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https://www.readbyqxmd.com/read/29782356/acute-neurologic-complications-during-extracorporeal-membrane-oxygenation-a-systematic-review
#1
Raoul Sutter, Kai Tisljar, Stephan Marsch
OBJECTIVES: We determine the frequency, risk factors, and mortality of neurologic complications in adults on extracorporeal membrane oxygenation and propose an algorithm for preventive strategies. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify cohort studies reporting neurologic complications in adults during extracorporeal membrane oxygenation from 1990 to 2017...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29780070/chronic-obstructive-pulmonary-disease-and-off-pump-coronary-surgery
#2
Cengiz Ovalı, Aykut Şahin
PURPOSE: To determine to what extent chronic obstructive pulmonary disease (COPD) affects mortality and morbidity rates in patients treated with off-pump coronary artery bypass graft (CABG). METHODS: A total of 321 patients treated with off-pump CABG were included in the present study. Of the 321 patients, 46 patients had COPD and they were designated as Group 1 and the remaining 275 patients did not have COPD and they were considered as Group 2. We compared the data obtained from the patients in both groups...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#3
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#4
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#5
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29774622/pediatric-marginal-donor-hearts-trends-in-us-national-use-2005-2014
#6
Adam K Morrison, Charitha Gowda, Dmitry Tumin, Christina M Phelps, Don Hayes, Joseph Tobias, Robert J Gajarski, Deipanjan Nandi
Pediatric patients awaiting heart transplant face high mortality rates due to donor organ shortages, including non-use of marginal donor hearts. We examined national trends in pediatric marginal donor heart use over time. UNOS data were queried for heart donors <18 years from 2005 to 2014. The proportion of donor hearts considered marginal was determined using previously cited marginal characteristics: left ventricular ejection fraction (LVEF) <50%, use of ≥2 inotropes, cerebrovascular death, CDC high-risk status, and eGFR < 30 mL/min/1...
May 17, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#7
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#8
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29772353/cardiac-profile-of-chimeric-antigen-receptor-car-t-cell-therapy-in-children-a-single-institution-experience
#9
Danielle Burstein, Shannon Maude, Stephen Grupp, Heather Griffis, Joseph Rossano, Kimberly Lin
BACKGROUND: Immunotherapy with chimeric antigen receptor (CAR)-modified T-cells targeting CD19 for pediatric acute lymphoblastic leukemia (ALL) has demonstrated significant efficacy. The principle toxicity is cytokine release syndrome with resultant hypotension. However, the spectrum of cardiovascular effects associated with CAR T-cell therapy has not been systematically evaluated. METHODS: We reviewed all patients who received CD19-directed CAR T-cells at the Children's Hospital of Philadelphia between April 2012 and September 2016...
May 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29767322/management-of-cardiogenic-shock-complicating-myocardial-infarction
#10
REVIEW
Alexandre Mebazaa, Alain Combes, Sean van Diepen, Alexa Hollinger, Jaon N Katz, Giovanni Landoni, Ludhmila Abrahao Hajjar, Johan Lassus, Guillaume Lebreton, Gilles Montalescot, Jin Joo Park, Susanna Price, Alessandro Sionis, Demetris Yannopolos, Veli-Pekka Harjola, Bruno Levy, Holger Thiele
Up to 10% of acute coronary syndromes are complicated by cardiogenic shock (CS) with contemporary mortality rates of 40-50%. The extent of ischemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis in this patient population. Individualized patient risk assessment plays an important role in determining appropriate revascularization, drug treatment with inotropes and vasopressors, mechanical circulatory support, intensive care support of other organ systems, hospital level of care triage, and allocation of clinical resources...
May 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#11
Pavel Szturz, Pavel Folwarczny, Roman Kula, Jan Neiser, Pavel Ševčík, Jan Benes
BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopresors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi- parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#12
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754457/cardioprotective-role-of-igf-1-in-the-hypertrophied-myocardium-of-the-spontaneously-hypertensive-rats-a-key-effect-on-nhe-1-activity
#13
Alejandra M Yeves, Juan I Burgos, Andrés J Medina, M Celeste Villa-Abrille, Irene L Ennis
AIM: Myocardial Na+ /H+ exchanger-1 (NHE-1) hyperactivity and oxidative stress are interrelated phenomena playing pivotal roles in the development of pathological cardiac hypertrophy and heart failure. Exercise training is effective to convert pathological into physiological hypertrophy in the spontaneously hypertensive rats (SHR) and IGF-1 -key humoral mediator of exercise training- inhibits myocardial NHE-1, at least in normotensive rats. Therefore, we hypothesize that IGF-1 by hampering NHE-1 hyperactivity and oxidative stress should exert a cardioprotective effect in the SHR...
