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https://www.readbyqxmd.com/read/28514777/direct-measurement-of-tissue-oxygenation-in-neonates-via-resonance-raman-spectroscopy-a-pilot-study
#1
Anjali Iyengar, Andrew Gaillardetz, Hocine Tighiouart, Betsabee Castillo, Padraic Romfh, Jonathan M Davis
BACKGROUND: The ability to monitor tissue oxygenation in neonates remains a challenge due to limited blood supply and the reliance on invasive procedures. Resonance Raman spectroscopy noninvasively measures tissue oxygenation (RRS-StO2). Peripheral tissue oxygenation using this novel technology has not been described in neonates. OBJECTIVES: To examine the relationship between short-term RRS-StO2 measurements and central venous saturation (ScvO2) and pulse oximetry (SpO2) in preterm and term neonates...
May 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28492385/the-prognostic-value-of-central-venous-to-arterial-co2-difference-arterial-central-venous-o2-difference-ratio-in-septic-shock-patients-with-central-venous-o2-saturation-%C3%A2-80
#2
Huaiwu He, Yun Long, Dawei Liu, Xiaoting Wang, Bo Tang
BACKGROUND: It is a great challenge for physician to assess the relationship between O2 delivery and O2 consumption in septic shock patients with high ScvO2. Recently, the venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio (P(v-a)CO2/C(a-v)O2) has shown potential for reflecting anaerobic metabolism. Therefore, we evaluated the value of using the P(v-a)CO2/C(a-v)O2 ratio to predict mortality and assess anaerobic metabolism in septic shock patients with high ScvO2 (≥ 80%)...
May 10, 2017: Shock
https://www.readbyqxmd.com/read/28364680/assessment-of-macro-and-micro-oxygenation-parameters-during-fractional-fluid-infusion-a-pilot-study
#3
Marc-Olivier Fischer, Vincent Bonnet, Emmanuel Lorne, Jean-Yves Lefrant, Olivier Rebet, Benoît Courteille, Charlotte Lemétayer, Jean-Jacques Parienti, Jean-Louis Gérard, Jean-Luc Fellahi, Jean-Luc Hanouz
PURPOSE: The main goal of this study was to assess whether maximal fluid infusion improves both oxygen delivery (DO2) and micro-circulatory parameters during hemodilution. The secondary objective was to assess the ability of baseline micro-circulatory parameters to predict oxygen consumption (VO2) response following fluid infusion. MATERIALS AND METHODS: In a postoperative cardiac ICU, patients received repeated fluid infusion until stroke volume (SV) was maximized...
March 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28321801/acute-hyperventilation-increases-the-central-venous-to-arterial-pco2-difference-in-stable-septic-shock-patients
#4
Jihad Mallat, Usman Mohammad, Malcolm Lemyze, Mehdi Meddour, Marie Jonard, Florent Pepy, Gaelle Gasan, Stephanie Barrailler, Johanna Temime, Nicolas Vangrunderbeeck, Laurent Tronchon, Didier Thevenin
BACKGROUND: To evaluate the effects of acute hyperventilation on the central venous-to-arterial carbon dioxide tension difference (∆PCO2) in hemodynamically stable septic shock patients. METHODS: Eighteen mechanically ventilated septic shock patients were prospectively included in the study. We measured cardiac index (CI), ∆PCO2, oxygen consumption (VO2), central venous oxygen saturation (ScvO2), and blood gas parameters, before and 30 min after an increase in alveolar ventilation (increased respiratory rate by 10 breaths/min)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28281216/a-hypoperfusion-context-may-aid-to-interpret-hyperlactatemia-in-sepsis-3-septic-shock-patients-a-proof-of-concept-study
#5
Leyla Alegría, Magdalena Vera, Jorge Dreyse, Ricardo Castro, David Carpio, Carolina Henriquez, Daniela Gajardo, Sebastian Bravo, Felipe Araneda, Eduardo Kattan, Pedro Torres, Gustavo Ospina-Tascón, Jean-Louis Teboul, Jan Bakker, Glenn Hernández
BACKGROUND: Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. However, clinical recognition of different sources of hyperlactatemia is unfortunately not a common practice and patients are treated with the same strategy despite the risk of over-resuscitation in some. Indeed, pursuing additional resuscitation in non-hypoperfusion-related cases might lead to the toxicity of fluid overload and vasoactive drugs...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28202033/use-of-stepwise-lactate-kinetics-oriented-hemodynamic-therapy-could-improve-the-clinical-outcomes-of-patients-with-sepsis-associated-hyperlactatemia
#6
Xiang Zhou, Dawei Liu, Longxiang Su, Bo Yao, Yun Long, Xiaoting Wang, Wenzhao Chai, Na Cui, Hao Wang, Xi Rui
BACKGROUND: Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate kinetics vs central venous oxygen saturation (ScvO2)-oriented hemodynamic therapy at 6 h as the protocol goal during early resuscitation. METHODS: The relevant parameters and adverse events after different targets in 360 randomly assigned patients with sepsis-associated hyperlactatemia were recorded and compared...
