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Venous Saturation

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https://www.readbyqxmd.com/read/29035429/where-is-the-optimal-fontan-hemodynamics
#1
REVIEW
Hideo Ohuchi
Fontan circulation is generally characterized by high central venous pressure, low cardiac output, and slightly low arterial oxygen saturation, and it is quite different from normal biventricular physiology. Therefore, when a patient with congenital heart disease is selected as a candidate for this type of circulation, the ultimate goals of therapy consist of 2 components. One is a smooth adjustment to the new circulation, and the other is long-term circulatory stabilization after adjustment. When either of these goals is not achieved, the patient is categorized as having "failed" Fontan circulation, and the prognosis is dismal...
September 18, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#2
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/29025825/comparison-of-the-cerebroprotective-effect-of-inhalation-anaesthesia-and-total-intravenous-anaesthesia-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-systematic-review-and-meta-analysis
#3
Feng Chen, Guangyou Duan, Zhuoxi Wu, Zhiyi Zuo, Hong Li
OBJECTIVE: Neurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA. DESIGN: Searching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/29020710/fluorescent-imaging-evaluation-of-lidocaine-distribution-following-bier-block-in-the-upper-extremity
#4
Andrea L Gale, Shari R Liberman, Suzanne Berry, Dmitry Zavlin, Anthony Echo
INTRODUCTION: Bier block regional anesthesia has been used as an alternative to general anesthesia for years. Despite multiple theories and multiple techniques to delineate the location of the action of lidocaine during Bier block anesthesia, there has not been a consensus on the location of action. The purpose of this study was to use fluorescent imaging to further investigate the site of action of lidocaine during Bier block. MATERIALS AND METHODS: Three patients with carpal tunnel syndrome underwent open carpal tunnel release with Bier block anesthesia performed in the standard fashion with 1cc of Indocyanine green (IcG) mixed with lidocaine...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29019017/leptospirosis-associated-catastrophic-respiratory-failure-supported-by-extracorporeal-membrane-oxygenation
#5
Tamara Cantwell, Andrés Ferre, Nicolette Van Sint Jan, Rodrigo Blamey, Jorge Dreyse, Cristian Baeza, Rodrigo Diaz, Tomás Regueira
A previously healthy, 39-year-old obese farmer, arrived hypotensive and tachycardic, with fever, myalgia, headache, abdominal pain, diarrhea, and progressive dyspnea. Ten days before symptoms onset, he was in direct contact with mice and working in a contaminated drain. Patient laboratory showed acute kidney injury and thrombocytopenia. Chest X-ray exhibited bilateral diffuse interstitial infiltrates. First-line empirical antibiotics were started and influenza discarded. Patient evolved with severe respiratory failure, associated with hemoptysis, and rapidly severe hemodynamic compromise...
October 10, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28979045/left-ventricular-unloading-during-peripheral-extracorporeal-membrane-oxygenator-support-a-bridge-to-life-in-profound-cardiogenic-shock
#6
Paolo Centofanti, Matteo Attisani, Michele La Torre, Davide Ricci, Massimo Boffini, Andrea Baronetto, Erika Simonato, Alberto Clerici, Mauro Rinaldi
A limit of peripheral veno-arterial Extracorporeal Membrane Oxigenator (VA-ECMO) is the inadequate unloading of the left ventricle. The increase of end-diastolic pressure reduces the possibility of a recovery and may cause severe pulmonary edema. In this study, we evaluate our results after implantation of VA-ECMO and Transapical Left Ventricular Vent (TLVV) as a bridge to recovery, heart transplantation or long-term left ventricular assit devices (LVAD). From 2011 to 2014, 24 consecutive patients with profound cardiogenic shock were supported by peripheral VA-ECMO as bridge to decision...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28979040/the-effect-of-autologus-blood-priming-on-cerebral-oximetry-in-congenital-cardiac-surgery-patients
#7
Ashley Hodge, Apryl Cohen, Peter Winch, Dmitry Tumin, Jeffrey Burnside, Todd Ratliff, Mark Galantowicz, Aymen Naguib
Hemodilution is one of the sequelae of cardiopulmonary bypass (CPB). Autologous blood priming (retrograde autologous priming [RAP]/venous antegrade priming [VAP]) and acute normovolemic hemodilution (ANH) may be effective techniques to minimize hemodilution. The primary objective of this study is to investigate the impact of RAP/VAP combined with ANH on changes in cerebral saturations. A retrospective analysis of 52 patients undergoing congenital cardiac surgery requiring CPB between July 2014 and March 2015 was performed...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28977264/recent-advances-in-bedside-microcirculation-assessment-in-critically-ill-patients
