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Cardiopulmonary interactions

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https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#1
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28100967/anesthetic-management-in-radiofrequency-catheter-ablation-of-ventricular-tachycardia
#2
REVIEW
Yi Deng, Payam S Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Radiofrequency catheter ablation is increasingly being used to treat patients who have ventricular tachycardia, and anesthesiologists frequently manage their perioperative care. This narrative review is intended to familiarize anesthesiologists with preprocedural, intraprocedural, and postprocedural implications of this ablation. Ventricular tachycardia typically arises from structural heart disease, most often from scar tissue after myocardial infarction. Many patients thus affected will benefit from radiofrequency catheter ablation in the electrophysiology laboratory to ablate the foci of arrhythmogenesis...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28065471/mutations-in-atp6v1e1-or-atp6v1a-cause-autosomal-recessive-cutis-laxa
#3
Tim Van Damme, Thatjana Gardeitchik, Miski Mohamed, Sergio Guerrero-Castillo, Peter Freisinger, Brecht Guillemyn, Ariana Kariminejad, Daisy Dalloyaux, Sanne van Kraaij, Dirk J Lefeber, Delfien Syx, Wouter Steyaert, Riet De Rycke, Alexander Hoischen, Erik-Jan Kamsteeg, Sunnie Y Wong, Monique van Scherpenzeel, Payman Jamali, Ulrich Brandt, Leo Nijtmans, G Christoph Korenke, Brian H Y Chung, Christopher C Y Mak, Ingrid Hausser, Uwe Kornak, Björn Fischer-Zirnsak, Tim M Strom, Thomas Meitinger, Yasemin Alanay, Gulen E Utine, Peter K C Leung, Siavash Ghaderi-Sohi, Paul Coucke, Sofie Symoens, Anne De Paepe, Christian Thiel, Tobias B Haack, Fransiska Malfait, Eva Morava, Bert Callewaert, Ron A Wevers
Defects of the V-type proton (H(+)) ATPase (V-ATPase) impair acidification and intracellular trafficking of membrane-enclosed compartments, including secretory granules, endosomes, and lysosomes. Whole-exome sequencing in five families affected by mild to severe cutis laxa, dysmorphic facial features, and cardiopulmonary involvement identified biallelic missense mutations in ATP6V1E1 and ATP6V1A, which encode the E1 and A subunits, respectively, of the V1 domain of the heteromultimeric V-ATPase complex. Structural modeling indicated that all substitutions affect critical residues and inter- or intrasubunit interactions...
December 29, 2016: American Journal of Human Genetics
https://www.readbyqxmd.com/read/28032572/postoperative-sepsis-prediction-in-patients-undergoing-major-cancer-surgery
#4
Akshay Sood, Firas Abdollah, Jesse D Sammon, Nivedita Arora, Matthew Weeks, James O Peabody, Mani Menon, Quoc-Dien Trinh
BACKGROUND: Cancer patients are at increased risk for postoperative sepsis. However, studies addressing the issue are lacking. We sought to identify preoperative and intraoperative predictors of 30-d sepsis after major cancer surgery (MCS) and derive a postoperative sepsis risk stratification tool. METHODS: Patients undergoing one of nine MCSs (gastrointestinal, urological, gynecologic, or pulmonary) were identified within the American College of Surgeons National Surgical Quality Improvement Program (2005-2011, n = 69,169)...
October 6, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28029591/cardiorespiratory-interactions-in-paediatrics-it-s-almost-always-the-circulation-stupid
#5
REVIEW
M L Rigby, M Rosenthal
The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations...
August 12, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#6
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27933732/hypothesis-driven-physical-examination-curriculum
#7
Sharon Allen, Andrew Olson, Jeremiah Menk, James Nixon
BACKGROUND: Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester...
December 9, 2016: Clinical Teacher
https://www.readbyqxmd.com/read/27928204/a-feasibility-study-related-to-inactive-cancer-survivors-compared-with-non-cancer-controls-during-aerobic-exercise-training
#8
Scott N Drum, Riggs J Klika, Susan D Carter, Lisa K Sprod, Lars Donath
Cancer survivors (CA) tend to demonstrate metabolic, cardiac, and ventilatory alterations due to previous chemotherapy and radiation that may impair adaptability following aerobic exercise training. Exercise training adaptations of CA finished with primary treatment compared to non-cancer participants (NC) have not yet been extensively elucidated. Thus, the present study compared physiologic responses of CA versus NC following a low-to-moderate intensity, 8-wk aerobic training program. Thirty-seven previously sedentary participants (CA: n = 14, 12 females; NC: n = 23, 19 females) with no heart or metabolic disease did not differ in age, height, weight, and body mass index (51 ± 2 y, 1...
