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Circulatory arrest

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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/29349365/d%C3%A3-bridement-of-atheroma-in-the-proximal-clamp-site-under-hypothermic-circulatory-arrest-for-repair-of-abdominal-aortic-aneurysm-with-severe-atherosclerosis
#2
Takashi Yamauchi, Suguru Kubota, Kosei Hasegawa
Postoperative renal and other ischemic complications due to atheroembolization after clamping of the proximal site of an abdominal aortic aneurysm are catastrophic. We present here a method of débridement of atheroma and clamping under hypothermic circulatory arrest to avoid iatrogenic atheroembolization.
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29346537/cerebral-mitochondrial-dysfunction-associated-with-deep-hypothermic-circulatory-arrest-in-neonatal-swine
#3
Constantine D Mavroudis, Michael Karlsson, Tiffany Ko, Marco Hefti, Javier I Gentile, Ryan W Morgan, Ross Plyler, Kobina G Mensah-Brown, Timothy W Boorady, Richard W Melchior, Tami M Rosenthal, Brandon C Shade, Kellie L Schiavo, Susan C Nicolson, Thomas L Spray, Robert M Sutton, Robert A Berg, Daniel J Licht, J William Gaynor, Todd J Kilbaugh
OBJECTIVES: Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model. METHODS: Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia...
January 15, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29341860/risk-management-of-free-radicals-involved-in-air-travel-syndromes-by-antioxidants
#4
Jeum-Nam Kim, Byung-Mu Lee
Frequent air travelers and airplane pilots may develop various types of illnesses. The environmental risk factors associated with air travel syndromes (ATS) or air travel-related adverse health outcomes raised concerns and need to be assessed in the context of risk management and public health. Accordingly, the aim of the present review was to determine ATS, risk factors, and mechanisms underlying ATS using scientific data and information obtained from Medline, Toxline, and regulatory agencies. Additional information was also extracted from websites of organizations, such as the International Air Transport Association (IATA), International Association for Medical Assistance to Travelers (IAMAT), and International Civil Aviation Organization (ICAO)...
January 17, 2018: Journal of Toxicology and Environmental Health. Part B, Critical Reviews
https://www.readbyqxmd.com/read/29339713/neuroprotective-effect-of-selective-antegrade-cerebral-perfusion-during-prolonged-deep-hypothermic-circulatory-arrest-cerebral-metabolism-evidence-in-a-pig-model
#5
Zhixian Tang, Mengya Liang, Guangxian Chen, Jian Rong, Jianping Yao, Zhen Chen, Xiao Yang, Zhongkai Wu
OBJECTIVE: The aim of this study was to elucidate the mechanism of cerebral injury and to evaluate selective antegrade cerebral perfusion (SACP) as a superior neuroprotective strategy for prolonged deep hypothermic circulatory arrest (DHCA). METHODS: Twelve pigs (6-8-week old) were randomly assigned to DHCA alone (n=6) and DHCA with SACP (n=6) at 18°C for 80 min groups. Serum S100 was determined using an immunoassay analyzer. The concentrations of cerebral dialysate glucose, lactate, pyruvate, glycerol, and glutamate were measured using a microdialysis analyzer...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29338863/in-elective-arch-surgery-with-circulatory-arrest-does-the-arterial-cannulation-site-really-matter-a-propensity-score-analysis-of-right-axillary-and-innominate-artery-cannulation
#6
Ourania Preventza, Matt D Price, Konstantinos Spiliotopoulos, Hiruni S Amarasekara, Lorraine D Cornwell, Shuab Omer, Kim I de la Cruz, Qianzi Zhang, Susan Y Green, Scott A LeMaire, Todd K Rosengart, Joseph S Coselli
OBJECTIVE: The preferred arterial cannulation site for elective proximal aortic procedures requiring circulatory arrest varies, and different sites have been tried. We evaluated the relationships between arterial cannulation site and adverse outcomes, including stroke, in patients undergoing elective aortic arch surgery. METHODS: We reviewed the records of 938 patients who underwent elective hemiarch or total arch surgery with circulatory arrest between 2006 and 2016...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338669/successful-operative-treatment-of-uterine-leiomyoma-with-extensive-intravenous-extension-to-the-ivc-right-heart-and-pulmonary-arteries
#7
Ranjeet Brar, Alicia Skervin, Karim El-Sakka, Andrew Fish, Michael Lewis
INTRODUCTION: Intravenous extension of benign uterine leiomyomata ('fibroids'), in the absence of discrete metastatic disease has rarely been reported. 'Fibroids' remain one of the most common premenopausal uterine pathologies. METHODS AND RESULTS: We report the diagnosis and multidisciplinary led operative management of a 52-year-old woman with a histologically benign, but biologically aggressive, uterine leiomyoma with intravenous extension to the inferior vena cava (IVC), right heart and pulmonary arteries...
