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https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#1
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28703124/comparison-between-the-effects-of-hydrochlorothiazide-and-indapamide-on-the-kidney-in-hypertensive-patients-inadequately-controlled-with-losartan
#2
S Wang, J Li, X Zhou, K Liu, X Zhang, Q Meng, R Shi, D Shi, X Chen
The aim of the study is to compare the effects of hydrochlorothiazide and indapamide on the kidney in patients with hypertension inadequately controlled with losartan. A total of 140 patients who met the criteria and inadequately controlled with losartan 50 mg per day for 2 weeks were randomized in two groups and administered either hydrochlorothiazide 12.5 mg per day (n=70) or indapamide (sustained release) 1.5 mg per day (n=70) in combination with losartan 50 mg per day. Office blood pressure (BP) were collected at baseline and upon each follow-up visit...
July 13, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28693594/the-impact-of-phosphate-balanced-crystalloid-infusion-on-acid-base-homeostasis-palance-study-study-protocol-for-a-randomized-controlled-trial
#3
Judith-Irina Pagel, Nikolai Hulde, Tobias Kammerer, Michaela Schwarz, Daniel Chappell, Alexander Burges, Klaus Hofmann-Kiefer, Markus Rehm
BACKGROUND: This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. METHODS/DESIGN: This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28651510/pharmacodynamics-of-intravenous-frusemide-bolus-in-critically-ill-patients
#4
Agnes Huang, Nora Luethi, Johan Mårtensson, Rinaldo Bellomo, Luca Cioccari
OBJECTIVE: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. DESIGN, SETTING AND PATIENTS: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia. INTERVENTIONS: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28641607/the-use-of-nesiritide-in-patients-with-critical-cardiac-disease
#5
Ronald A Bronicki, Michele Domico, Paul A Checchia, Curtis E Kennedy, Ayse Akcan-Arikan
OBJECTIVE: We evaluated the use of nesiritide in children with critical CHD, pulmonary congestion, and inadequate urine output despite undergoing conventional diuretic therapy. DESIGN: We conducted a retrospective analysis of 11 patients with critical CHD, comprising 18 infusions, each of which occurred during separate hospitalisations. Haemodynamic parameters were assessed, and the stage of acute kidney injury was determined before and throughout the duration of therapy using a standardised definition of acute kidney injury - The Kidney Disease: Improving Global Outcomes criteria...
June 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28637179/is-delayed-surgical-revascularization-in-acute-myocardial-infarction-useful-or-dangerous-new-insights-into-an-old-problem
#6
Philippe Grieshaber, Peter Roth, Lukas Oster, Tobias M Schneider, Gerold Görlach, Bernd Nieman, Andreas Böning
OBJECTIVES: Haemodynamically stable patients admitted for coronary artery bypass grafting in acute myocardial infarction often undergo delayed surgery in order to avoid the risks of emergency surgery. However, initially stable patients undergoing delayed surgery may develop low cardiac output syndrome (LCOS) during the waiting period, which might be a major drawback of this strategy. We aim to define risk factors and clinical consequences of LCOS during the waiting period. METHODS: A total of 530 consecutive patients with acute myocardial infarction (33% non-ST-segment elevation myocardial infarction and 67% ST-segment-elevation myocardial infarction) underwent isolated coronary artery bypass grafting between 2008 and 2013...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28636754/linagliptin-and-its-effects-on-hyperglycaemia-and-albuminuria-in-patients-with-type-2-diabetes-and-renal-dysfunction-the-randomized-marlina-t2d%C3%A2-trial
#7
P-H Groop, M E Cooper, V Perkovic, B Hocher, K Kanasaki, M Haneda, G Schernthaner, K Sharma, R C Stanton, R Toto, J Cescutti, M Gordat, T Meinicke, A Koitka-Weber, S Thiemann, M von Eynatten
AIMS: The MARLINA-T2D™ study (ClinicalTrials.gov, NCT01792518) was designed to investigate the glycaemic and renal effects of linagliptin added to standard-of-care in individuals with type 2 diabetes and albuminuria. METHODS: 360 individuals with type 2 diabetes, HbA1c 6.5 - 10.0% (48 - 86 mmol/mol), estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m(2) , and urinary albumin-to-creatinine ratio (UACR) 30-3000 mg/g despite single agent renin-angiotensin-system blockade were randomized to double-blind linagliptin (n = 182) or placebo (n = 178) for 24 weeks...