December 2016: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/27894909/characteristics-of-bystander-cardiopulmonary-resuscitation-for-paediatric-out-of-hospital-cardiac-arrests-a-national-observational-study-from-2012-to-2014
#9
Ikwan Chang, Young Ho Kwak, Sang Do Shin, Young Sun Ro, Do Kyun Kim
OBJECTIVES: This study evaluated the associations between the provision of bystander cardiopulmonary resuscitation (BCPR) and both the relationship of bystanders with paediatric out-of-hospital cardiac arrest (OHCA) victims and the community educational level. METHODS: This observational study was conducted using the Korean national OHCA registry of paediatric OHCAs (<19years old) between 2012 and 2014. The main factor was the relationship between the bystander and the OHCA victim...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27890016/the-inflammatory-response-to-extracorporeal-membrane-oxygenation-ecmo-a-review-of-the-pathophysiology
#10
REVIEW
Jonathan E Millar, Jonathon P Fanning, Charles I McDonald, Daniel F McAuley, John F Fraser
Extracorporeal membrane oxygenation (ECMO) is a technology capable of providing short-term mechanical support to the heart, lungs or both. Over the last decade, the number of centres offering ECMO has grown rapidly. At the same time, the indications for its use have also been broadened. In part, this trend has been supported by advances in circuit design and in cannulation techniques. Despite the widespread adoption of extracorporeal life support techniques, the use of ECMO remains associated with significant morbidity and mortality...
November 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27865723/mechanisms-of-effort-intolerance-in-patients-with-rheumatic-mitral-stenosis-combined-echocardiography-and-cardiopulmonary-stress%C3%A2-protocol
#11
Michal Laufer-Perl, Yaniv Gura, Jason Shimiaie, Jack Sherez, Gregg S Pressman, Galit Aviram, Simon Maltais, Ricki Megidish, Amir Halkin, Meirav Ingbir, Simon Biner, Gad Keren, Yan Topilsky
OBJECTIVES: This study sought to evaluate mechanisms of effort intolerance in patients with rheumatic mitral stenosis (MS). BACKGROUND: Combined stress echocardiography and cardiopulmonary testing allows assessment of cardiac function, hemodynamics, and oxygen extraction (A-Vo2 difference). METHODS: Using semirecumbent bicycle exercise, 20 patients with rheumatic MS (valve area 1.36 ± 0.4 cm(2)) were compared to 20 control subjects at 4 pre-defined activity stages (rest, unloaded, anaerobic threshold, and peak)...
November 10, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27843778/acute-severe-thrombocytopenia-occurring-after-administration-of-eptifibatide-postpones-emergent-coronary-artery-surgery
#12
Brent T Boettcher, Timothy J Olund, Paul S Pagel
INTRODUCTION: Eptifibatide is a platelet glycoprotein IIb/IIIa (GP IIb/IIIa) receptor antagonist that inhibits fibrinogen binding to the activated GP IIb/IIIa site and prevents platelet-platelet interaction and clot formation. GP IIb/IIIa inhibitors improve outcome in patients undergoing percutaneous coronary intervention for acute coronary syndrome. Thrombocytopenia is a complication of GP IIb/IIIa inhibitors, but severe thrombocytopenia is unusual. Most reported cases of severe thrombocytopenia after eptifibatide occurred in patients with acute coronary syndrome...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27837303/prediction-of-fluid-responsiveness-using-pulse-pressure-variation-in-infants-undergoing-ventricular-septal-defect-repair-with-median-sternotomy-or-minimally-invasive-right-thoracotomy
#13
Ding Han, Ya-Guang Liu, Yi Luo, Jia Li, Chuan Ou-Yang
Fluid management is challenging in infants after cardiopulmonary bypass. Pulse pressure variation (PPV) derived from pressure recording analytical method (PRAM) is based on lung-heart interaction during mechanical ventilation. A prospective observational study conducted in operating room tested PPV to predict fluid responsiveness in ventricular septal defect infants. Infants in open chest conditions with median sternotomy (n = 26) or minimally invasive right thoracotomy (n = 29) undergoing ventricular septal defect repair were enrolled...
November 11, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27831907/randomised-crossover-trial-of-rate-feedback-and-force-during-chest-compressions-for-paediatric-cardiopulmonary-resuscitation
#14
Rachael Kathleen Gregson, Tim James Cole, Sophie Skellett, Emmanouil Bagkeris, Denise Welsby, Mark John Peters
OBJECTIVE: To determine the effect of visual feedback on rate of chest compressions, secondarily relating the forces used. DESIGN: Randomised crossover trial. SETTING: Tertiary teaching hospital. SUBJECTS: Fifty trained hospital staff. INTERVENTIONS: A thin sensor-mat placed over the manikin's chest measured rate and force. Rescuers applied compressions to the same paediatric manikin for two sessions...
