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https://www.readbyqxmd.com/read/29351897/transitions-between-circulatory-states-after-out-of-hospital-cardiac-arrest-protocol-for-an-observational-prospective-cohort-study
#1
Halvor Langeland, Daniel Bergum, Magnus Løberg, Knut Bjørnstad, Jan Kristian Damås, Tom Eirik Mollnes, Nils-Kristian Skjærvold, Pål Klepstad
BACKGROUND: The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure. OBJECTIVE: This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS...
January 19, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29351431/feasibility-of-phase-contrast-cine-magnetic-resonance-imaging-for-measuring-blood-flow-in-the-sheep-fetus
#2
An Qi Duan, Jack R T Darby, Jia Yin Soo, Mitchell C Lock, Meng Yuan Zhu, Lucy V Flynn, Sunthara Rajan Perumal, Christopher K Macgowan, Joseph B Selvanayagam, Janna L Morrison, Mike Seed
Phase-contrast cine MRI (PC-MRI) is the gold-standard non-invasive technique for measuring vessel blood flow and has previously been applied in the human fetal circulation. We aimed to assess the feasibility of using PC-MRI to define the distribution of the fetal circulation in sheep. Fetuses were catheterized at 119-120 days gestation (term, 150 days) and underwent MRI at 123 days gestation under isoflurane anesthesia, ventilated at a FiO2 of 1.0. PC-MRI was performed using a fetal arterial blood pressure catheter signal for cardiac triggering...
December 13, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29345417/catheter-based-edge-to-edge-mitral-valve-repair-for-pulmonary-pressure-reduction-and-to-postpone-heart-transplantation-in-a-teenaged-patient
#3
Moritz Messner, Florian Hintringer, Silvana Müller, Marc Michael Zaruba, Nikolaos Bonaros, Herwig Antretter, Daniel Basic, Gerhard Pölzl
We report a case of catheter-based edge-to-edge mitral valve repair in a teenage male patient with non-ischaemic cardiomyopathy to improve pulmonary hypertension secondary to severe functional mitral regurgitation (FMR) to defer anticipated heart transplantation. A 19-year-old patient with previous history of fulminant myocarditis followed by markedly left ventricular dysfunction presented with severe mitral regurgitation 3 years after initial recovery. Slightly over time, deterioration of FMR was associated with gradual increase in pulmonary artery pressures despite optimal medical therapy...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#4
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29324489/comparing-methods-for-cardiac-output-intraoperatively-doppler-derived-cardiac-output-measured-with-3-dimensional-echocardiography-is-not-interchangeable-with-cardiac-output-by-pulmonary-catheter-thermodilution
#5
Karin Graeser, Mikhail Zemtsovski, Klaus F Kofoed, Matilde Winther-Jensen, Jens C Nilsson, Jesper Kjaergaard, Hasse Møller-Sørensen
BACKGROUND: Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29316567/modern-invasive-hemodynamic-assessment-of-pulmonary-hypertension
#6
Alberto Pagnamenta, Frédéric Lador, Andrea Azzola, Maurice Beghetti
Since 1998 pulmonary hypertension has been clinically classified into five well-defined, distinct categories. A definitive diagnosis of pulmonary hypertension requires the invasive confirmation of an elevated mean pulmonary artery pressure of 25 mm Hg or above during a right heart catheterization. From a hemodynamic point of view, pulmonary hypertension is classified into precapillary and postcapillary pulmonary hypertension on the basis of a pulmonary artery wedge pressure threshold value of 15 mm Hg. Pulmonary vascular resistance is better characterized by multi-point pressure/flow measurements than by single-point determination...