#8
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/28975080/unexpected-collection-of-pulmonary-venous-blood-from-a-pulmonary-artery-catheter-a-case-report
#9
Naomi Ono, Junko Nakahira, Sayuri Matsunami, Toshiyuki Sawai, Toshiaki Minami
BACKGROUND: Pressure and waveform at the catheter tip are continuously monitored during catheterization of pulmonary artery to ensure accurate catheter placement. We present a case in which pulmonary venous blood was unexpectedly collected from the pulmonary artery catheter despite pulmonary artery pressure and waveform detection at the catheter tip, and describe the measures taken to correct the catheter placement. CASE PRESENTATION: A 74-year-old male underwent mitral valve plasty for cardiac failure caused by mitral valve regurgitation...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28973374/effects-of-intravitreal-dexamethasone-implants-on-retinal-oxygen-saturation-vessel-diameter-and-retrobulbar-blood-flow-velocity-in-me-secondary-to-rvo
#10
Katharina Eibenberger, Leopold Schmetterer, Sandra Rezar-Dreindl, Piotr Wozniak, Reinhard Told, Georgios Mylonas, Christoph Krall, Ursula Schmidt-Erfurth, Stefan Sacu
Purpose: To investigate the effects of intravitreal 0.7 mg dexamethasone implants (Ozurdex) on arterial and venous oxygen saturation, retinal vessel diameter, and retrobulbar blood flow velocity in patients with macular edema (ME) due to retinal vein occlusion (RVO). Methods: This prospective, nonrandomized clinical trial included 40 eyes of 40 patients with ME due to RVO. Measurements of arterial and venous oxygen saturation and retinal vessel diameters were performed using the Dynamic Vessel Analyzer...
October 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28973227/effect-of-an-early-resuscitation-protocol-on-in-hospital-mortality-among-adults-with-sepsis-and-hypotension-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Ben Andrews, Matthew W Semler, Levy Muchemwa, Paul Kelly, Shabir Lakhi, Douglas C Heimburger, Chileshe Mabula, Mwango Bwalya, Gordon R Bernard
Importance: The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown. Objective: To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. Design, Setting, and Participants: Randomized clinical trial of 212 adults with sepsis (suspected infection plus ≥2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure ≤90 mm Hg or mean arterial pressure ≤65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between October 22, 2012, and November 11, 2013...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28943117/lack-of-methemoglobin-elevations-after-topical-applications-of-benzocaine-alone-or-benzocaine-plus-tetracaine-to-the-oral-mucosa
#12
Steven Wang, Helen Giannakopoulos, Jamie Lowstetter, Laura Kaye, Catherine Lee, Stacey Secreto, Vanessa Ho, Matthew C Hutcheson, John T Farrar, Ping Wang, Geraldine Doyle, Stephen A Cooper, Elliot V Hersh
PURPOSE: This study evaluated changes in methemoglobin and oxygen saturation concentrations after the administration of recommended doses of 14% benzocaine alone or 14% benzocaine combined with 2% tetracaine. METHODS: American Society of Anesthesiology class 1 and 2 subjects (n = 40) were enrolled in this modified crossover study. Subjects were administered 0.2 mL of 14% benzocaine alone, 0.2 mL of 14% benzocaine plus 2% tetracaine, or 0.4 mL of 14% benzocaine plus 0...
September 21, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#13
Diego Orbegozo, Fuhong Su, Keliang Xie, Lokmane Rahmania, Fabio Silvio Taccone, Daniel De Backer, Jean-Louis Vincent, Jacques Creteur
BACKGROUND: Non-invasive evaluation of muscle perfusion using near infrared spectroscopy (NIRS) coupled with a vascular occlusion test (VOT) may provide an early and simple marker of altered perfusion and microcirculatory function in sepsis. OBJECTIVE: To compare the time-course of NIRS-derived variables with systemic measures of perfusion in an experimental model of peritonitis. METHODS: Peritonitis was induced in eight anesthetized, mechanically ventilated, adult sheep (24-34 Kg), by injecting autologous feces into the peritoneal cavity...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28927232/association-between-intradialytic-central-venous-oxygen-saturation-and-ultrafiltration-volume-in-chronic-hemodialysis-patients
#14
Hanjie Zhang, Lili Chan, Anna Meyring-Wösten, Israel Campos, Priscila Preciado, Jeroen P Kooman, Frank M van der Sande, Doris Fuertinger, Stephan Thijssen, Peter Kotanko
Background: Cardiac disease is highly prevalent in hemodialysis (HD) patients. Decreased tissue perfusion, including cardiac, due to high ultrafiltration volumes (UFVs) is considered to be one of the drivers of cardiac dysfunction. While central venous oxygen saturation (ScvO 2 ) is frequently used as an indicator of cardiac output in non-uremic populations, the relationship of ScvO 2 and UFV in HD patients remains unclear. Our aim was to determine how intradialytic ScvO 2 changes associate with UFV...
