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https://www.readbyqxmd.com/read/29049712/easy-technique-for-emergency-fenestration-in-non-fenestrated-fontan-patients
#1
Qiang Fan, Yunfei Ling, Yabo Wang, Qi An
The Fontan procedure is a commonly used final pathway of palliation for single-ventricle physiology. Performing it without fenestration can avoid fenestration-related drawbacks, including subnormal oxygen saturation, decreased exercise tolerance, paradoxical embolization and subsequent need for closure by catheter intervention. If emergency fenestration is required, however, it is not always technically easy to perform, particularly when the atrium is posteriorly located and difficult to expose. We describe an easy technique for creating an anastomosis using a ring-supported polytetrafluoroethylene graft to the atrium for fenestration, performed in 2 patients who underwent extracardiac conduit Fontan procedures without fenestration...
July 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049710/the-effect-of-antegrade-pulmonary-blood-flow-following-a-late-bidirectional-glenn-procedure
#2
Tao Yan, Guang Tong, Ben Zhang, Feng Yan, Xuan Zhou, Xianyue Wang, Hua Lu, Tao Ma, Xiaowu Wang, Hao Yu, Zhongchan Sun, Weida Zhang
OBJECTIVES: The effect of antegrade pulmonary blood flow (APBF) has never been studied in the bidirectional Glenn (BDG) procedure performed late. METHODS: Records of 112 consecutive patients who had a BDG procedure during a 10-year period were reviewed retrospectively. The patients were divided into 2 groups based on whether APBF occurred following the BDG procedure (APBF group, n = 81) or not (non-APBF group, n = 31). The median age at the BDG procedure was 6...
October 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049537/bilateral-bidirectional-glenn-outcome-of-off-pump-technique
#3
Ashraf A H El Midany, Ezzeldin A Mostafa, Sherif A Mansour, Mohammed Saffan, Mahmoud Zalat, Ismail N El-Sokkary, Ahmed M E Aletreby
OBJECTIVES: Off-pump bilateral bidirectional Glenn (b-BDG) poses a surgical challenge and may add complexity to the postoperative outcome especially regarding uniformity of the anastomosis and central pulmonary artery growth. Herein, we report early- and mid-term outcomes after off-pump b-BDG without using superior vena cava decompression techniques. METHODS: Ninety-seven consecutive patients, between 2009 and 2014, were included in this prospective study. All patients had complete pre- and postoperative clinical and detailed neurological assessments...
June 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049225/factors-related-to-pediatric-obstructive-sleep-apnea-hypopnea-syndrome-in-children-with-attention-deficit-hyperactivity-disorder-in-different-age-groups
#4
Jiali Wu, Meizhen Gu, Shumei Chen, Wei Chen, Kun Ni, Hongming Xu, Xiaoyan Li
This study aimed to retrospectively investigate the factors related to pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) with attention deficit hyperactivity disorder (ADHD) in children younger than 6 years and those older than 6 years.A total of 437 children who were hospitalized due to OSAHS between January 2014 and December 2014 were retrospectively reviewed. The children were further divided into OSAHS group and OSAHS + ADHD group. The general characteristics, OSA-18 quality of life, intention-hyperactivity score, and polysomnographic parameters (apnea-hypopnea index and the lowest oxygen saturation) were collected and compared between groups...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049136/comparisons-of-traditional-metabolic-markers-and-compensatory-reserve-as-early-predictors-of-tolerance-to-central-hypovolemia-in-humans
#5
Alicia M Schiller, Jeffrey T Howard, Kristen R Lye, Christian G Magby, Victor A Convertino
Circulatory shock remains a leading cause of death in both military and civilian trauma. Early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes. Individual tolerance to reduced central blood volume can serve as a model to assess the sensitivity and specificity of vital sign measurements. The compensatory reserve (CRM) is the measurement of this capacity. Measurements of muscle oxygen saturation (SmO2), blood lactate and end tidal CO2 (EtCO2) have recently gained attention as prognostic tools for early assessment of the status of patients with progressive hemorrhage, but lack the ability to adequately differentiate individual tolerance to hypovolemia...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29048941/patient-perceptions-of-the-adequacy-of-supplemental-oxygen-therapy-results-of-the-american-thoracic-society-nursing-assembly-oxygen-working-group-survey
#6
Susan S Jacobs, Kathleen O Lindell, Eileen G Collins, Chris M Garvey, Carme Hernandez, Sally McLaughlin, Ann M Schneidman, Paula M Meek
RATIONALE: Pulmonary clinicians and patients anecdotally report barriers to home supplemental oxygen services including inadequate supply, unacceptable portable options, and equipment malfunction. Limited evidence exists to describe or quantify these problems. OBJECTIVE: To describe the frequency and type of problems experienced by supplemental oxygen users in the United States. METHODS: The Patient Supplemental Oxygen Survey, a self-report questionnaire, was posted on the American Thoracic Society (ATS) Public Advisory Roundtable and patient and healthcare-affiliated websites...
