonary bypass (CPB) and is associated with increased morbidity and mortality, especially when refractory to conventional vasoconstrictor therapy. This is the first reported case of vasoplegia on CPB unresponsive to methylene blue whereas responsive to hydroxocobalamin, which indicates that the effect of hydroxocobalamin outside of the nitric oxide system is significant or that the two drugs have a synergistic effect in one or multiple mechanisms...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28928568/role-of-methylene-blue-in-the-maintenance-of-postinduction-hemodynamic-status-in-patients-with-perforation-peritonitis-a-pilot-study
#4
Muthapillai Senthilnathan, Anusha Cherian, Hemavathi Balachander, Nanda Kishore Maroju
CONTEXT: Methylene blue is an inhibitor of guanylate cyclase and hence prevents vasoplegia mediated by nitric oxide in patients with sepsis. AIMS: This study aimed to analyze the effect of methylene blue on blood pressure maintenance following induction of anesthesia in patients presenting with peritonitis. SUBJECTS AND METHODS: Thirty patients diagnosed to have perforation peritonitis were randomized into two groups (Group MB, Group NS). Patients in Group MB were given injection methylene blue 2 mg/kg over 20 min and patients in Group NS were given 50 ml of normal saline over 20 min, before induction...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28864211/effects-of-spak-on-vascular-reactivity-and-nitric-oxide-production-in-endotoxemic-mice
#5
Chih-Chin Shih, Lin-Pin Hsu, Mei-Hui Liao, Sung-Sen Yang, Shung-Tai Ho, Chin-Chen Wu
Vasoplegia impedes therapeutic interventions to restore vascular tone, leading to severe hypotension, poor tissue perfusion, and multiple organ failure in septic shock. High levels of circulating nitric oxide (NO) play a crucial role in endotoxin-induced vascular hyporeactivity. Proinflammatory cytokines have been implicated in the induction of inducible NO synthase and overproduction of NO. Anti-inflammatory therapy can diminish NO formation and improve vascular hyporeactivity in septic shock. STE20/SPS1-realted proline/alanine-rich kinase (SPAK) has been reported to activate mitogen-activated protein kinase and contribute to intestinal inflammation...
November 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28777136/incidence-and-impact-of-on-cardiopulmonary-bypass-vasoplegia-during-heart-transplantation
#6
Lauren K Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C Colombo, Veli Tokpara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama
Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm despite a high pressor requirement (>1,500 μg neosynephrine bolused)...
August 2, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28612323/risk-assessment-and-outcomes-of-vasoplegia-after-cardiac-surgery
#7
Athanasios Tsiouris, Lynn Wilson, Ala S Haddadin, James J Yun, Abeel A Mangi
OBJECTIVE: The aim of this study was to analyze risk factors and outcomes of vasoplegia after cardiac surgery based on our experience with almost 2000 cardiac operations performed at our institution. METHODS: We retrospectively analyzed patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between 2011 and 2013. Data were available for a total of 1992 patients. We defined vasoplegia as hypotension with persistently low systemic vascular resistance (<800 dyn/s/cm) and preserved Cardiac Index (>2...
June 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28551045/methylene-blue-for-vasoplegic-syndrome-after-cardiac-operation-early-administration-improves-survival
#8
J Hunter Mehaffey, Lily E Johnston, Robert B Hawkins, Eric J Charles, Leora Yarboro, John A Kern, Gorav Ailawadi, Irving L Kron, Ravi K Ghanta
BACKGROUND: Vasoplegic syndrome, defined by hypotension despite normal or increased cardiac output, is associated with high mortality rate after cardiopulmonary bypass. Methylene blue (MB) is reported to ameliorate vasoplegic syndrome through the nitric oxide pathway. We hypothesized that early administration of MB would improve outcomes in patients with vasoplegic syndrome after cardiopulmonary bypass. METHODS: All patients that underwent cardiopulmonary bypass at our institution (Jan 1, 2011 to Jun 30, 2016) were identified through our Society of Thoracic Surgery database...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28469689/refractory-vasoplegic-syndrome-in-an-adult-patient-with-infective-endocarditis-a-case-report-and-literature-review
#9
Seyed Mohsen Mirhosseini, Ali Sanjari Moghaddam, Paritash Tahmaseb Pour, Ali Dabbagh
Postoperative vasoplegic syndrome (VS) is characterized by low systemic vascular resistance, normal or elevated cardiac output, and poor response to volume expansion. The incidence of VS after cardiac surgery requiring cardiopulmonary bypass is about 20%. Sometimes, VS becomes refractory and initial treatments do not work, rendering treatment a great challenge. In this study, we describe a young male patient with endocarditis undergoing tricuspid valve replacement. When being weaned off cardiopulmonary bypass, the patient experienced VS...
