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https://www.readbyqxmd.com/read/29679599/mortality-in-pulmonary-arterial-hypertension-patients-treated-with-continuous-prostanoids
#1
S D Bartolome, N Sood, T S Shah, K Styrvoky, F T Torres, K M Chin
INTRODUCTION: Parenteral prostanoids are considered the treatment of choice for patients with severe pulmonary arterial hypertension (PAH). Prognostic studies for patients treated in the modern era are limited. METHODS: In this retrospective cohort study, patients initiating IV epoprostenol or IV or SC treprostinil therapy for PAH from 2007-2016 at UT Southwestern, Dallas, TX and Ohio State University, Columbus, OH were included. Transplant-free survival was assessed from the time of IV/SC initiation and from the time of first follow-up...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29488329/method-comparison-of-two-non-invasive-dual-wavelength-spectrophotometric-retinal-oximeters-in-healthy-young-subjects-during-normoxia
#2
Reinhard Told, Agnes Boltz, Leopold Schmetterer, Gerhard Garhöfer, Stefan Sacu, Ursula Schmidt-Erfurth, Andreas Pollreisz
PURPOSE: Spectrophotometric retinal oximetry is a non-invasive technology for measuring oxygen saturation in arterioles and venules (SaO2 , SvO2 ). We compared two commercially available systems: the Oxymap T1 (Oxymap ehf., Reykjavik, Iceland) and the Dynamic Vessel Analyzer (DVA, Imedos, Jena, Germany). METHODS: Twenty healthy adults were included after giving informed consent. Two measurement cycles 30 min apart, including Oxymap T1, DVA, arterialized capillary blood draw of the earlobe (ScO2 ) and peripheral oxygen saturation using finger pulse oximetry (SpO2 ) were scheduled...
February 28, 2018: Acta Ophthalmologica
https://www.readbyqxmd.com/read/29484605/the-effects-of-systemic-oxygenation-on-cerebral-oxygen-saturation-and-its-relationship-to-mixed-venous-oxygen-saturation-a-prospective-observational-study-comparison-of-the-invos-and-foresight-elite-cerebral-oximeters
#3
Christian Schmidt, Matthias Heringlake, Patrick Kellner, Astrid Ellen Berggreen, Holger Maurer, Sebastian Brandt, Bence Bucsky, Michael Petersen, Efstratios I Charitos
PURPOSE: The present study aimed to test the hypothesis that cerebral oxygen saturation (ScO2 ) measurements with the INVOS-5100-C and the ForeSight-Elite cerebral oximeters vary in their correlation with mixed venous oxygen saturation (SvO2 ) upon changes in systemic oxygenation in extubated cardiac surgical patients. Additionally, we aimed to elucidate whether the ScO2 measurements of both devices can be used interchangeably to detect reduced SvO2 . METHODS: Forty-eight spontaneously breathing patients extubated after cardiac surgery were included in this prospective observational study...
February 26, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29395815/association-of-oral-intake-and-transient-mixed-venous-oxygen-desaturation-in-patients-undergoing-fast-track-postoperative-care-after-open-heart-surgery
#4
Yuichi Maki, Daisuke Toyoda, Keiko Tomichi, Jun Onodera, Yoshifumi Kotake
OBJECTIVE: The impact of early resumption of oral intake after cardiac surgery on hemodynamics has not been characterized. The authors examined the effects of early oral intake on the oxygen supply-demand relationship in patients undergoing on-pump cardiac surgery in an early recovery after surgery program. DESIGN: Prospective data were collected in postcardiac surgical patients in a multidisciplinary intensive care unit (ICU) during an 18-month period. SETTING: Single institution study...
December 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29382517/-fluid-balance-and-acute-kidney-injury-in-septic-shock
#5
Jesús Javier Martínez-García, Nidia Maribel León-Sicairos, Adrián Canizalez-Román, Bianca Azucena García-Arellano
BACKGROUND: In patients with septic shock, excessive fluid administration can lead to increased morbidity and mortality. The aim of this study was to evaluate the association between fluid balance, acute kidney injury and mortality in patients with septic shock. METHODS: A study of cases and controls was conducted in a Pediatric Intensive Care Unit. The fluid balance in the first 72h and the presence of acute kidney injury was compared in patients diagnosed with septic shock who died against patients who survived the same condition...
