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https://www.readbyqxmd.com/read/29747290/-the-relationship-between-arterial-blood-lactate-clearance-prognosis-and-myocardial-damage-in-patients-with-septic-shock-after-early-goal-directed-therapy
#1
X L Shang, D W Liu, X T Wang, H W He, H M Zhang, L X Su, P Pan
Objective: To evaluate the prognostic value of arterial blood lactate clearance based on central venous oxygen saturation and perfusion index in patients with septic shock related myocardial injury after early goal-directed therapy. Methods: One hundred and fifty-seven patients with septic shock after early resuscitation were enrolled from August 2013 to July 2016 in ICU at Peking Union Medical College Hospital. Parameters indicating early resuscitation included central venous pressure (CVP) 8-12 mmHg (1 mmHg=0...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#2
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#3
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29671035/-prognostic-relevance-of-tissue-oxygen-saturation-in-patients-in-the-early-stage-of-multiple-organ-dysfunction-syndrome
#4
D Huster, F Härtel, S Nuding, J Schroeder, Y Zhang, K Werdan, H Ebelt
BACKGROUND: Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (St O2 ) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS). MATERIALS AND METHODS: A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29664900/accuracy-and-precision-of-scvo2-measured-with-the-cevox-device-a-prospective-study-in-patients-with-a-wide-variation-of-scvo2-values
#5
Alexander Herner, Bernhard Haller, Ulrich Mayr, Sebastian Rasch, Lea Offman, Roland Schmid, Wolfgang Huber
INTRODUCTION: Central-venous oxygen saturation (ScvO2) is a key parameter of hemodynamic monitoring and has been suggested as therapeutic goal for resuscitation. Several devices offer continuous monitoring features. The CeVOX-device (Pulsion Medical Systems) uses a fibre-optic probe inserted through a conventional central-venous catheter (CVC) to obtain continuous ScvO2. OBJECTIVES: Since there is a lack of studies validating the CeVOX, we prospectively analyzed data from 24 patients with CeVOX-monitoring...
2018: PloS One
https://www.readbyqxmd.com/read/29652273/assessment-of-the-effect-of-two-regimens-of-milrinone-infusion-in-pediatric-patients-undergoing-fontan-procedure-a-randomized-study
#6
Rabie Soliman, Adel Ragheb
Objective: The aim of the study was to compare the effect of two different regimens of milrinone on hemodynamics and oxygen saturation in pediatric patients undergoing Fontan procedure. Design: This was a randomized study. Setting: Cardiac centers. Patients: This study included 116 patients undergoing Fontan procedure. Material and Methods: Group E: Milrinone was started as infusion 0.5 μg/kg/min without a loading dose at the beginning of cardiopulmonary bypass (CPB) followed by infusion 0...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29643948/central-venous-oxygen-saturation-as-a-predictor-of-a-successful-spontaneous-breathing-trial-from-mechanical-ventilation-a-prospective-nested-case-control-study
#7
Ioannis Georgakas, Afroditi K Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Kristina Matei, Paraskevi Argyropoulou, Ioannis Stanopoulos
Background: Weaning from mechanical ventilation is a key element in the care of critically ill patients, and Spontaneous Breathing Trial (SBT) is a crucial step in this procedure. This nested case-control study aimed to evaluate whether central oxygen saturation (ScvO2 ) values and their changes could independently predict the SBT outcome among mechanically ventilated patients. Methods: A prospective cohort of patients who were mechanically ventilated for at least 48hours and fulfilled the criteria of readiness to wean constituted the study population...
2018: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/29618823/oxygen-extraction-ratio-oer-as-a-measurement-of-hemodialysis-hd-induced-tissue-hypoxia-a-pilot-study
#8
Silverio Rotondi, Lida Tartaglione, Maria Luisa Muci, Alessio Farcomeni, Marzia Pasquali, Sandro Mazzaferro
HD tissue hypoxia associates with organ dysfunctions. OER, the ratio between SaO2 and central-venous-oxygen-saturation, could estimate oxygen requirements during sessions, but no data are available. We evaluated OER behavior in 20 HD patients with permanent central venous catheter (CVC) as vascular access. Pre-HD OER (33.6 ± 1.4%; M ± SE) was higher than normal (range 20-30%). HD sessions increased OER to 39.2 ± 1.5% (M ± SE; p < 0.05) by 30' and to 47.4 ± 1.5% (M ± SE; p < 0...
