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https://www.readbyqxmd.com/read/27926661/the-effect-of-intraoperative-and-6-h-postoperative-intravenous-administration-of-low-dose-prostacyclin-on-the-endothelium-hemostasis-and-hemodynamics-in-patients-undergoing-a-pancreaticoduodenoctemy-a-randomized-controlled-pilot-study
#1
Pär I Johansson, Christian R Mortensen, Tatiana Nielsen, Carsten Tollund, Jakob Stensballe, Carsten P Hansen, Hans J Frederiksen, Sisse R Ostrowski
BACKGROUND: Capillary leakage, secondary to endothelial breakdown, is common in patients undergoing major surgical procedures with extensive tissue injury and this is associated with increased morbidity and mortality. Prostacyclin has been ascribed cytoprotective properties together with its vasodilatory and antiplatelet effects. The present pilot study investigated the safety and endothelial protective effects of low-dose prostacyclin infusion. PATIENTS AND METHODS: A randomized placebo-controlled pilot study evaluating the effect of prostacyclin (iloprost) infusion (1...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27925612/transthoracic-echocardiography-to-assess-aortic-regurgitation-after-tavr-a-comparison-with-periprocedural-transesophageal-echocardiography
#2
Alexandra Goncalves, Charles Nyman, David R Okada, Avinainder Singh, Jeffrey Swanson, Michael Cheezum, Michael Steigner, Marcelo Di Carli, Scott Solomon, Pinak B Shah, Deepak L Bhatt, Douglas Shook, Ron Blankstein
BACKGROUND: We aimed to compare periprocedural transesophageal echocardiography (TEE) with postprocedural transthoracic echocardiography (TTE) for the diagnosis of aortic regurgitation (AR). METHODS AND RESULTS: TEE and TTE images of 163 transcatheter aortic valve replacement (TAVR) patients (mean age 81 ± 8 years; 56% men) were reviewed separately and blinded to each other as well as to all clinical data. The median time between TEE during TAVR (TEE/TAVR) and TTE was 4 days (IQR 2-10 days)...
December 8, 2016: Cardiology
https://www.readbyqxmd.com/read/27925469/complications-of-pulmonary-hypertension-a-pictorial-review
#3
Sze Mun Mak, Nicola Strickland, Deepa Gopalan
Pulmonary hypertension (PH) is a rare disease with significant morbidity and mortality if untreated. The disease has multifactorial etiology and is often associated with insidious onset of signs and symptoms. Multimodality imaging is often required for establishing the diagnosis, evaluating the underlying hemodynamic compromise and follow up after institution of therapy. The range of potential complications associated with PH vary widely. We aim to summarise the imaging findings of complications that the radiologist should be familiar with...
December 7, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27925464/risk-factors-for-severity-and-recurrence-of-colonic-diverticular-bleeding
#4
Natércia Joaquim, Paulo Caldeira, Artur G Antunes, Marta Eusébio, Horácio Guerreiro
BACKGROUND: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined. OBJECTIVE: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding. METHODS: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution...
December 7, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27925417/effects-of-temperature-on-multiparametric-evaluation-of-hindlimb-ischemia-with-dynamic-fluorescence-imaging
#5
Wenjuan Cai, Huizhi Guang, Chuangjian Cai, Jianwen Luo
Quantitative evaluation of hindlimb ischemia is essential for early diagnosis and therapy of peripheral arterial disease (PAD). Dynamic imaging using near-infrared (NIR) fluorophore indocyanine green (ICG) is a noninvasive and effective tool to monitor multiple vascular parameters including perfusion rate (PR), perfusion vascular density (PVD) and hemodynamics. It has been previously demonstrated that temperature changes could lead to significant variations of blood flow rate and vascular perfusion. In this paper, multiparametric evaluation of hindlimb ischemia was performed at different temperatures...
December 7, 2016: Journal of Biophotonics
https://www.readbyqxmd.com/read/27925332/left-atrial-appendage-closure-with-the-new-occlutech%C3%A2-device-first-in-man-experience-and-neurological-outcome
#6
Barbara Bellmann, Steffen Schnupp, Peter Kühnlein, Christian Javernik, Caroline Kleinecke, Andreas Rillig, Ulf Landmesser, Johannes Brachmann, Jai-Wun Park
AIMS: Percutaneous left atrial appendage closure (LAAC) is a valuable treatment option for stroke prevention in patients with atrial fibrillation and a HAS-BLED-Score ≥ 3. Determinants of procedural safety events and neurological outcome of the patients with the Occlutech Device (OD) are not established yet. METHODS AND RESULTS: Between 2012 and 2016, 30 patients underwent LAAC using the OD. This is a prospective, study. Neurological examination and transesophageal echocardiography was performed directly before and after the procedure and after 1, 3 and 12 months...