July 2017: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29304150/non-invasive-assessment-of-cerebral-oxygenation-a-comparison-of-retinal-and-transcranial-oximetry
#6
COMPARATIVE STUDY
Karel Van Keer, Jan Van Keer, João Barbosa Breda, Vahid Nassiri, Cathy De Deyne, Cornelia Genbrugge, Luís Abegão Pinto, Ingeborg Stalmans, Evelien Vandewalle
BACKGROUND: To investigate the correlation between cerebral (SO2-transcranial), retinal arterial (SaO2-retinal) and venous (SvO2-retinal) oxygen saturation as measured by near-infrared spectroscopy (NIRS) and retinal oximetry respectively. METHODS: Paired retinal and cerebral oxygen saturation measurements were performed in healthy volunteers. Arterial and venous retinal oxygen saturation and diameter were measured using a non-invasive spectrophotometric retinal oximeter...
2018: PloS One
https://www.readbyqxmd.com/read/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#7
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29249064/reduced-deep-regional-cerebral-venous-oxygen-saturation-in-hemodialysis-patients-using-quantitative-susceptibility-mapping
#8
Chao Chai, Saifeng Liu, Linlin Fan, Lei Liu, Jinping Li, Chao Zuo, Tianyi Qian, E Mark Haacke, Wen Shen, Shuang Xia
Cerebral venous oxygen saturation (SvO2 ) is an important indicator of brain function. There was debate about lower cerebral oxygen metabolism in hemodialysis patients and there were no reports about the changes of deep regional cerebral SvO2 in hemodialysis patients. In this study, we aim to explore the deep regional cerebral SvO2 from straight sinus using quantitative susceptibility mapping (QSM) and the correlation with clinical risk factors and neuropsychiatric testing. 52 hemodialysis patients and 54 age-and gender-matched healthy controls were enrolled...
February 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29161235/influence-of-ductus-arteriosus-on-peripheral-muscle-oxygenation-and-perfusion-in-neonates
#9
Lukas Peter Mileder, Tessa Mueller, Nariae Baik-Schneditz, Jasmin Pansy, Bernhard Schwaberger, Corinna Binder-Heschl, Berndt Urlesberger, Gerhard Pichler
In neonates, a patent ductus arteriosus (DA) may be associated with severe complications. We used near-infrared spectroscopy (NIRS) with venous occlusion to investigate the influence of an open DA on peripheral muscle oxygenation/perfusion in preterm neonates. Approach: We analyzed secondary outcome parameters collected as part of prospective observational studies. NIRS measurements were performed between the first and third day of life. Arterial oxygen saturation (SaO2) and heart rate (HR) were monitored by pulse oximetry on the ipsilateral foot...
November 21, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29153931/disturbances-in-oxygen-balance-during-cardiopulmonary-bypass-a-risk-factor-for-postoperative-delirium
#10
Nina Smulter, Helena Claesson Lingehall, Yngve Gustafson, Birgitta Olofsson, Karl Gunnar Engström, Micael Appelblad, Staffan Svenmarker
OBJECTIVE: The aim of this study was to determine risk factors for postoperative delirium after cardiac surgery, specifically associated with the conduct of cardiopulmonary bypass (CPB). DESIGN: Prospective observational study. SETTING: Heart Centre, University Hospital. PARTICIPANTS: The study included 142 patients aged 70 years and older scheduled for elective cardiac surgery with CPB. INTERVENTIONS: Risk factor analysis comprised information collected from the hospital clinical and CPB dedicated databases in addition to the medical chart...
