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https://www.readbyqxmd.com/read/29778240/the-autonomic-neural-mechanism-of-right-ventricular-outflow-tract-tachycardia
#1
Hung-Yu Chang, Li-Wei Lo, Yu-Ruey Chen, Yu-Hui Chou, Wei-Lun Lin, Yenn-Jiang Lin, Wei-Hsian Yin, An-Ning Feng, Shih-Ann Chen
BACKGROUND: Ventricular tachycardia (VT) and ventricular premature complexes (VPCs) originating from the right ventricular outflow tract (RVOT) are generally considered as benign arrhythmias, with ECG morphology showing LBBB pattern and inferior axis. Pathogenic mechanisms in the genesis of RVOT VT/VPC remain largely unknown. We aimed to investigate the neural mechanism in RVOT ventricular arrhythmias in canine model. METHODS: Twelve mongrel dogs (13.7 ± 1...
July 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#2
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29752666/lung-water-assessment-from-gravimetry-to-wearables
#3
Frederic Michard
Several techniques are now available to detect and quantify pulmonary edema, from the laboratory postmortem method (gravimetry) to non-invasive wearable sensors. In critically ill patients with adult respiratory distress syndrome (ARDS), computed tomography scans are often performed to visualize lung lesions and quantify lung aeration, but their value seems somewhat limited to quantify pulmonary edema on a routine basis and of course to track changes with therapy. In this context, transpulmonary thermodilution is a convenient technique...
May 11, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29745622/noninvasive-assessment-of-cardiac-index-using-impedance-cardiography-during-liver-transplantation-surgery-a-comparison-with-pulmonary-artery-thermodilution
#4
Vlad Suparschi, Eric Le Bihan, Amélie Toussaint, Diana Saptefrat, Heykel Ben Abdallah, Faouzi Gloulou, Farida Aouati, Tobias Gauss, Catherine Paugam-Burtz
BACKGROUND: Liver Transplantation (LT) is a high-risk surgery associated with significant hemodynamic changes requiring advanced hemodynamic monitoring. Pulmonary Artery Catheter (PAC) is still considered as a gold-standard for cardiac index (CI) measurement during LT despite association with an increased risk of complications. Noninvasive impedance cardiography (ICG) could be an interesting alternative tool for CI monitoring. The aim of this study was to compare the precision and trending ability of ICG versus PAC methods during LT...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744658/catheter-mri-and-ct-imaging-in-newborns-with-pulmonary-atresia-with-ventricular-septal-defect-and-aortopulmonary-collaterals-quantifying-the-risks-of-radiation-dose-and-anaesthetic-time
#5
David F A Lloyd, Sebastian Goreczny, Conal Austin, Tarique Hussain, Shakeel A Qureshi, Eric Rosenthal, Thomas Krasemann
A comprehensive understanding of the native pulmonary blood supply is crucial in newborns with pulmonary atresia with ventricular septal defect and aortopulmonary collaterals (PA/VSD/MAPCA). We sought to describe the accuracy in terms of identifying native pulmonary arteries, radiation dose and anaesthetic time associated with multi-modality imaging in these patients, prior to their first therapeutic intervention. Furthermore, we wanted to evaluate the cumulative radiations dose and anaesthetic time over the study period...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29744656/pediatric-pulmonary-artery-rehabilitation-a-review-of-our-experience-and-a-novel-approach-using-bronchial-blockers
#6
Peter D Winch, Dmitry Tumin, Jeffrey Moore, Samantha J Vizzini, Darren P Berman, Aymen N Naguib
Recent advances in the field of pediatric interventional cardiology have resulted in therapies for patients in need of augmented pulmonary artery (PA) flow. Catheter-based PA rehabilitation can be performed safely but not without the potential risk of pulmonary hemorrhage. When severe, this bleeding has the ability to contaminate the bronchi and trachea, and possibly occlude the endotracheal tube. This can result in a critical inability to ventilate and oxygenate these patients. Herein, we review our institutional experience with pulmonary hemorrhage associated with these procedures and the feasibility of predicting this outcome...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29730148/mri-derived-regional-biventricular-function-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-before-and-after-pulmonary-endarterectomy
#7
Sabine K Maschke, Christian O Schoenfeld, Till F Kaireit, Serghei Cebotari, Karen Olsson, Marius Hoeper, Frank Wacker, Jens Vogel-Claussen
RATIONALE AND OBJECTIVES: The aim of this study was to assess regional myocardial function in patients with chronic thromboembolic hypertension (CTEPH) before and after successful pulmonary endarterectomy (PEA) using magnetic resonance imaging. METHODS: Twenty-two patients with CTEPH underwent cardiac magnetic resonance imaging before and 12 (11, 17) days after PEA. Mean pulmonary artery pressure was evaluated preoperatively by right heart catheterization and during post-PEA intensive care unit-stay using a Swan-Ganz catheter...