June 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28614093/central-diastolic-pressure-decay-mediates-the-relationship-between-aortic-stiffness-and-myocardial-viability-potential-implications-for-aortosclerosis-induced-myocardial-ischemia
#8
Junichiro Hashimoto, Sadayoshi Ito
OBJECTIVE: Stiffening of the aorta often precedes coronary events, but little is known about the aetiological mechanism. We hypothesized that the predisposition to myocardial ischemia could be attributable to aortosclerosis-induced alterations in the central haemodynamics during diastole. METHODS: Using noninvasive tonometry and ultrasonography, we investigated the arterial pressure pulse waveforms, pulse wave velocities (PWVs) and compliance in 222 patients with hypertension...
June 16, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28575331/oesophageal-doppler-guided-goal-directed-haemodynamic-therapy-in-thoracic-surgery-a-single-centre-randomized-parallel-arm-trial
#9
K B Kaufmann, L Stein, L Bogatyreva, F Ulbrich, J T Kaifi, D Hauschke, T Loop, U Goebel
Background: Postoperative pulmonary and renal complications are frequent in patients undergoing lung surgery. Hyper- and hypovolaemia may contribute to these complications. We hypothesized that goal-directed haemodynamic management based on oesophageal Doppler monitoring would reduce postoperative pulmonary complications in a randomized clinical parallel-arm trial. Methods: One hundred patients scheduled for thoracic surgery were randomly assigned to either standard haemodynamic management (control group) or goal-directed therapy (GDT group) guided by an oesophageal Doppler monitoring-based algorithm...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28572879/effects-of-glycaemic-management-on-diabetic-kidney-disease
#10
REVIEW
Richard J MacIsaac, George Jerums, Elif I Ekinci
Hyperglycaemia contributes to the onset and progression of diabetic kidney disease (DKD). Observational studies have not consistently demonstrated a glucose threshold, in terms of HbA1c levels, for the onset of DKD. Tight glucose control has clearly been shown to reduce the incidence of micro- or macroalbuminuria. However, evidence is now also emerging to suggest that intensive glucose control can slow glomerular filtration rate loss and possibly progression to end stage kidney disease. Achieving tight glucose control needs to be balanced against the increasing appreciation that glucose targets for the prevention of diabetes related complications need be individualised for each patient...
May 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28564127/impact-of-terlipressin-infusion-during-and-after-live-donor-liver-transplantation-on-incidence-of-acute-kidney-injury-and-neutrophil-gelatinase-associated-lipocalin-serum-levels-a-randomized-controlled-trial
#11
Mohamed Abdelrauf Kandil, Khalid Mousa Abouelenain, Ayman Alsebaey, Hanaa Said Rashed, Mohamed Helmi Afifi, Mohamed Abdelmoneem Mahmoud, Khaled Ahmed Yassen
Acute kidney injury (AKI) with liver transplantation is not uncommon. Impact of Terlipressin infusion on AKI, haemodynamics and plasma concentration of Neutrophil Gelatinase Associated Lipocalin (NGAL) was studied METHODS: Patients (n=50) were randomized (NCT02059460, USA) into 2 equal groups; Terlipressin vs Controls. Terlipressin (1-4 μg/kg/h) was administrated for 5 days. Intraoperative Transoesophageal Doppler for haemodynamic management. Renal functions, peak portal vein blood flow velocity (PPV) and hepatic artery resistive index (HARI) were recorded...
May 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28558715/modern-peptide-biomarkers-and-echocardiography-in-cardiac-healthy-haemodialysis-patients
#12
Franz Maximilian Rasche, Stephan Stoebe, Thomas Ebert, Silvana Feige, Andreas Hagendorff, Wilma Gertrud Rasche, Filip Barinka, Volker Busch, Ulrich Sack, Jochen G Schneider, Stephan Schiekofer
BACKGROUND: In this prospective study, we aimed to assess the haemodynamic changes before and after haemodialysis (HD) in cardiac healthy subjects on chronic HD by imaging methods and endocrine markers of fluid balance. METHODS: Mid-regional pro-atrial natriuretic peptide (MR-proANP), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), vasopressin (AVP) and copeptin (CT-proAVP), metanephrines and normetanephrines, renin and aldosterone, standard transthoracic echocardiography and diameter of vena cava inferior (VCID) were performed in 20 patients with end stage renal disease (CKD5D) before and after HD and were stratified in residual excretion (RE, less or more 0...
May 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28532189/non-selective-beta-blocker-treatment-does-not-impact-on-kidney-function-in-cirrhotic-patients-with-varices
#13
Bernhard Scheiner, Diego Parada-Rodriguez, Theresa Bucsics, Philipp Schwabl, Mattias Mandorfer, Nikolaus Pfisterer, Florian Riedl, Wolfgang Sieghart, Arnulf Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Thomas Reiberger
GOALS AND BACKGROUND: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress. STUDY: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs. without NSBB therapy...