January 9, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29310563/evaluation-of-factors-associated-with-achievement-of-biventricular-repair-after-bilateral-pulmonary-artery-banding-in-patients-with-interrupted-aortic-arch
#7
Yasuhiro Hirano, Noboru Inamura, Yukiko Kawazu, Hisaaki Aoki, Futoshi Kayatani, Shigemitsu Iwai, Hiroaki Kawata
BACKGROUND: At our institution, we perform bilateral pulmonary artery banding (BPAB) as the first-stage palliation for interrupted aortic arch (IAA) with low birth weight or severe subaortic stenosis (SAS). The present study aimed to identify factors that may influence the decision regarding the type of second-stage operation, that is, univentricular palliation or biventricular repair, in these patients. METHODS: Cardiac catheterization and angiographic data of nine patients with IAA who underwent initial BPAB and subsequent univentricular or biventricular repair were retrospectively analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29310560/staged-palliation-of-cyanotic-obstructive-lesions-with-a-modified-right-ventricular-outflow-procedure
#8
Sarosh P Batlivala, Mary K Hood, Jannika Dodge-Khatami, Divya Shakti, Mary B Taylor, Makram R Ebeid, Jorge D Salazar, Ali Dodge-Khatami
BACKGROUND: Traditional palliation for biventricular cyanotic congenital heart lesions often involves staging with systemic-to-pulmonary arterial shunts to secure pulmonary blood flow (PBF) in the newborn period prior to complete repair. However, shunts may lead to life-threatening events secondary to shunt occlusion or acute coronary steal. They may be associated with morbidity secondary to diastolic runoff, systemic steal and volume loading, and do not provide pulsatile flow which has the potential to promote pulmonary artery (PA) growth...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29290381/a-comparison-of-the-strain-and-tissue-doppler-based-indices-as-echocardiographic-correlates-of-the-left-ventricular-filling-pressures
#9
Rohan Magoon, Vishwas Malik, Arindam Choudhury, Sandeep Chauhan, Milind P Hote, Sivasubramanian Ramakrishnan, Vishwajeet Singh
OBJECTIVES: Diastolic strain and strain rate, combined with E (peak transmitral velocity), have been proposed as novel noninvasive predictors of left ventricle (LV) filling pressures, avoiding angulation errors inherent to tissue Doppler indices (TDI). The primary objective was to study the correlation of strain-based indices (SBI) and TDI with pulmonary artery catheter-derived LV end-diastolic pressures (LVEDP). The secondary aim was to determine appropriate cut-off of indices to predict LVEDP ≥15 mmHg...
November 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#10
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29249170/occult-catheter-rupture-causing-episodic-symptoms-in-a-patient-treated-with-epoprostenol
#11
Barbara L LeVarge, Anica C Law, Blanche Murphy
Infection, thrombosis, and catheter dislodgment are well-recognized potential complications of chronic intravenous prostanoid therapy for pulmonary arterial hypertension. As long-term outcomes of pulmonary hypertension patients improve, novel adverse events are likely to arise. We describe the sudden development of unexplained hypotension and lightheadedness in a patient receiving intravenous epoprostenol for several years, ultimately determined to be due to an unusual catheter complication, not previously described in this population...
January 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/29248101/design-and-rationale-of-a-randomized-trial-comparing-standard-versus-ultrasound-assisted-thrombolysis-for-submassive-pulmonary-embolism
#12
Efthymios D Avgerinos, Abhisekh Mohapatra, Belinda Rivera-Lebron, Catalin Toma, Christopher Kabrhel, Larry Fish, Joan Lacomis, Iclal Ocak, Rabih A Chaer
BACKGROUND: Catheter-directed interventions for the treatment of patients with submassive pulmonary embolism (sPE) have shown promise in rapidly improving right-sided heart strain and preventing decompensation to massive pulmonary embolism. Among various catheter interventions, ultrasound-assisted thrombolysis (USAT) has attracted interest as potentially having more efficient lytic effect that could achieve thrombolysis faster and with a reduced lytic dose. However, based on clinical evidence, it is unclear whether USAT is superior to standard catheter-directed thrombolysis (SCDT)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29239263/percutaneous-mechanical-thrombectomy-combined-with-catheter-directed-thrombolysis-in-the-treatment-of-acute-pulmonary-embolism-and-lower-extremity-deep-venous-thrombosis-a-novel-one-stop-endovascular-strategy
#13
Bing Liu, MingYuan Liu, LiHong Yan, JunWei Yan, Jiang Wu, XueFei Jiao, MingJin Guo
Objective This study was performed to evaluate the efficacy and feasibility of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in patients with acute pulmonary embolism (APE) and lower extremity deep venous thrombosis (LEDVT). Methods In total, 20 consecutive patients with APE and LEDVT were prospectively selected for PMT combined with CDT. Mechanical thrombus fragmentation and aspiration using a pigtail rotation catheter followed by CDT was performed in each patient...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29239149/agreement-between-ccnexfin-co-trek-cardiac-output-and-intermittent-cold-bolus-pulmonary-thermodilution-in-a-prospective-multi-centre-study
#14