September 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28919828/jugular-bulb-oxygen-saturation-correlates-with-full-outline-of-responsiveness-score-in-severe-traumatic-brain-injury-patients
#15
Tjokorda Gde Agung Senapathi, Made Wiryana, Ketut Sinardja, Ketut Wibawa Nada, Ida Bagus Krisna Jaya Sutawan, Christopher Ryalino, Aloysius Alphonso
BACKGROUND: Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative for Glasgow Coma Scale (GCS) in evaluating neurologic status of patients with severe traumatic head injury, especially for those under mechanical ventilation...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28901415/effect-of-continuous-positive-airway-pressure-therapy-on-inflammatory-cytokines-and-atherosclerosis-in-patients-with-obstructive-sleep-apnea-syndrome
#16
Fa Jin, Jiannan Liu, Xiuwei Zhang, Wei Cai, Yuqiong Zhang, Wei Zhang, Jian Yang, Gan Lu, Xilong Zhang
Obstructive sleep apnea syndrome (OSAS) is known to be a risk factor for atherosclerosis (AS), derived from a series of chronic inflammatory reactions caused by hypoxia. However, the association between chronic inflammation and high blood pressure caused by hypoxia remains to be fully elucidated. The aim of the present study was to investigate the effect of continuous positive airway pressure (CPAP) therapy on inflammatory cytokines and AS. A total of 100 patients with OSAS and 50 healthy control subjects were enrolled...
August 30, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28890467/prediction-of-arterial-blood-gas-values-from-venous-blood-gas-values-in-asiatic-black-bears-ursus-thibetanus-anesthetized-with-intramuscular-medetomidine-and-zolazepam-tiletamine
#17
Dong-Hyuk Jeong, Jeong-Jin Yang, Lyon Lee, Seong-Chan Yeon
The objective of this study was to measure differences between arterial and venous blood gas parameters and to evaluate whether arterial blood gas values can be estimated from venous blood in Asiatic black bears (ABBs). Twelve healthy captive ABBs (8 males and 4 females; 8-16 years; 76.8-220 kg) were included in this study. The bears were immobilized with medetomidine and zolazepam-tiletamine using a dart gun. Arterial and venous samples were collected simultaneously at 5 and 35 min after recumbency (5- and 35-min points)...
September 10, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#18
RANDOMIZED CONTROLLED TRIAL
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887041/partial-anomalous-pulmonary-venous-connection-in-a-dog
#19
Chloe L Thorn, Naomi R Ford, Meg M Sleeper
A 2-year-old male intact Belgian Malinois was presented for exercise intolerance. A grade III/VI left basilar systolic murmur was detected. Echocardiography revealed moderate right atrial and ventricular dilation and increased pulmonic outflow velocity. Thoracic radiographs showed right heart enlargement and a dilated caudal vena cava. In addition, on the left lateral projection, an enlarged aberrant right cranial pulmonary lobar vein was suspected to be diverging ventrally from the course of the right cranial lobar bronchus and inserting more ventrally than normal in the region of the right atrium...
September 5, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28885662/differential-diagnosis-of-alterations-in-arterial-flow-and-tissue-oxygenation-on-venoarterial-extracorporeal-membrane-oxygenation
#20
Anna Hofer, Sylvia Leitner, Michaela Kreuzer, Jens Meier
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be life-saving in several clinical situations, but it is also one of the most invasive therapeutic procedures, with significant potential for life-threatening complications. Pulse pressure waves are typically very small or even absent at the onset of ECMO therapy, and will reappear with the improvement of cardiac function. A low pulse pressure may indicate low cardiac output due to heart failure during sustained ECMO support...
September 5, 2017: International Journal of Artificial Organs
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