December 7, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27925328/screening-for-preeclampsia-in-the-first-trimester-the-usefulness-of-maternal-hemodynamics-and-bioimpedence-in-non-obese-patients
#7
Giulia Gagliardi, Grazia Maria Tiralongo, Damiano Lo Presti, Ilaria Pisani, Daniele Farsetti, Barbara Vasapollo, Gian Paolo Novelli, Angela Andreoli, Herbert Valensise
OBJECTIVE: To test if maternal hemodynamics, and bioimpedance, together with the Combined Screening (maternal history, biophysical and biochemical markers), are able to identify normotensive non-obese patients at risk for preeclampsia (PE) and/or intrauterine growth restriction (IUGR) in the first trimester of gestation. METHODS: 150 healthy nulliparous non-obese women (BMI<30Kg/m(2) ) were enrolled in the study in the first trimester of pregnancy and submitted to USCOM to detect hemodynamic parameters, bioimpedence to characterize body composition, and combined screening for preeclampsia (maternal history, biophysical and maternal biochemical markers)...
December 7, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27925247/does-flexible-arterial-tubing-retain-more-hemodynamic-energy-during-pediatric-pulsatile-extracorporeal-life-support
#8
Shigang Wang, Allen R Kunselman, Akif Ündar
The objective of this study was to evaluate the hemodynamic performance and energy transmission of flexible arterial tubing as the arterial line in a simulated pediatric pulsatile extracorporeal life support (ECLS) system. The ECLS circuit consisted of a Medos Deltastream DP3 diagonal pump head, Medos Hilite 2400 LT oxygenator, Biomedicus arterial/venous cannula (10 Fr/14 Fr), 3 feet of polyvinyl chloride (PVC) arterial tubing or latex rubber arterial tubing, primed with lactated Ringer's solution and packed red blood cells (hematocrit 40%)...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27925228/a-mock-circulatory-system-incorporating-a-compliant-3d-printed-anatomical-model-to-investigate-pulmonary-hemodynamics
#9
Paul G M Knoops, Giovanni Biglino, Alun D Hughes, Kim H Parker, Linzhang Xu, Silvia Schievano, Ryo Torii
A realistic mock circulatory system (MCS) could be a valuable in vitro testbed to study human circulatory hemodynamics. The objective of this study was to design a MCS replicating the pulmonary arterial circulation, incorporating an anatomically representative arterial model suitable for testing clinically relevant scenarios. A second objective of the study was to ensure the system's compatibility with magnetic resonance imaging (MRI) for additional measurements. A latex pulmonary arterial model with two generations of bifurcations was manufactured starting from a 3D-printed mold reconstructed from patient data...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27924673/postnatal-outcome-and-placental-blood-flow-after-plasmapheresis-during-pregnancy
#10
Mária Jakó, Andrea Surányi, Márta Janáky, Péter Klivényi, László Kaizer, László Vécsei, György Bártfai, Gábor Németh
PURPOSE: Plasmapheresis in pregnancy adversely affects maternal hemodynamics, however there are studies suggesting it to reduce pregnancy loss in immunological diseases when medication is more harmful to the fetus. The overall optimal plasmapheresis treatment protocol remains unknown. MATERIALS AND METHODS: A pregnant with neuromyelitis optica was followed up after receiving six volumes of fresh frozen plasma via plasmapheresis. RESULTS: The placenta compensated the hemodynamic change until the 33rd week of gestation, resulting a small for gestational age, otherwise healthy girl...
December 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27924461/life-satisfaction-and-hemodynamic-reactivity-to-mental-stress
#11
Andreas Schwerdtfeger, Kerstin Gaisbachgrabner, Claudia Traunmüller
BACKGROUND: Satisfaction with life has been considered a health-protective variable, which could impact cardiovascular morbidity and mortality. However, few studies have examined the physiological pathways involved in the potentially salutary effect of life satisfaction. It was hypothesized that life satisfaction should be associated with a cardiovascular response profile that signals challenge (i.e., higher cardiac output, lower peripheral resistance), rather than threat during a mental stress task...