October 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29048708/effect-of-the-midazolam-addition-the-propofol-based-sedation-in-esophagogastroduodenoscopy-a-randomized-trial
#7
Eun Hye Kim, Jun Chul Park, Sung Kwan Shin, Yong Chan Lee, Sang Kil Lee
BACKGROUND: Although propofol has been widely used for sedation during esophagogastroduodenoscopy (EGD), adverse events including hypoxia and hypotension may be a concern in the propofol-based sedation. We aimed to analyze whether administration of midazolam would improve safety and efficacy of propofol-based sedation in EGD. METHODS: One hundred twenty patients who were scheduled to undergo diagnostic EGD were randomly assigned to either midazolam plus propofol (MP) or propofol alone groups...
October 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29048407/pulse-oximetry-screening-for-critical-congenital-heart-diseases-at-two-different-hospital-settings-in-thailand
#8
P Nuntnarumit, P Thanomsingh, A Limrungsikul, S Wanitkun, T Sirisopikun, P Ausayapao
OBJECTIVE: To evaluate the predictive abilities of pulse oximetry screening (POS) for critical congenital heart disease (CRIT.CHD) at two different hospital settings in Thailand. STUDY DESIGN: The study was conducted in healthy newborns at Ramathibodi Hospital (RH), a university hospital and Maharat Nakhon Ratchasima Hospital (MH), a regional hospital. Positive POS was defined as oxygen saturation (SpO2) <95% or difference between pre- and postductal SpO2 >3%...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29048404/association-of-unit-wide-oxygen-saturation-target-on-incidence-of-pulmonary-hypertension-in-very-low-birthweight-premature-infants
#9
U Kanaan, B Srivatsa, J Huckaby, M Kelleman
OBJECTIVE: Assess the effect of increasing pulse oximetry targets on incidence of pulmonary hypertension in very low birthweight premature infants. STUDY DESIGN: Retrospective cohort study comparing pulmonary hypertension incidence among three cohorts of premature infants exposed to varying oxygen saturation targets (Cohort 1: n=459, 1 May 2009 to 30 April 2011, 85-94%; Cohort 2: n=474, 1 May 2011 to 31 May 2013, 88-94%; Cohort 3: n=387, 1 June 2013 to 31 May 2015, 90-95%)...