January 17, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29336968/reappearance-of-motor-evoked-potentials-during-the-rewarming-phase-after-deep-hypothermic-circulatory-arrest
#8
Eiki Kanemaru, Kenji Yoshitani, Shinya Kato, Yuichi Tanaka, Yoshihiko Ohnishi
OBJECTIVE: Although motor-evoked potentials (MEPs) disappear in deep hypothermic circulatory arrest (DHCA), MEPs have been used to confirm whether motor function is intact after DHCA. It is crucial to know the timing, body temperature, and MEP amplitude at MEP reappearance to detect spinal cord ischemia after DHCA. However, data on these parameters are sparse. The authors investigated the characteristics of MEPs at reappearance after DHCA. DESIGN: A retrospective observational study...
June 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29331091/terminal-spreading-depolarization-and-electric-silence-in-death-of-human-cortex
#9
Jens P Dreier, Sebastian Major, Brandon Foreman, Maren K L Winkler, Eun-Jeung Kang, Denny Milakara, Coline L Lemale, Vince DiNapoli, Jason M Hinzman, Johannes Woitzik, Norberto Andaluz, Andrew Carlson, Jed A Hartings
OBJECTIVE: Restoring the circulation is the primary goal in emergency treatment of cerebral ischemia. However, better understanding of how the brain responds to energy depletion could inform the time available for resuscitation until irreversible damage and advance development of interventions that prolong this span. Experimentally, injury to central neurons begins only with anoxic depolarization. This potentially reversible, spreading wave typically starts 2-5 min after the onset of severe ischemia, marking the onset of a toxic intraneuronal change that eventually results in irreversible injury...
January 13, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29329188/the-impact-of-combined-warm-ischemia-time-on-development-of-acute-kidney-injury-in-donation-after-circulatory-death-liver-transplantation-stay-within-the-golden-hour
#10
Marit Kalisvaart, Andrea Schlegel, Ilaria Umbro, Jubi E de Haan, Irene Scalera, Wojciech G Polak, Jan Nm IJzermans, Darius F Mirza, M Thamara Pr Perera, John I Isaac, James Ferguson, Anna Paola Mitterhofer, Jeroen de Jonge, Paolo Muiesan
BACKGROUND: Acute kidney injury (AKI) is a common complication after liver transplantation and more frequently observed when high-risk grafts, such as DCD grafts are used. Our aim was to investigate the impact of the ischemia periods on development of AKI in DCD liver transplantation. METHODS: We performed a 2-center retrospective study with 368 DCD graft-recipients. Donor warm ischemia time (DWIT) was divided into agonal phase (withdrawal of life-support - cardiac arrest) and asystolic phase (cardiac arrest - start cold perfusion)...
January 11, 2018: Transplantation
https://www.readbyqxmd.com/read/29317058/whole-body-periodic-acceleration-pgz-as-a-non-invasive-preconditioning-strategy-for-pediatric-cardiac-surgery
#11
Jose A Adams, Peter Pastuszko, Arkady Uryash, David Wilson, Jose R Lopez Padrino, Vinay Nadkarni, Anna Pastuszko
We hypothesized that pGz has cardio and neuroprotective effects due to upregulation of pathways which include eNOS, anti-apoptotic, and anti-inflammatory pathways. We analyze protein expression of these pathways in the brain of neonatal piglets, as well as report on the myocardial function after Deep Hypothermic Circulatory Arrest (DHCA) and pGz preconditioning. Animal data affirms both a cardio and neuroprotective role for pGz. These findings suggest that pGz can be a simple, non-invasive cardio and neuroprotective strategy preconditioning strategy in children requiring surgical intervention...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#12
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29302600/a-few-realistic-questions-raised-by-organ-retrieval-in-the-intensive-care-unit
#13
REVIEW
Olivier Lesieur, Liliane Genteuil, Maxime Leloup
Organ transplantation saves the lives of many persons who would otherwise die from end-stage organ disease. The increasing demand for donated organs has led to a renewed interest in donation after circulatory determination of death (CDD). In many countries (including France), terminally ill patients who die of circulatory arrest after a planned withdrawal of life support may be considered as organ donors under certain conditions. While having equal responsibility towards the potential donor and the persons awaiting a transplant, caregivers may experience an ethical dilemma between the responsibility to deliver the best care to the dying, and the need to retrieve the organs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29299821/brain-protection-in-aortic-arch-aneurysm-antegrade-or-retrograde
#14
Amer Harky, Matthew Fok, Mohamad Bashir, Anthony L Estrera
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery...