January 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/28459983/vasoplegia-after-heart-transplantation-outcomes-at-1-year
#10
Joshua L Chan, Jon A Kobashigawa, Tamar L Aintablian, Yanqing Li, Paul A Perry, Jignesh K Patel, Michelle M Kittleson, Lawrence S Czer, Parham Zarrini, Angela Velleca, Jenna Rush, Francisco A Arabia, Alfredo Trento, Fardad Esmailian
OBJECTIVES: Vasoplegia syndrome is a potentially life-threatening condition that can occur following cardiopulmonary bypass. Heart transplantation is a recognized risk factor for developing this vasodilatory state. The objective of this study was to determine the effects of vasoplegia syndrome on 1-year heart transplant outcomes. METHODS: A retrospective review of orthotopic heart transplants at a single institution between November 2010 and December 2014 was performed...
August 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28437389/normothermic-perfusion-in-the-assessment-and-preservation-of-declined-livers-before-transplantation-hyperoxia-and-vasoplegia-important-lessons-from-the-first-12-cases
#11
Christopher J E Watson, Vasilis Kosmoliaptsis, Lucy V Randle, Alexander E Gimson, Rebecca Brais, John R Klinck, Mazin Hamed, Anastasia Tsyben, Andrew J Butler
BACKGROUND: A program of normothermic ex situ liver perfusion (NESLiP) was developed to facilitate better assessment and use of marginal livers, while minimizing cold ischemia. METHODS: Declined marginal livers and those offered for research were evaluated. Normothermic ex situ liver perfusion was performed using an erythrocyte-based perfusate. Viability was assessed with reference to biochemical changes in the perfusate. RESULTS: Twelve livers (9 donation after circulatory death [DCD] and 3 from brain-dead donors), median Donor Risk Index 2...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28364440/incidence-and-predictors-of-vasoplegia-after-heart-failure-surgery
#12
Marieke E van Vessem, Meindert Palmen, Lotte E Couperus, Bart Mertens, Remco R Berendsen, Laurens F Tops, Harriëtte F Verwey, Evert de Jonge, Robert J M Klautz, Martin J Schalij, Saskia L M A Beeres
Objectives: Vasoplegia has been described as a complication after cardiac surgery, particularly in patients with a poor left ventricular ejection fraction. The aim of this study was to assess the incidence, survival and predictors of vasoplegia in patients undergoing heart failure surgery and to propose a risk model. Methods: A retrospective study including heart failure patients who underwent surgical left ventricular restoration, CorCap implantation or left ventricular assist device implantation between 2006 and 2015...
March 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#13
Hori Hariyanto, Corry Quando Yahya, Monika Widiastuti, Primartanto Wibowo, Oloan Eduard Tampubolon
BACKGROUND: Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner...
February 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28121911/normothermic-perfusion-in-the-assessment-and-preservation-of-declined-livers-prior-to-transplantation-hyperoxia-and-vasoplegia-important-lessons-from-the-first-12-cases
#14
Christopher J E Watson, Vasilis Kosmoliaptsis, Lucy V Randle, Alexander E Gimson, Rebecca Brais, John R Klinck, Mazin Hamed, Anastasia Tsyben, Andrew J Butler
BACKGROUND: A programme of normothermic ex situ liver perfusion (NESLiP) was developed to facilitate better assessment and use of marginal livers, while minimising cold ischaemia. METHODS: Declined marginal livers and those offered for research were evaluated. NESLiP was performed using an erythrocyte-based perfusate. Viability was assessed with reference to biochemical changes in the perfusate. RESULTS: 12 livers (9 from circulatory death (DCD) and 3 from brain-dead donors), median Donor Risk Index 2...