October 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29047091/hydrogen-sulfide-as-an-o2-sensor-a-critical-analysis
#10
Jesus Prieto-Lloret, Philip I Aaronson
There is increasing interest in the physiological actions and therapeutic potential of the gasotransmitter hydrogen sulfide (H2S). In addition to exerting antihypertensive, anti-inflammatory, antioxidant, and pro-angiogenic effects, H2S has been suggested to play a central and ubiquitous role in O2 sensing. According to this concept, because H2S is metabolized by oxidation, its cellular concentration varies inversely with the ambient pO2 such that hypoxia causes a rise in intracellular [H2S]; this then acts to induce appropriate cellular responses...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#11
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046213/-changes-in-blood-oxygen-metabolism-indices-and-their-clinical-significance-in-children-with-septic-shock
#12
Ling-Yang Xu, Ding Xu
The key to the treatment of septic shock is to provide adequate oxygen supply and improve tissue perfusion. Lactate and central venous oxygen saturation (ScvO2) are commonly used as the indices of oxygen metabolism, but tissue hypoxia may still exist even when lactate and ScvO2 are within the normal range. Arteriovenous difference in carbon dioxide partial pressure (CO2 gap) can accurately reflect oxygen delivery when ScvO2 is in the normal range. This article reviews the advantages and shortages of lactate, lactate clearance rate, ScvO2, and CO2 gap in evaluating tissue hypoxia, in order to provide a reference for treatment and severity evaluation of septic shock...
October 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29045954/-pulmonary-arterial-hypertension-as-leading-manifestation-of-methylmalonic-aciduria-clinical-characteristics-and-gene-testing-in-15-cases
#13
X Q Liu, H Yan, J X Qiu, C Y Zhang, J G Qi, X Zhang, H J Xiao, Y L Yang, Y H Chen, J B DU
OBJECTIVE: To deepen our understanding of Methylmalonic aciduria (MMA) associated pulmonary hypertension (PH) by analyzing the characteristics of clinical presentation, pulmonary high resolusion CT(HRCT), treatment response and gene mutation. METHODS: This study includes 15 cases of pediatric patients with MMA associated PH diagnosed and treated in Peking University First Hospital pediatric department between May 2012 and May 2016 with symptoms of PH as their leading presentation...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29045578/effectiveness-of-enhanced-pulse-oximetry-sonifications-for-conveying-oxygen-saturation-ranges-a-laboratory-comparison-of-five-auditory-displays
#14
E Paterson, P M Sanderson, N A B Paterson, R G Loeb
Background: Anaesthetists monitor auditory information about a patient's vital signs in an environment that can be noisy and while performing other cognitively demanding tasks. It can be difficult to identify oxygen saturation (SpO2) values using existing pulse oximeter auditory displays (sonifications). Methods: In a laboratory setting, we compared the ability of non-clinician participants to detect transitions into and out of an SpO2 target range using five different sonifications while they performed a secondary distractor arithmetic task in the presence of background noise...
October 13, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29044805/the-relationship-between-forearm-skin-speed-resolved-perfusion-and-oxygen-saturation-and-finger-arterial-pulsation-amplitudes-as-indirect-measures-of-endothelial-function
#15
Sara Bergstrand, Maria-Aurora Morales, Giuseppe Coppini, Marcus Larsson, Tomas Strömberg
OBJECTIVE: Endothelial function is important for regulating peripheral blood flow to meet varying metabolic demands and can be measured indirectly during vascular provocations. In this study, we compared the peripheral arterial tonometry finger response (EndoPAT) after a 5 min arterial occlusion to that from forearm skin comprehensive microcirculation analysis (Enhanced Perfusion and Oxygen Saturation, EPOS). METHOD: Measurements in 16 subjects with varying cardiovascular risk factors were done concurrently with both methods during arterial occlusion, while forearm skin was also evaluated during local heating RESULTS: Peak values for EPOS skin conventional perfusion and speed resolved total perfusion after the release of the occlusion, were significantly correlated to the EndoPAT reactive hyperemia index (RHI; ρ=0...