February 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28151454/effects-of-blood-transfusion-on-oxygen-extraction-ratio-and-central-venous-saturation-in-children-after-cardiac-surgery
#7
Bana Nasser, Mohmad Tageldein, Abdulrahman AlMesned, Mohammad Kabbani
BACKGROUND: Red blood cell transfusion is common in critically ill children after cardiac surgery. Since the threshold for hemoglobin (Hb) transfusion need is not well defined, the threshold Hb level at which dependent critical oxygen uptake-to-delivery (VO2-DO2) status compensation is uncertain. OBJECTIVES: To assess the effects of blood transfusion on the oxygen extraction ratio (O2ER) and central venous oxygen saturation (ScvO2) to identify a critical O2ER value that could help us determine the critical need for blood transfusion...
January 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28149028/comparative-evaluation-of-central-venous-pressure-and-sonographic-inferior-vena-cava-variability-in-assessing-fluid-responsiveness-in-septic-shock
#8
Manjri Garg, Jyotsna Sen, Sandeep Goyal, Dhruva Chaudhry
OBJECTIVE: Fluid infusion, the most critical step in the resuscitation of patients with septic shock, needs preferably continuous invasive hemodynamic monitoring. The study was planned to evaluate the efficacy of ultrasonographically measured inferior vena cava collapsibility index (IVC CI) in comparison to central venous pressure (CVP) in predicting fluid responsiveness in septic shock. MATERIALS AND METHODS: Thirty-six patients of septic shock requiring ventilatory support (invasive/noninvasive) were included...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28144579/microvascular-response-to-transfusion-in-elective-spine-surgery
#9
J Matthias Walz, Ottokar Stundner, Federico P Girardi, Bruce A Barton, Aimee R Koll-Desrosiers, Stephen O Heard, Stavros G Memtsoudis
AIM: To investigate the microvascular (skeletal muscle tissue oxygenation; SmO2) response to transfusion in patients undergoing elective complex spine surgery. METHODS: After IRB approval and written informed consent, 20 patients aged 18 to 85 years of age undergoing > 3 level anterior and posterior spine fusion surgery were enrolled in the study. Patients were followed throughout the operative procedure, and for 12 h postoperatively. In addition to standard American Society of Anesthesiologists monitors, invasive measurements including central venous pressure, continual analysis of stroke volume (SV), cardiac output (CO), cardiac index (CI), and stroke volume variability (SVV) was performed...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#10
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27836261/cardiac-output-scvo2-relationship-during-sepsis-a-subtle-association
#11
EDITORIAL
Karim Bendjelid
No abstract text is available yet for this article.
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27832407/central-venous-to-arterial-carbon-dioxide-difference-and-the-effect-of-venous-hyperoxia-a-limiting-factor-or-an-additional-marker-of-severity-in-shock
#12
P Saludes, L Proença, G Gruartmoner, L Enseñat, A Pérez-Madrigal, C Espinal, J Mesquida
Central venous-to-arterial carbon dioxide difference (PcvaCO2) has demonstrated its prognostic value in critically ill patients suffering from shock, and current expert recommendations advocate for further resuscitation interventions when PcvaCO2 is elevated. PcvaCO2 combination with arterial-venous oxygen content difference (PcvaCO2/CavO2) seems to enhance its performance when assessing anaerobic metabolism. However, the fact that PCO2 values might be altered by changes in blood O2 content (the Haldane effect), has been presented as a limitation of PCO2-derived variables...
November 10, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27829180/changes-of-central-venous-oxygen-saturation-define-fluid-responsiveness-in-patients-with-septic-shock-a-prospective-observational-study
#13
Biao Xu, Xiaobo Yang, Chunyao Wang, Wei Jiang, Li Weng, Xiaoyun Hu, Jinmin Peng, Bin Du
PURPOSE: To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock. METHODS: In this prospective observational study, septic shock patients with invasive cardiac output monitoring requiring fluid challenge were included. Cardiac index (CI) and Scvo2 were measured before and after fluid challenges. The changes of CI (ΔCI) and the changes of Scvo2 (ΔScvo2) were calculated and analyzed using Pearson correlation...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27821162/physiological-effects-of-invasive-ventilation-with-neurally-adjusted-ventilatory-assist-nava-in-a-crossover-study
#14
Jean-Michel Liet, François Barrière, Bénédicte Gaillard-Le Roux, Pierre Bourgoin, Arnaud Legrand, Nicolas Joram
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a mode of assisted mechanical ventilation that delivers inspiratory pressure proportionally to the electrical activity of the diaphragm. To date, no pediatric study has focused on the effects of NAVA on hemodynamic parameters. This physiologic study with a randomized cross-over design compared hemodynamic parameters when NAVA or conventional ventilation (CV) was applied. METHODS: After a baseline period, infants received NAVA and CV in a randomized order during two consecutive 30-min periods...