January 3, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29284512/quantifying-the-learning-curve-for-pulmonary-thromboendarterectomy
#15
Smita Sihag, Bao Le, Alison S Witkin, Josanna M Rodriguez-Lopez, Mauricio A Villavicencio, Gus J Vlahakes, Richard N Channick, Cameron D Wright
BACKGROUND: Pulmonary thromboendarterectomy (PTE) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but is a technically challenging operation for cardiothoracic surgeons. Starting a new program allows an opportunity to define a learning curve for PTE. METHODS: A retrospective case review was performed of 134 consecutive PTEs performed from 1998 to 2016 at a single institution. Outcomes were compared using either a two-tailed t-test for continuous variables or a chi-squared test for categorical variables according to experience of the program by terciles (T)...
December 28, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29282149/the-effect-of-angiotensin-ii-on-blood-pressure-in-patients-with-circulatory-shock-a-structured-review-of-the-literature
#16
Laurence W Busse, Michael T McCurdy, Osman Ali, Anna Hall, Huaizhen Chen, Marlies Ostermann
BACKGROUND: Circulatory shock is a common syndrome with a high mortality and limited therapeutic options. Despite its discovery and use in clinical and experimental settings more than a half-century ago, angiotensin II (Ang II) has only been recently evaluated as a vasopressor in distributive shock. We examined existing literature for associations between Ang II and the resolution of circulatory shock. METHODS: We searched PubMed, MEDLINE, Ovid, and Embase to identify all English literature accounts of intravenous Ang II in humans for the treatment of shock (systolic blood pressure [SBP] ≤ 90 mmHg or a mean arterial pressure [MAP] ≤ 65 mmHg), and hand-searched the references of extracted papers for further studies meeting inclusion criteria...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29274695/diminutive-porcelain-ascending-aorta-with-supravalvular-aortic-stenosis
#17
Mustafa Houmsse, Asia McDavid, Ahmet Kilic
This case report describes a case of a 49-year-old male, with a past medical history significant for congenital aortic stenosis, who presented with progressive shortness of breath and decreased stamina. The patient was found to have a concentric, diminutive porcelain ascending aorta with diffuse supravalvular aortic stenosis. Herein we describe treatment with an aortic root augmentation and Bentall procedure utilizing hypothermic circulatory arrest.
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29274600/evidence-of-intimal-tear-in-type-a-intramural-hematoma-of-the-aorta-a-case-series
#18
Gianfranco Filippone, Giovanni Caruana, Claudia Calia, Violetta Moscaritolo, Vincenzo Argano
INTRODUCTION: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease. PRESENTATION OF CASES: We report two patients admitted to our institution with sudden onset thoracic pain...
December 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29258403/a-novel-augmented-venous-drainage-model-of-cardiopulmonary-bypass-for-deep-hypothermic-circulatory-arrest-without-blood-priming
#19
Xuan Jiang, Tianxiang Gu, Yu Liu, Chun Wang, Enyi Shi, Guangwei Zhang
OBJECTIVE: Cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) are commonly used in cardiac surgery. However, the mortality and morbidity are still high in practice. Developing novel protective stategies and elucidating the underlying mechanisms for the pathophysiological consequences of DHCA have been hampered because of the absence of a satisfactory recovery animal model. The aim of this study was to establish a novel and safe DHCA model without blood priming in rats to study the pathophysiology of potential complications...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29249769/open-conversion-for-type-a-ascending-aortic-dissection-after-thoracic-endovascular-aortic-repair-by-the-chimney-graft-technique
#20
Hirofumi Kasahara, Yoshito Inoue, Takashi Hachiya
An 83-year-old man with aortic arch aneurysm underwent zone 0 thoracic endovascular aortic repair (TEVAR) by the chimney graft technique with two supra-aortic arch debranching grafts and developed subacute type A ascending aortic dissection. We performed emergency open conversion with circulatory arrest under deep hypothermia. The tip of the chimney graft (around the sino-tubular junction in the ascending aorta) was stiff, making it difficult to inspect the lumen and perform anastomosis. Deep hypothermic circulatory arrest and cutting the endograft stents to mobilize the graft were necessary for secure anastomosis...
December 18, 2017: Annals of Thoracic and Cardiovascular Surgery
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