April 4, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29600177/intravitreal-anti-vegf-agents-oral-glucocorticoids-and-laser-photocoagulation-combination-therapy-for-macular-edema-secondary-to-retinal-vein-occlusion-preliminary-report
#9
Xiao-Xiao Feng, Cheng Li, Wan-Wen Shao, Yong-Guang Yuan, Xiao-Bing Qian, Qi-Shan Zheng, Yu-Jie Li, Qian-Ying Gao
AIM: To evaluate the efficacy and safety of combined anti-vascular endothelial growth factor (VEGF) agents, oral glucocorticoid, and laser photocoagulation therapy for macular edema (ME) secondary to retinal vein occlusion (RVO). METHODS: This study included 16 eyes of 16 patients with RVO-associated ME. Patients were initially treated with oral prednisone and an intravitreal anti-VEGF agent. Two weeks later, patients underwent standard laser photocoagulation. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), and retinal vessel oxygenation were examined over 12mo...
2018: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/29593416/influence-of-stroke-volume-variation-on-fluid-treatment-and-postoperative-complications-in-thoracic-surgery
#10
Cengiz Sahutoglu, Erbil Turksal, Seden Kocabas, Fatma Zekiye Askar
Background: Fluid management in critically ill patients usually relies on increasing preload to augment cardiac output. In the present study, we aimed to evaluate whether stroke volume variation (SVV) can guide fluid therapy and reduce complications. Patients and methods: In this retrospective study, a total of 88 patients who underwent lobectomy were divided into two groups: group 1 (SVV, n=43) and group 2 (conventional or central venous pressure [CVP], n=45). Heart rate, blood pressure, oxygen saturation, SVV (only group 1), CVP (all patients), urea, creatinine, and hemoglobin levels before and after surgery, use of fluid, blood and inotropic agents, and postoperative complications were recorded retrospectively...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29578169/clinical-research-of-goal-directed-fluid-therapy-in-elderly-patients-with-radical-resection-of-bladder-cancer
#11
Tie-Jun Liu, Jin-Cun Zhang, Xiao-Zeng Gao, Zhi-Bin Tan, Jian-Jun Wang, Pan-Pan Zhang, Ai-Bin Cheng, Shu-Bo Zhang
Objective: The aim of this study is to investigate the clinical effect of goal-directed fluid therapy in elderly patients with radical resection of bladder cancer. Materials and Methods: Seventy-six elderly patients with radical resection of bladder cancer were selected from October 2012 to October 2014 and randomly divided into two groups, in which 38 patients received routine treatment as the control group and 38 patients received goal-directed fluid therapy based on routine treatment as the observation group...
2018: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29570428/intravascular-cooling-catheter-related-venous-thromboembolism-after-hypothermia-a-case-report-and-review-of-the-literature
#12
Xuan Wang, Brian T Moy, Brett J Hiendlmayr, Felix Krainski, W Lane Duvall, Antonio B Fernandez
Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase...
March 23, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29538053/prevention-of-low-cardiac-output-syndrome-after-pediatric-cardiac-surgery-a-double-blind-randomized-clinical-pilot-study-comparing-dobutamine-and-milrinone
#13
Anna Cavigelli-Brunner, Maja I Hug, Hitendu Dave, Oskar Baenziger, Christoph Buerki, Dominique Bettex, Vincenzo Cannizzaro, Christian Balmer
OBJECTIVES: Dobutamine and milrinone are commonly used after open-heart surgery to prevent or treat low cardiac output syndrome. We sought to compare efficacy and safety of these drugs in pediatric patients. DESIGN: Prospective, single-center, double-blinded, randomized clinical pilot study. SETTING: Tertiary-care university children's hospital postoperative pediatric cardiac ICU. PATIENTS: After written consent, 50 consecutive patients (age, 0...
March 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29444562/fluid-resuscitation-during-early-sepsis-a-need-for-individualization
#14
Mathieu Jozwiak, Olfa Hamzaoui, Xavier Monnet, Jean-Louis Teboul
The prognosis of septic shock is tightly linked to the earliness of both appropriate antibiotic therapy and early hemodynamic resuscitation. This latter is essentially based on fluid and vasopressors administration. The step-by-step strategy, called "early goal-directed therapy" (EGDT) developed in 2001 and endorsed by the Surviving Sepsis Campaign (SSC) between 2004 and 2016 is no longer recommended. Indeed, recent multicenter randomized clinical trials showed no reduction in all-cause mortality, duration of organ support and in-hospital length of stay with EGDT in comparison with standard care...