September 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28489448/immediate-postoperative-management-and-complications-on-the-intensive-care-unit
#14
REVIEW
Eleanor Bates, Daniel Martin
The postoperative management of patients immediately after liver transplantation requires knowledge of this complex surgery and the physiology that accompanies liver failure. A multidisciplinary approach to the care of these patients is essential in order to reduce postoperative complications and preserve function in the transplanted organ. By their nature, patients undergoing liver transplantation have complicated medical problems before surgery which must be borne in mind when managing them after surgery...
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28483456/protective-role-of-cgmp-in-early-sepsis
#15
Vanessa Kovalski, Ana P Prestes, Junior G Oliveira, Gustavo F Alves, Daiandra Fr Colarites, Jheniffer El Mattos, Regina Sordi, José Cr Vellosa, Daniel Fernandes
Septic shock, which is triggered by microbial products, is mainly characterised by inadequate tissue perfusion, which can lead to multiple organ dysfunction and death. An intense release of vasoconstrictors agents occurs in the early stages of shock, which can lead to ischemic injury. In this scenario, cGMP could play a key role in counterbalancing these agents and preventing tissue damage. Sildenafil, which is a phosphodiesterase-5 inhibitor, increases cGMP in smooth muscle cells and promotes vasodilation...
July 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28468676/blood-pressure-deficits-in-acute-kidney-injury-not-all-about-the-mean-arterial-pressure
#16
Lui G Forni, Michael Joannidis
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points...
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28465331/renal-resistive-index-reflects-fontan-pathophysiology-and-predicts-mortality
#17
Hideo Ohuchi, Jun Negishi, Yohsuke Hayama, Aya Miyazaki, Isao Shiraishi, Hajime Ichikawa
OBJECTIVES: The renal resistive index (RRI) reflects non-renal pathophysiology, such as great artery stiffness, haemodynamics and even end-organ damage in patients with hypertension. This study was conducted to clarify the clinical significance of the RRI in Fontan pathophysiology. METHODS: We measured the RRI in 280 consecutive Fontan patients and 36 healthy controls. RESULTS: The patients exhibited a higher RRI than the controls (0.71±0...
May 2, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28463737/propafenone-for-supraventricular-arrhythmias-in-septic-shock-comparison-to-amiodarone-and-metoprolol
#18
M Balik, I Kolnikova, M Maly, P Waldauf, G Tavazzi, J Kristof
PURPOSE: The occurence of supraventricular arrhythmias associate with an unfavourable prognosis in septic shock. Propafenone could be a feasible antiarrhythmic. MATERIALS AND METHODS: Patients collected over a period of 24months were divided into the three groups based on antiarrhythmic: Group1(amiodarone), Group2(propafenone), Group3(metoprolol). Type of arrhythmia, cardioversion rates, demographic, haemodynamic, laboratory parameters were recorded in the first 24h...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28449402/postprandial-renal-haemodynamic-effect-of-lixisenatide-versus-once-daily-insulin-glulisine-in-type-2-diabetes-patients-on-insulin-glargine-an-8-week-randomised-open-label-trial
#19
Lennart Tonneijck, Marcel H A Muskiet, Mark M Smits, Trynke Hoekstra, Mark H H Kramer, A H Jan Danser, Michaela Diamant, Jaap A Joles, Daniël H van Raalte
AIMS: To determine whether lixisenatide, a prandial short-acting glucagon-like peptide receptor agonist (GLP-1RA), ameliorates postprandial glomerular hyperfiltration in type 2 diabetes mellitus (T2DM)-patients compared to insulin-glulisine (iGlu) . METHODS: Postprandial renal haemodynamic effects of 8-week treatment with lixisenatide 20 µg versus once-daily titrated iGlu were measured in 35 overweight T2DM-patients inadequately controlled on insulin-glargine, with or without metformin (mean±SD age 62 ± 7years, HbA1c 8...
April 27, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28444472/the-effect-of-sodium-glucose-co-transporter-2-sglt-2-inhibitors-on-cardiometabolic-profile-beyond-the-hypoglycaemic-action
#20
Eirini Lioudaki, Emmanouil S Androulakis, Martin Whyte, Konstantinos G Stylianou, Eugenios K Daphnis, Emmanouil S Ganotakis
Type 2 diabetes mellitus (T2DM) has growing prevalence worldwide and major clinical implications, chiefly cardiovascular (CV) and renal disease burden. Sodium-glucose co-transporter (SGLT)-2 inhibitors are a new drug class in the management of T2DM with a mechanism of action independent of insulin. In addition to their hypoglycaemic effect, SGLT-2 inhibitors appear to have haemodynamic and nephroprotective effects. Studies have consistently showed a modest but significant blood pressure (BP) reduction. Metabolic benefits are also attributed to SGLT-2 inhibitors with a modest but consistent body weight decrease recorded along with improvements in lipid profile and uric acid levels...
April 25, 2017: Cardiovascular Drugs and Therapy
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