May 2, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29725794/cardiac-output-measurement-in-liver-transplantation-patients-using-pulmonary-and-transpulmonary-thermodilution-a-comparative-study
#8
Luigi Vetrugno, Elena Bignami, Federico Barbariol, Nicola Langiano, Francesco De Lorenzo, Carola Matellon, Giuseppe Menegoz, Giorgio Della Rocca
During liver transplantation surgery, the pulmonary artery catheter-despite its invasiveness-remains the gold standard for measuring cardiac output. However, the new EV1000 transpulmonary thermodilution calibration technique was recently introduced into the market by Edwards LifeSciences. We designed a single-center prospective observational study to determine if these two techniques for measuring cardiac output are interchangeable in this group of patients. Patients were monitored with both pulmonary artery catheter and the EV1000 system...
May 3, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29725695/alternatives-to-the-swan-ganz-catheter
#9
REVIEW
Daniel De Backer, Jan Bakker, Maurizio Cecconi, Ludhmila Hajjar, Da Wei Liu, Suzanna Lobo, Xavier Monnet, Andrea Morelli, Sheila Neinan Myatra, Azriel Perel, Michael R Pinsky, Bernd Saugel, Jean-Louis Teboul, Antoine Vieillard-Baron, Jean-Louis Vincent
While the pulmonary artery catheter (PAC) is still interesting in specific situations, there are many alternatives. A group of experts from different backgrounds discusses their respective interests and limitations of the various techniques and related measured variables. The goal of this review is to highlight the conditions in which the alternative devices will suffice and when they will not or when these alternative techniques can provide information not available with PAC. The panel concluded that it is useful to combine different techniques instead of relying on a single one and to adapt the "package" of interventions to the condition of the patient...
May 3, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29722288/ultrasound-guided-central-venous-tip-confirmation-via-right-external-jugular-vein-using-a-right-supraclavicular-fossa-view
#10
Mariko Kosaka, Yoshimasa Oyama, Tetsuya Uchino, Yojiro Ogihara, Hironori Koga, Chihiro Shingu, Shigekiyo Matsumoto, Takaaki Kitano
INTRODUCTION: Ultrasound-guided central venous catheter tip confirmation has a potential to precisely locate the central venous catheter, preventing its misplacement, using real-time guidance. This observational study sought to determine the accuracy of central venous catheter tip positioning via the external jugular vein via a supraclavicular fossa view under ultrasound guidance. METHODS: In total, 77 patients scheduled for central venous catheter insertion via the right external jugular vein were enrolled...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29716712/contemporary-outcomes-of-percutaneous-closure-of-patent-ductus-arteriosus-in-adolescents-and-adults
#11
Sudhakar P, John Jose, Oommen K George
BACKGROUND: Catheter based treatment has gained wide acceptance for management of patent ductus arteriosus (PDA) ever since its introduction. Percutaneous closure in adults can be challenging because of anatomical factors including large sizes, associated pulmonary arterial hypertension (PAH) and co-morbidities. This study aimed to provide comprehensive contemporary data on the safety and efficacy of percutaneous device closure of PDA in adult and adolescent population at a large referral center...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29715164/early-versus-delayed-use-of-ultrasound-assisted-catheter-directed-thrombolysis-in-patients-with-acute-submassive-pulmonary-embolism
#12
Sushruth Edla, Howard Rosman, Saroj Neupane, Andrew Boshara, Susan Szpunar, Edouard Daher, David Rodriguez, Thomas LaLonde, Hiroshi Yamasaki, Rajendra H Mehta, Antonious Attallah
OBJECTIVES: The effect of early vs delayed use of ultrasound-assisted catheter-directed thrombolysis (USAT) on invasive hemodynamics and in-hospital outcomes in patients with acute submassive pulmonary embolism (PE) is not well known. METHODS: We evaluated 41 patients with submassive PE to study the association of early USAT (≤24 hours; n = 21) vs delayed USAT (>24 hours; n = 20) with change in invasive hemodynamic measures from pre USAT to post USAT. RESULTS: Significantly greater improvement was observed in the early USAT group compared to the delayed group for median cardiac index (0...
May 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29709396/rivaroxaban-plus-percutaneous-catheter-directed-treatment-for-a-patient-with-massive-pulmonary-embolism-and-colporrhagia
#13
Wuchao Wang
Massive pulmonary embolism (PE) is defined by acute PE with sustained systemic arterial hypotension that is below 90 mm Hg for at least 15 min or requires inotropic agents (Jaff et al., 2011). For patients with absolute contraindications to thrombolysis, interventional treatment requires the removal of obstructing thrombi from the main pulmonary arteries to facilitate RV recovery and improve symptoms and survival (European Respiratory Society et al., 2014). For patients with acute PE, anticoagulation is recommended, with the objective of preventing both early death and recurrent symptomatic or fatal VTE...