October 24, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27787571/-anesthesia-for-medical-students-a-brief-guide-to-practical-anesthesia-in-adults-with-a-web-based-video-illustration
#15
S Mathis, O Schlafer, J Abram, J Kreutziger, P Paal, V Wenzel
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27763552/maporal-hantavirus-causes-mild-pathology-in-deer-mice-peromyscus-maniculatus
#16
Amanda McGuire, Kaitlyn Miedema, Joseph R Fauver, Amber Rico, Tawfik Aboellail, Sandra L Quackenbush, Ann Hawkinson, Tony Schountz
Rodent-borne hantaviruses can cause two human diseases with many pathological similarities: hantavirus cardiopulmonary syndrome (HCPS) in the western hemisphere and hemorrhagic fever with renal syndrome in the eastern hemisphere. Each virus is hosted by specific reservoir species without conspicuous disease. HCPS-causing hantaviruses require animal biosafety level-4 (ABSL-4) containment, which substantially limits experimental research of interactions between the viruses and their reservoir hosts. Maporal virus (MAPV) is a South American hantavirus not known to cause disease in humans, thus it can be manipulated under ABSL-3 conditions...
October 18, 2016: Viruses
https://www.readbyqxmd.com/read/27756648/sexual-dimorphism-of-cardiopulmonary-regulation-in-the-arcuate-nucleus-of-the-hypothalamus
#17
Evelyn H Schlenker
The arcuate nucleus of the hypothalamus (ANH) interacts with other hypothalamic nuclei, forebrain regions, and downstream brain sites to affect autonomic nervous system outflow, energy balance, temperature regulation, sleep, arousal, neuroendocrine function, reproduction, and cardiopulmonary regulation. Compared to studies of other ANH functions, how the ANH regulates cardiopulmonary function is less understood. Importantly, the ANH exhibits structural and functional sexually dimorphic characteristics and contains numerous neuroactive substances and receptors including leptin, neuropeptide Y, glutamate, acetylcholine, endorphins, orexin, kisspeptin, insulin, Agouti-related protein, cocaine and amphetamine-regulated transcript, dopamine, somatostatin, components of renin-angiotensin system and gamma amino butyric acid that modulate physiological functions...
October 15, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27747844/running-economy-measurement-norms-and-determining-factors
#18
Kyle R Barnes, Andrew E Kilding
Running economy (RE) is considered an important physiological measure for endurance athletes, especially distance runners. This review considers 1) how RE is defined and measured and 2) physiological and biomechanical factors that determine or influence RE. It is difficult to accurately ascertain what is good, average, and poor RE between athletes and studies due to variation in protocols, gas-analysis systems, and data averaging techniques. However, representative RE values for different caliber of male and female runners can be identified from existing literature with mostly clear delineations in oxygen uptake across a range of speeds in moderately and highly trained and elite runners...
December 2015: Sports Medicine—Open
https://www.readbyqxmd.com/read/27696332/a-novel-constitutive-model-for-passive-right-ventricular-myocardium-evidence-for-myofiber-collagen-fiber-mechanical-coupling
#19
Reza Avazmohammadi, Michael R Hill, Marc A Simon, Will Zhang, Michael S Sacks
The function of right ventricle (RV) is recognized to play a key role in the development of many cardiopulmonary disorders, such as pulmonary arterial hypertension (PAH). Given the strong link between tissue structure and mechanical behavior, there remains a need for a myocardial constitutive model that accurately accounts for right ventricular myocardium architecture. Moreover, most available myocardial constitutive models approach myocardium at the length scale of mean fiber orientation and do not explicitly account for different fibrous constituents and possible interactions among them...
October 1, 2016: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/27665488/effect-of-dispatcher-assisted-cardiopulmonary-resuscitation-program-and-location-of-out-of-hospital-cardiac-arrest-on-survival-and-neurologic-outcome
#20
Young Sun Ro, Sang Do Shin, Yu Jin Lee, Seung Chul Lee, Kyoung Jun Song, Hyun Wook Ryoo, Marcus Eng Hock Ong, Bryan McNally, Bentley Bobrow, Hideharu Tanaka, Helge Myklebust, Tonje Søraas Birkenes
STUDY OBJECTIVE: We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). METHODS: All emergency medical services (EMS)-treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR...
January 2017: Annals of Emergency Medicine
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