December 6, 2016: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/27924207/combined-spinal-epidural-anesthesia-for-urgent-cesarean-section-in-a-parturient-with-a-single-ventricle-a-case-report
#12
Stefano Catarci, Fabio Sbaraglia, Bruno Antonio Zanfini, Salvatore Vagnoni, Luciano Frassanito, Gaetano Draisci
The number of women with major congenital heart defects reaching reproductive age is likely increasing. We herein describe the anesthetic management of a 33-year-old woman at 37 gestational weeks with a history of Glenn surgery who was undergoing an urgent cesarean section due to pathological cardiotocography. Combined spinal-epidural anesthesia was the most suitable technique for urgent cesarean section in our patient with a single ventricle and phasic flow in the pulmonary artery because it provided rapid-onset anesthesia with negligible hemodynamic effects...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27924198/comparison-of-effect-of-electroacupuncture-and-nefopam-for-prevention-of-postanesthetic-shivering-in-patients-undergoing-urologic-operation-under-spinal-anesthesia
#13
Jun-Ho Hong, Su-Jin Kim, Min-Sub Hwang
BACKGROUND: Shivering during spinal anesthesia is a frequent complication and is induced by the core-to-peripheral redistribution of heat. Nefopam has minimal side effects and prevents shivering by reducing the shivering threshold. Electroacupuncture is known to prevent shivering by preserving the core body temperature. We compared the efficacies of electroacupuncture and nefopam for the prevention of shivering during spinal anesthesia. METHODS: Ninety patients scheduled for elective urological surgery under spinal anesthesia were enrolled in the study...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27924197/dexmedetomidine-infusion-as-an-anesthetic-adjuvant-to-general-anesthesia-for-appropriate-surgical-field-visibility-during-modified-radical-mastectomy-with-i-gel%C3%A2-a-randomized-control-study
#14
Kumkum Gupta, Bhawana Rastogi, Prashant K Gupta, Ivesh Singh, Vijendra Pal Singh, Manish Jain
BACKGROUND: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. METHODS: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27923943/venovenous-ecmo-support-in-an-infant-with-single-ventricle-physiology-and-catastrophic-pulmonary-venous-abnormalities
#15
Richard P Fernandez, Don Hayes, Patrick I McConnell, Darren Berman
Extracorporeal membrane oxygenation (ECMO) is an accepted treatment modality for life support refractory to conventional efforts in neonates with complex congenital heart lesions. Cannulation for ECMO can be accomplished by venovenous (VV) access where patients receive primarily respiratory support or venoarterial (VA) access which provides complete cardiopulmonary support. VV ECMO delivered by a single-vessel cannulation with a dual-chamber venous cannula allows for respiratory support while the patient remains dependent upon intrinsic cardiac function to support hemodynamics...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27923789/influence-of-sympathetic-nerve-activity-on-aortic-hemodynamics-and-pulse-wave-velocity-in-women
#16
Ronee E Harvey, Jill N Barnes, Emma C J Hart, Wayne T Nicholson, Michael J Joyner, Darren P Casey
Central (aortic) blood pressure, arterial stiffness, and sympathetic nerve activity increase with age in women. However, it is unknown if the age-related increase in sympathetic activity influences aortic hemodynamics and carotid-femoral pulse wave velocity (cfPWV), an index of central aortic stiffness. The goal of this study was to determine if aortic hemodynamics and cfPWV are directly influenced by sympathetic nerve activity by measuring aortic hemodynamics, cfPWV, and muscle sympathetic nerve activity (MSNA) in women before and during autonomic ganglionic blockade with trimethaphan camsylate...
December 6, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27923692/a-hemodynamic-directed-approach-to-pediatric-cardiopulmonary-resuscitation-hd-cpr-improves-survival
#17
Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27923236/the-effect-of-head-positioning-and-head-tilting-on-the-incidence-of-intraventricular-hemorrhage-in-very-preterm-infants-a-systematic-review
#18
Karen A de Bijl-Marcus, Annemieke J Brouwer, Linda S de Vries, Gerda van Wezel-Meijler
BACKGROUND: Despite advances in neonatal intensive care, germinal matrix-intraventricular hemorrhage (GMH-IVH) remains a frequent, serious complication of premature birth. Neutral head position and head tilting have been suggested to reduce the risk of GMH-IVH in preterm infants during the first 72 h of life. OBJECTIVE: The aim of this study was to provide a systematic review of the effect of neutral head positioning and head tilting on the incidence of GMH-IVH in very preterm infants (gestational age ≤30 weeks)...
December 7, 2016: Neonatology
https://www.readbyqxmd.com/read/27922889/pump-speed-optimization-in-stable-patients-with-a-left-ventricular-assist-device
#19
Lotte E Couperus, Victoria Delgado, Mand J H Khidir, Marijke P M Vester, Meindert Palmen, Marta Fiocco, Eduard R Holman, Laurens F Tops, Robert J M Klautz, Harriëtte F Verwey, Martin J Schalij, Saskia L M A Beeres
Optimal left ventricular assist device (LVAD) functioning and preservation of right ventricular (RV) function are major survival determinants in destination therapy (DT)-LVAD recipients. Currently, the indication for routine pump speed optimization in stable patients and its effect on RV function at follow-up remain underexplored. Hemodynamically stable patients (N=17, age 61 [interquartile range {IQR} 51-66]years; 13 [77%] male) underwent a routine speed ramp test. Echocardiographic images were obtained at incremental speed settings to determine optimal pump speed...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27922885/ventricular-assist-device-implantation-configurations-impact-overall-mechanical-circulatory-support-system-thrombogenic-potential
#20
Wei-Che Chiu, Yared Alemu, Allison J McLarty, Shmuel Einav, Marvin J Slepian, Danny Bluestein
Ventricular assist devices (VAD) became in recent years the standard of care therapy for advanced heart failure with hemodynamic compromise. With the steadily growing population of device recipients, various post-implant complications have been reported, mostly associated with the hyper-shear generated by VADs that enhance their thrombogenicity by activating platelets. While VAD design optimization can significantly improve its thromboresistance, the implanted VAD need to be evaluated as part of a system. Several clinical studies indicated that variability in implantation configurations may contribute to the overall system thrombogenicity...
December 2, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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