January 25, 2017: Transplantation
https://www.readbyqxmd.com/read/27984228/new-innovations-in-circulatory-support-with-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-therapy
#15
REVIEW
Robert N Sladen
The past decade has seen an exponential increase in the application and development of durable long-term as well as nondurable short-term mechanical circulatory support for cardiogenic shock and acute or chronic heart failure. Support has evolved from bridge-to-transplant to destination therapy, bridge to rescue, bridge to decision making, and bridge to a bridge. Notable trends include device miniaturization, minimally invasive and/or percutaneous insertion, and efforts to superimpose pulsatility on continuous flow...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27849860/218-evaluation-of-hydroxocobalamin-in-vasoplegia-in-cardiac-surgery
#16
Sarah Klemm, Craig Glienke
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27749291/hydroxocobalamin-for-vasoplegic-syndrome-in-liver-transplantation-restoration-of-blood-pressure-without-vasospasm
#17
Harvey J Woehlck, Brent T Boettcher, Kathryn K Lauer, David C Cronin, Johnny C Hong, Michael A Zimmerman, Joohyun Kim, Motaz Selim
Systemic vasoplegia is common in patients undergoing liver transplantation. In this report, we present a case in which treatment with conventional vasopressors caused peripheral arterial spasm, rendering arterial blood pressure monitoring impossible. Administration of methylene blue resolved the vasospasm; however, concern for toxic dose requirements limited its use. Hydroxocobalamin administration resolved the vasospasm and increased blood pressure without the potential adverse effects seen with methylene blue...
December 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27697359/mast-cell-activation-and-arterial-hypotension-during-proximal-aortic-repair-requiring-hypothermic-circulatory-arrest
#18
Miklos D Kertai, Sreekanth Cheruku, Wenjing Qi, Yi-Ju Li, G Chad Hughes, Joseph P Mathew, Jörn A Karhausen
OBJECTIVE: Aortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated their role in intraoperative hypotension. METHODS: We studied 31 patients undergoing proximal aortic repair with hypothermic circulatory arrest between June 2013 and April 2015 at Duke University Medical Center...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27582371/platelet-and-erythrocyte-sources-of-s1p-are-redundant-for-vascular-development-and-homeostasis-but-both-rendered-essential-after-plasma-s1p-depletion-in-anaphylactic-shock
#19
Salomé L Gazit, Boubacar Mariko, Patrice Thérond, Benoit Decouture, Yuquan Xiong, Ludovic Couty, Philippe Bonnin, Véronique Baudrie, Sylvain M Le Gall, Blandine Dizier, Nesrine Zoghdani, Jessica Ransinan, Justin R Hamilton, Pascale Gaussem, Pierre-Louis Tharaux, Jerold Chun, Shaun R Coughlin, Christilla Bachelot-Loza, Timothy Hla, Benoit Ho-Tin-Noé, Eric Camerer
RATIONALE: Sphingosine-1-phosphate (S1P) signaling is essential for vascular development and postnatal vascular homeostasis. The relative importance of S1P sources sustaining these processes remains unclear. OBJECTIVE: To address the level of redundancy in bioactive S1P provision to the developing and mature vasculature. METHODS AND RESULTS: S1P production was selectively impaired in mouse platelets, erythrocytes, endothelium, or smooth muscle cells by targeted deletion of genes encoding sphingosine kinases -1 and -2...
September 30, 2016: Circulation Research
https://www.readbyqxmd.com/read/27526256/vasoplegia-in-sepsis-depends-on-the-vascular-system-vasopressor-and-time-point-a-comparative-evaluation-in-vessels-from-rats-subjected-to-the-cecal-ligation-puncture-model
#20
Angélica K Bernardelli, Rita de C V de A F Da Silva, Thiago Corrêa, José Eduardo Da Silva-Santos
We evaluated the effects of phenylephrine, norepinephrine, angiotensin II, and vasopressin in mesenteric, renal, carotid, and tail arteries, and in perfused mesenteric vascular bed from rats subjected to the cecal ligation and puncture (CLP) model of sepsis. Phenylephrine and angiotensin II were less efficacious in mesenteric arteries from the CLP 6 h and CLP 18 h groups than in preparations from non-septic animals, but no differences were found for norepinephrine and vasopressin between the preparations. In renal arteries, none of the vasoconstrictors had impaired activity in the CLP groups...
June 24, 2016: Canadian Journal of Physiology and Pharmacology
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