October 16, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29044337/beneficial-effects-of-intradialytic-cardiopulmonary-rehabilitation
#16
Bruno Medeiros Guio, Carlos Perez Gomes, Fabio Brandão da Costa, Adriana Dos Santos de Oliveira, Marta Turano Duarte, Maurilo Leite
INTRODUCTION: Patients on hemodialysis (HD) present high mortality from cardiovascular complications and high morbidity, including decreasing functional capacity and quality of life. OBJECTIVE: To analyze clinical and laboratory responses of patients in HD to intradialytic cardiopulmonary rehabilitation on an outpatient basis. METHODS: We evaluated 14 patients in a prospective study for 8 months using cardiopulmonary rehabilitation protocol (CRehab) consisted of intradialytic aerobic exercise with a cycle ergometer...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29043714/spectroscopic-doppler-analysis-for-visible-light-optical-coherence-tomography
#17
Xiao Shu, Wenzhong Liu, Lian Duan, Hao F Zhang
Retinal oxygen metabolic rate can be effectively measured by visible-light optical coherence tomography (vis-OCT), which simultaneously quantifies oxygen saturation and blood flow rate in retinal vessels through spectroscopic analysis and Doppler measurement, respectively. Doppler OCT relates phase variation between sequential A-lines to the axial flow velocity of the scattering medium. The detectable phase shift is between -π and π due to its periodicity, which limits the maximum measurable unambiguous velocity without phase unwrapping...
October 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29043600/effects-of-ultrasound-guided-stellate-ganglion-block-on-sleep-and-regional-cerebral-oxygen-saturation-in-patients-undergoing-breast-cancer-surgery-a-randomized-controlled-double-blinded-trial
#18
Feng Jin, Xiao-Qian Li, Wen-Fei Tan, Hong Ma, Bo Fang, A-Yong Tian, Huang-Wei Lu
Numerous factors could contribute to sleep disturbances in women with breast cancer. We hypothesized that stellate ganglion block (SGB) during surgery would preserve sleep after surgery and increase intraoperative regional cerebral oxygen saturation (rSO2) on the blocked side in patients undergoing breast cancer surgery. A randomized, double-blinded, controlled trial was conducted at the First Hospital of China Medical University from January 2016 to September 2016. Ninety-six patients who underwent radical breast cancer surgery requiring general anaesthesia were randomly assigned to one of two study groups: a control group that received a saline SGB and a block group that received a 0...
October 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29043406/predictive-value-of-scvo2-monitoring-for-pericardial-tamponade-after-cardiac-surgery
#19
S Saha, H Baraki, I Kutschka, J Hadem
BACKGROUND: We examined the predictive value of central venous oxygen saturation (ScvO2) changes regarding the occurrence of pericardial tamponade following cardiac surgery. METHODS: We retrospectively identified 66 consecutive patients in whom ScvO2 and arterial lactate levels were analyzed during an 8‑h time interval preceding pericardiotomy due to pericardial tamponade (PT), and at equivalent time points in 30 control patients (C) who had an uncomplicated course...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29042272/effect-of-dietary-nitrate-on-respiratory-physiology-at-high-altitude-results-from-the-xtreme-alps-study
#20
Andrew Cumpstey, Philip J Hennis, Edward T Gilbert-Kawai, Bernadette O Fernandez, Matthieu Poudevigne, Alexandra Cobb, Paula Meale, Kay Mitchell, Helen Moyses, Helmut Pöhnl, Monty G Mythen, Michael P W Grocott, Martin Feelisch, Daniel S Martin
Nitric oxide (NO) production plays a central role in conferring tolerance to hypoxia. Tibetan highlanders, successful high-altitude dwellers for millennia, have higher circulating nitrate and exhaled NO (ENO) levels than native lowlanders. Since nitrate itself can reduce the oxygen cost of exercise in normoxia it may confer additional benefits at high altitude. Xtreme Alps was a double-blinded randomised placebo-controlled trial to investigate how dietary nitrate supplementation affects physiological responses to hypoxia in 28 healthy adult volunteers resident at 4559 m for 1 week; 14 receiving a beetroot-based high-nitrate supplement and 14 receiving a low-nitrate 'placebo' of matching appearance/taste...
October 14, 2017: Nitric Oxide: Biology and Chemistry
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