May 13, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#14
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753687/istaroxime-a-positive-inotropic-agent-devoid-of-proarrhythmic-properties-in-sensitive-chronic-atrioventricular-block-dogs
#15
Alexandre Bossu, Amée Kostense, Henriette D M Beekman, Marien J C Houtman, Marcel A G van der Heyden, Marc A Vos
Current inotropic agents in heart failure therapy associate with low benefit and significant adverse effects, including ventricular arrhythmias. Istaroxime, a novel Na+ /K+ -transporting ATPase inhibitor, also stimulates SERCA2a activity, which would confer improved inotropic and lusitropic properties with less proarrhythmic effects. We investigated hemodynamic, electrophysiological and potential proarrhythmic and antiarrhythmic effects of istaroxime in control and chronic atrioventricular block (CAVB) dogs sensitive to drug-induced Torsades de Pointes arrhythmias (TdP)...
May 10, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29752171/association-between-furosemide-exposure-and-patent-ductus-arteriosus-in-hospitalized-infants-of-very-low-birth-weight
#16
Elizabeth J Thompson, Rachel G Greenberg, Karan Kumar, Matthew Laughon, P Brian Smith, Reese H Clark, Andromeda Crowell, Layla Shaw, Louis Harrison, Gabrielle Scales, Nicole Bell, Christoph P Hornik
OBJECTIVE: To evaluate the association between furosemide exposure and patent ductus arteriosus (PDA) in a large, contemporary cohort of hospitalized infants with very low birth weight (VLBW). STUDY DESIGN: Using the Pediatrix Medical Group Clinical Data Warehouse, we identified all inborn infants of VLBW <37 weeks of gestation discharged from the neonatal intensive care unit after the first postnatal week from 2011 to 2015. We defined PDA as any medical (ibuprofen or indomethacin) or surgical PDA therapy...
May 8, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29750687/evaluation-of-clinical-outcomes-with-phosphodiesterase-5-inhibitor-therapy-for-right-ventricular-dysfunction-after-left-ventricular-assist-device-implantation
#17
Katherine L Roberts, Jerrica E Shuster, Nicholas S Britt, Keki R Balsara, Thomas J Graetz, Mohammad Helwani, Akinobu Itoh, Bethany R Tellor
Few studies have evaluated the use of phosphodiesterase-5 inhibitors (PDE5-i) for right ventricular (RV) dysfunction after left ventricular assist device (LVAD) implantation. The study purpose was to examine the impact of postoperative inpatient PDE5-i therapy on clinical outcomes in patients with LVADs. This single-center, retrospective cohort study screened 428 LVAD recipients between January 2011 and May 2015 for eligibility. Subjects receiving post-LVAD PDE5-i were compared with those who did not. The primary outcome was the proportion of all-cause hospital readmission at 30 days...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29748076/comparison-of-levosimendan-and-milrinone-for-ecls-weaning-in-patients-after-cardiac-surgery-a-retrospective-before-and-after-study
#18
Annina Jacky, Alain Rudiger, Bernard Krüger, Markus J Wilhelm, Sebastian Paal, Burkhardt Seifert, Donat R Spahn, Dominique Bettex
OBJECTIVES: Pharmacodynamics suggests that levosimendan might be a valuable inotrope for weaning from extracorporeal life support (ECLS). As there is a paucity of evidence regarding the effectiveness and safety of such an approach, the aim was to report the authors' experiences in ECLS weaning before and after the implementation of levosimendan in clinical practice. DESIGN: Retrospective before-and-after study. SETTING: Cardiac intensive care unit of a university hospital...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29745073/hemodynamic-stability-achievement-by-application-of-goal-directed-fluid-therapy-with-different-infusion-solutions-in-colorectal-surgery
#19
Ana Cvetkovic, Nevena Kalezic, Biljana Milicic, Srdjan Nikolic, Milan Zegarac, Dejan Stojiljkovic, Merima Goran, Marina Stojanovic
PURPOSE: To determine whether there was a correlation between the type of administered infusion solutions intraoperatively with the quantity of administered infusion solutions, differences in values of cardiac output (CO) and cardiac index (CI) and need to use vasopressors and inotropes, between control and research groups. METHODS: This randomized prospective study included 55 patients with colorectal cancer. Subjects in the control group received only crystalloid solutions intraoperatively and postoperatively...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#20
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
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