Nicolaas H Sperna Weiland, Jim W de Wever, Yoni van Duivenvoorde, Christa Boer, Ludmil Mitrev, Muhammad Muntazar, Kinjal Patel, Markus W Hollmann, Benedikt Preckel
BACKGROUND: The ccNexfin system uses the CO-trek algorithm to analyse a non-invasively obtained arterial pressure waveform and calculate cardiac output (NEXCO). It remains matter of debate whether NEXCO can replace invasive, pulmonary artery catheter derived, cold-bolus pulmonary thermodilution cardiac output measurement (PACCO). This study aimed at testing NEXCO-PACCO agreement in a large sample size, multi-centre study. We hypothesized that agreement between NEXCO and PACCO would be demonstrated by a mean accuracy (bias) < 0...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29206697/perioperative-pulmonary-thromboembolism-current-concepts-and-treatment-options
#15
David M Ruohoniemi, Akhilesh K Sista, Charles F Doany, Paul M Heerdt
PURPOSE OF REVIEW: Anesthesiologists are familiar with pulmonary emboli prophylaxis paradigms and many have witnessed acute intraoperative embolization. Clinicians must balance conservative anticoagulation and aggressive intervention in perioperative submassive pulmonary emboli, yet the bulk of the literature excludes surgery as a relative contraindication. This review will summarize the current treatment options for acute pulmonary emboli, drawing attention to special considerations in perioperative submassive pulmonary emboli, and discuss right ventricular monitoring to improve assessment of intervention efficacy...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29203299/evaluation-of-cardiac-index-and-extravascular-lung-water-after-single-lung-transplantation-using-the-transpulmonary-thermodilution-technique-by-the-picco2-device
#16
Alexy Tran-Dinh, Pascal Augustin, Guillaume Dufour, Sigismond Lasocki, Nicolas Allou, Gabriel Thabut, Yves Castier, Philippe Montravers, Mathieu Desmard
OBJECTIVES: First evaluation of the transpulmonary thermodilution technique by the PiCCO2 device to assess cardiac index and pulmonary edema during the postoperative course after single-lung transplantation. DESIGN: Prospective observational study. SETTINGS: Intensive care unit, university hospital (single center). PARTICIPANTS: Single-lung transplant patients. INTERVENTIONS: The authors compared cardiac index measured by PiCCO2 and pulmonary artery catheter and assessed pulmonary edema using extravascular lung water index and pulmonary vascular permeability index measured by PiCCO2...
December 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29194227/oesophageal-or-transgastric-views-for-estimating-mean-pulmonary-artery-pressure-with-transoesophageal-echocardiography
#17
Brian Cowie, Roman Kluger
BACKGROUND: Recent data suggest that in cardiac surgical patients, the pulmonary artery acceleration time (PAT) is useful for estimating mean pulmonary artery pressure (MPAP) noninvasively with transoesophageal echocardiography (TOE). The pulmonary valve can be visualised from multiple echocardiographic windows, but it is unclear which, if any, view correlates best with MPAP. OBJECTIVE(S): To compare the PAT measured with TOE from oesophageal and transgastric views with MPAP obtained invasively with a pulmonary artery catheter...
November 30, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29193283/diastolic-dysfunction-in-pulmonary-artery-hypertension-creatine-kinase-and-the-potential-therapeutic-benefit-of-beta-blockers
#18
Ewan D Fowler, Mark J Drinkhill, Rachel Stones, Ed White
Passive properties of the myocardium influence diastolic filling and cardiac output. In heart failure, changes in contributors to the passive properties of the ventricle, such as titin and collagen, and loss of the metabolic enzyme creatine kinase, increase resistance to filling resulting in diastolic dysfunction. Pulmonary artery hypertension (PAH) arises from interactions between the pulmonary vasculature and the right ventricle (RV) which ultimately leads to RV failure. Beta1-adrenergic receptor blockers (BB) act on the myocardium and are beneficial in left heart failure but are not used in PAH...
November 28, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29174781/utilization-of-veno-arterial-extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism
#19
Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat these patients. METHODS: All patients with a massive pulmonary embolism who were placed on VA-ECMO, as an initial intervention determined by protocol, were retrospectively reviewed...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29169604/validation-of-peripherally-inserted-central-catheter-derived-fick-cardiac-outputs-in-patients-with-heart-failure
#20
Kristen M Tecson, Anupama Vasudevan, Amarinder Bindra, Susan M Joseph, Joost Felius, Shelley A Hall, Parag Kale
The pulmonary artery catheter (PAC) remains the gold standard to calculate Fick cardiac outputs (FCOs) in patients with heart failure admitted to the intensive care unit (ICU). The peripherally inserted central catheter (PICC) provides long-term intravenous access and is used outside the ICU; however, there is scant literature validating venous oxygen saturations (VOSs) from PICC lines. Heart failure patients in the ICU with an existing PAC requiring a PICC line to transition were enrolled. Three blood samples were taken per person (1 at PICC, 1 at central venous pressure [CVP], and 1 at distal PAC)...
October 10, 2017: American Journal of Cardiology
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