November 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27749764/the-predictive-ability-of-pv-aco2-gap-and-pv-aco2-ca-vo2-ratio-in-shock-a-prospective-cohort-study
#15
Mohammad Shaban, Nawal Salahuddin, Mohammad Raed Kolko, Moh'd Sharshir, Mohannad AbuRageila, Ahmed AlHussain
INTRODUCTION: Compromised tissue oxygenation leads to anaerobiosis, leading to organ failure and death. This study attempts to demonstrate the predictive abilities of the Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio in shock patients undergoing resuscitation. METHODS: In a prospective study, consecutive patients with shock were included. Timed measurements of Pv-aCO2 gap, ScvO2, lactate, and Pv-aCO2/ Ca-vO2 ratio were obtained. The association between the mortality and each variable at all intervals was analyzed...
April 2017: Shock
https://www.readbyqxmd.com/read/27716694/perioperative-utility-of-goal-directed-therapy-in-high-risk-cardiac-patients-undergoing-coronary-artery-bypass-grafting-a-clinical-outcome-and-biomarker-based-study
#16
RANDOMIZED CONTROLLED TRIAL
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27667276/-the-effect-and-factors-associated-with-outcome-of-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock-patients
#17
R Q Zhu, C Z Liu, J H Lu, Y P Su, S C Wen, G J Nie, Y Z Hu, L E Zuo
Objective: To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients. Methods: Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed. The clinical status before ECMO support, ECMO timing, complications and outcome were observed and analyzed.The hemodynamic data and the amount of vasoactive drugs at 2 hours before ECMO support and at 2, 6, 24 and 48 hours after ECMO support were collected and compared...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27652257/the-effect-of-esmolol-on-tissue-perfusion-and-clinical-prognosis-of-patients-with-severe-sepsis-a-prospective-cohort-study
#18
Xiuling Shang, Kaiyu Wang, Jingqing Xu, Shurong Gong, Yong Ye, Kaihua Chen, Fayang Lian, Wei Chen, Rongguo Yu
Purpose. This study was aimed at investigating the effect of esmolol on tissue perfusion and the clinical prognosis of patients with severe sepsis. Materials and Methods. One hundred fifty-one patients with severe sepsis were selected and divided into the esmolol group (n = 75) or the control group (n = 76), who received conventional antiseptic shock treatment. The esmolol group received a continuous infusion of esmolol via a central venous catheter, and their heart rate (HR) was maintained at 70-100 bpm over 72 hours...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27476492/the-effect-of-blood-transfusion-on-central-venous-oxygen-saturation-in-critically-ill-patients-admitted-to-a-neurointensive-care-unit
#19
R M Surve, R Muthuchellappan, G S U Rao, M Philip
BACKGROUND: Literature suggests poorer outcomes during anaemia as well as following red blood cell transfusion (BT) in brain injured patients. Recently, central venous oxygen saturation (ScvO2 ) has been proposed as a physiological trigger to guide red BT. In this study, we looked at ScvO2 changes following BT in patients admitted to a neurointensive care unit (NICU). STUDY DESIGN: In this prospective, observational study, adult, acutely ill neurological patients of >18 years were recruited...
October 2016: Transfusion Medicine
https://www.readbyqxmd.com/read/27467272/assessment-of-the-adequacy-of-oxygen-delivery
#20
Katherine Mayer, Stephen Trzeciak, Nitin K Puri
PURPOSE OF REVIEW: This article reviews the recent literature pertaining to assessment of the adequacy of oxygen delivery in critically ill patients with circulatory shock. RECENT FINDINGS: The assessment of the adequacy of oxygen delivery has traditionally involved measurement of lactate, central (or mixed) venous oxygen saturation (ScvO2), and global hemodynamic markers such as mean arterial pressure and cardiac index. The search for noninvasive, reliable, and sensitive methods to detect derangements in oxygen delivery and utilization continues...
October 2016: Current Opinion in Critical Care
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