August 25, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o-2-saturation-in-cardiac-surgery-patients-following-extubation
#11
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (Sv O2 ) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2 ) or an increase in global O2 consumption ([Formula: see text]O2 ). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29126662/levosimendan-in-patients-with-cardiogenic-shock-complicating-myocardial-infarction-a-meta-analysis
#12
M Fang, H Cao, Z Wang
PURPOSE: Cardiac shock is the leading cause of death in patients with acute myocardial infarction. The objective of this systematic review and meta-analysis was to evaluate whether levosimendan, compared to any type of control, is associated with improved clinical outcomes in patients with cardiogenic shock complicating myocardial infarction. MATERIALS AND METHODS: The PubMed, EMBASE, Cochrane Central Register, and China National Knowledge Information databases were searched for pertinent studies published up until 1 May 2016...
November 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29061467/an-interactive-simulation-tool-for-patient-specific-clinical-decision-support-in-single-ventricle-physiology
#13
Timothy Conover, Anthony M Hlavacek, Francesco Migliavacca, Ethan Kung, Adam Dorfman, Richard S Figliola, Tain-Yen Hsia
OBJECTIVE: Modeling of single-ventricle circulations has yielded important insights into their unique flow dynamics and physiology. Here we translated a state-of-the-art mathematical model into a patient-specific clinical decision support interactive Web-based simulation tool and show validation for all 3 stages of single-ventricular palliation. METHODS: Via the adoption a validated lumped parameter method, complete cardiovascular-pulmonary circulatory models of all 3 stages of single-ventricle physiology were created within a simulation tool...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28985705/accuracy-of-the-spectrum-medical-m4-and-terumo-cdi-500-compared-to-the-radiometer-abl90-flex-benchtop-blood-analyzer
#14
James A Reagor, Zhiqian Gao, John P Lombardi, Barbara B Millin, James S Tweddell, David S Cooper
The benchtop blood analyzer is the gold standard for blood oxygen saturation (SO2) and hemoglobin (Hb) analysis. However, the benchtop analyzer only provides values at a given point in time. In the field of cardiovascular perfusion and the practice of cardiopulmonary bypass (CPB), continuous measurement of SvO2 and hemoglobin values have become commonplace. Two devices currently available which monitor these values are the Terumo CDI 500 and Spectrum Medical M4. A retrospective study was conducted to examine the accuracy of the M4 technology and the CDI 500 as they compare to each other and the ABL90 FLEX, a benchtop blood gas analyzer...
October 2017: Perfusion
https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#15
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/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
#16
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/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#17
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
January 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/28868660/in-vivo-whole-blood-t-2-versus-hbo-2-calibration-by-modulating-blood-oxygenation-level-in-the-femoral-vein-through-intermittent-cuff-occlusion
#18
Michael C Langham, Ana E Rodríguez-Soto, Nadav Schwartz, Felix W Wehrli
PURPOSE: To investigate the feasibility of estimating calibration constants (K and T2o ) in vivo for converting whole-blood T2 to blood hemoglobin oxygen saturation (HbO2 ) according to the Luz-Meiboom model, 1/T2=1/T2o+K(1-HbO2)2, where K and T2o are relaxivity and transverse relaxation time of fully saturated blood, respectively. METHODS: A range of HbO2 values was achieved in the superficial femoral vein with intermittent cuff occlusion in seven healthy adults (four males) to establish a calibration curve between blood T2 and HbO2 at 1...
April 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28819713/plasma-growth-differentiation-factor-15-is-a-potential-biomarker-for-pediatric-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#19
Gang Li, Yan Li, Xiao-Qiu Tan, Peng Jia, Jian Zhao, Dong Liu, Ting Wang, Bin Liu
We aimed to investigate plasma growth differentiation factor-15 (GDF-15) levels in pediatric pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD), and assess the association with hemodynamic parameters. Plasma GDF-15 levels were measured in children with PAH-CHD (n = 46) and compared to children with CHD without PAH (n = 39). Normal individuals (n = 30) served as health control group. Plasma GDF-15 levels were significantly elevated in patients with PAH-CHD compared with those with CHD without PAH (median 1415 ng/L, interquartile range [IQR] 926...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#20
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
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