February 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29428622/targeted-increase-in-pulmonary-blood-flow-in-a-bidirectional-glenn-circulation
#15
Samuel L Casella, Aditya Kaza, Pedro Del Nido, James E Lock, Audrey C Marshall
In patients with a Glenn shunt and unilateral pulmonary vascular abnormalities, supplemental pulmonary blood flow may improve antegrade flow in the target lung and may permit eventual Fontan completion, while mitigating the risks of uncontrolled additional flow to the contralateral lung. We attempted this by inserting a small aortopulmonary shunt into the affected pulmonary artery and banding the central pulmonary artery. We performed a retrospective review of all patients who underwent this procedure from 2000 to 2015...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29397598/-the-clinical-significance-of-microcirculation-and-oxygen-metabolism-evaluation-in-acute-kidney-injury-assessment-in-patients-with-septic-shock-after-resuscitation
#16
C Yu, D W Liu, X T Wang, H W He, P Pan, Z Q Xing
Objective: To evaluate the value of microcirculation and oxygen metabolism evaluation (MicrOME) in acute kidney injury(AKI) evaluation in patients with septic shock after resuscitation. Methods: Consecutive patients with septic shock after resuscitation and mechanical ventilation were enrolled from October 2016 to February 2017 in ICU at Peking Union Medical College Hospital.Patients were divided into 3 groups based on 10 min transcutaneous oxygen challenge test transcutaneous partial pressure of oxygen(PtcO(2))and venoarterial pressure of carbon dioxide difference (Pv-aCO(2)) /arteriovenous O(2) content difference (Ca-vO(2)) by blood gas analysis, i...
February 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29318718/regional-cerebral-tissue-oxygen-saturation-changes-following-blood-transfusion-in-neuro-intensive-care-unit-patients-a-pilot-observational-study
#17
R Muthuchellappan, N A Shaikh, R M Surve, U R S Ganne, M Philip
BACKGROUND: Although central venous oxygen saturation (ScvO2 ) is used to decide on red blood cell (RBC) transfusion, whether its improvement is associated with parallel improvement in cerebral oxygenation is not adequately studied. This study looked at changes in regional cerebral tissue oxygen saturation (rSO2 ) following RBC transfusion in neuro-intensive care unit (ICU) patients. METHODS: In this prospective observational pilot study, rSO2 was measured in adult neuro-ICU patients before RBC transfusion, at the end and at 6, 12, 18 and 24 h after RBC transfusion...
January 10, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29297372/detailing-the-cardiovascular-profile-in-shock-patients
#18
REVIEW
Daniel De Backer
Evaluation of the cardiovascular profile of critically ill patients is one of the most important actions performed in critically ill patients. It allows recognition that the patient is in shock and characterization of the type of circulatory failure. This step is crucial to initiate supportive interventions and to cure the cause responsible for the development of shock. Evaluation of tissue perfusion allows identification of the patient insufficiently resuscitated and also to trigger therapeutic interventions...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29183321/effects-of-controlled-hypoxemia-or-hypovolemia-on-global-and-intestinal-oxygenation-and-perfusion-in-isoflurane-anesthetized-horses-receiving-an-alpha-2-agonist-infusion
#19
Klaus Hopster, Liza Wittenberg-Voges, Florian Geburek, Charlotte Hopster-Iversen, Sabine B R Kästner
BACKGROUND: Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia...
November 28, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29169604/validation-of-peripherally-inserted-central-catheter-derived-fick-cardiac-outputs-in-patients-with-heart-failure
#20
Kristen M Tecson, Anupama Vasudevan, Amarinder Bindra, Susan M Joseph, Joost Felius, Shelley A Hall, Parag Kale
The pulmonary artery catheter (PAC) remains the gold standard to calculate Fick cardiac outputs (FCOs) in patients with heart failure admitted to the intensive care unit (ICU). The peripherally inserted central catheter (PICC) provides long-term intravenous access and is used outside the ICU; however, there is scant literature validating venous oxygen saturations (VOSs) from PICC lines. Heart failure patients in the ICU with an existing PAC requiring a PICC line to transition were enrolled. Three blood samples were taken per person (1 at PICC, 1 at central venous pressure [CVP], and 1 at distal PAC)...
January 1, 2018: American Journal of Cardiology
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