April 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701425/analgesia-management-for-mitral-valve-repair-via-minithoracotomy-a-case-report
#14
Andreia Fernandes, Clara Gaio Lima, Nelson Paulo, Catarina Celestino, Ana Fonte Boa, Fátima Lima, Manuela Vieira
INTRODUCTION: Minimally invasive cardiac surgery (MICS), via minithoracotomy, is thought to be a fast track to extubation and recovery after surgery. Chronic pain, due to intercostal nerve injury, develops in up to 50% of postthoracotomy patients.A number of regional anaesthesia and analgesia techniques may be employed, and the anaesthesiologists play a key role in facilitating optimal outcomes after surgery. METHODS: We report a case of postoperative pain management with a local anesthetic infiltration for MICS...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29700275/anesthesia-management-of-modified-ex-vivo-liver-resection-and-autotransplantation
#15
Fujun Cheng, Zhiyong Yang, Jing Zeng, Jianteng Gu, Jian Cui, Jiaoning Ning, Bin Yi
BACKGROUND Ex situ liver surgery allows liver resection and vascular reconstruction in patients who have liver tumors located in critical sites. Only a small series of studies about ex situ liver surgery is available in the literature. No anesthesia management experience has been previously published. The aim of the currents study was to summarize our experience with anesthetic management of patients during ex vivo liver surgery. MATERIAL AND METHODS The first 43 patients who received ex vivo liver surgery between January 2007 and April 2012 were included...
April 27, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29689088/electrocardiogram-synchronized-pulsatile-extracorporeal-life-support-preserves-left-ventricular-function-and-coronary-flow-in-a-porcine-model-of-cardiogenic-shock
#16
Petr Ostadal, Mikulas Mlcek, Holger Gorhan, Ivo Simundic, Svitlana Strunina, Matej Hrachovina, Andreas Krüger, Dagmar Vondrakova, Marek Janotka, Pavel Hala, Martin Mates, Martin Ostadal, James C Leiter, Otomar Kittnar, Petr Neuzil
INTRODUCTION: Veno-arterial extracorporeal life support (ECLS) is increasingly being used to treat rapidly progressing or severe cardiogenic shock. However, it has been repeatedly shown that increased afterload associated with ECLS significantly diminishes left ventricular (LV) performance. The objective of the present study was to compare LV function and coronary flow during standard continuous-flow ECLS support and electrocardiogram (ECG)-synchronized pulsatile ECLS flow in a porcine model of cardiogenic shock...
2018: PloS One
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#17
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29671105/mapping-and-ablation-of-rvot-type-arrhythmias-comparison-between-the-conventional-and-reversed-u-curve-methods
#18
Zhuo Liang, Xuejun Ren, Tao Zhang, Zhihong Han, Jianzeng Dong, Yunlong Wang
PURPOSE: We assessed conventional and reversed U curve methods for mapping and ablation of RVOT-type VAs. METHODS: Single-center data were reviewed from consecutive cases of symptomatic VAs of RVOT-type origin that were mapped and ablated successfully using conventional method in RVOT (pulmonary artery might be included) from January 2014 to December 2015 (cohort 1, n = 75) or conventional method in RVOT and reversed U curve in PSC (for first ablation attempt) from January 2016 to March 2017 (cohort 2, n = 60)...
June 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29667097/an-elevated-respiratory-quotient-predicts-complications-after-cardiac-surgery-under-extracorporeal-circulation-an-observational-pilot-study
#19
J Piot, A Hébrard, M Durand, J F Payen, P Albaladejo
Following cardiac surgery, hyperlactatemia due to anaerobic metabolism is associated with an increase in both morbidity and mortality. We previously found that an elevated respiratory quotient (RQ) predicts anaerobic metabolism. In the present study we aimed to demonstrate that it is also associated with poor outcome following cardiac surgery. This single institution, prospective, observational study includes all those patients that were consecutively admitted to the intensive care unit (ICU) after cardiac surgery with cardiopulmonary bypass, that had also been monitored using pulmonary artery catheter...
April 17, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29664428/-case-report-and-the-surgical-treatment-of-two-cases-with-pulmonary-atresia-in-which-pulmonary-arteries-is-circulated-by-coronary-arteries
#20
Kahraman Yakut, Kürşad Tokel, Birgül Varan, İlkay Erdoğan, Murat Özkan
Pulmonary atresia (PA) and ventricular septal defect (VSD) can occur in a variety of ways, from simple valve atresia to a condition in which circulation to the pulmonary bed occurs through collateral arteries separated from the aorta and there are no real pulmonary arteries, or they are present but hypoplastic. The size of the pulmonary arteries and concomitant complex cardiac lesions are important in making decisions about treatment and correctional alternatives. While complete correction surgeries in the style of a correction of tetralogy of Fallot are performed in simpler cases, many very invasive procedures are also performed and the resulting quality of life is very variable...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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