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Hypovolemia

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https://www.readbyqxmd.com/read/28709156/gastrointestinal-impedance-spectroscopy-to-detect-hypoperfusion-during-hemorrhage
#1
Andreas Bloch, Andreas Kohler, Horst Posthaus, David Berger, Laura Santos, Stephan Jakob, Jukka Takala, Matthias Haenggi
BACKGROUND: Changes in tissue impedance (Ω) have been proposed as early signs of impaired tissue perfusion. We hypothesized that hemorrhage may induce early changes in alimentary tract tissue impedance and that these can be detected by impedance spectroscopy. We evaluated impedance spectroscopy in an acute hemorrhage model in pigs. METHODS: Twenty anesthetized pigs were randomized to stepwise hemorrhage to mean arterial blood pressure (MAP) targets of 60 mm Hg, 50 mm Hg, 45 mm Hg, and 40 mm Hg, followed by retransfusion in two steps, or control (n = 10 each)...
August 2017: Shock
https://www.readbyqxmd.com/read/28682802/nineteen-victims-of-homicide-and-attempted-homicide-in-sweden-their-injuries-cause-of-death-and-offender-relationship
#2
Ardavan Khoshnood, Marie Väfors Fritz, Ulf Ekelund
Victims of homicide and attempted homicide are not uncommon in Sweden. We therefore aimed to study these victims to understand their injuries, their cause of death, and their relationship to the offender. All cases during five years in a district court in Sweden, where an offender had been convicted for homicide or attempted homicide, were identified and the court documents reviewed. Nineteen victims were identified; 14 males and five females, with an average age of 39.1 years. Although knife/sharp weapon was the most common weapon used, the use of firearm caused more deaths...
July 6, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28671554/a-machine-learning-based-analysis-for-the-recognition-of-progressive-central-hypovolemia
#3
Frank Cornelis Bennis, Björn Van der Ster, Johannes Van Lieshout, Peter Andriessen, Tammo Delhaas
Traditional patient monitoring during surgery include heart rate (HR), blood pressure (BP) and peripheral oxygen saturation. However, their use as predictors for central hypovolemia is limited, which may lead to cerebral hypoperfusion. The aim of this study was to develop a monitoring model that can indicate a decrease in central blood volume (CBV) in an early stage. Approach: Twenty-eight healthy subjects (age 18-50 yr) were included. Lower body negative pressure (-50 mmHg) was applied to induce central hypovolemia until onset of pre-syncope...
July 3, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28660179/monitoring-cerebral-and-renal-oxygenation-status-during-neonatal-digestive-surgeries-using-near-infrared-spectroscopy
#4
Jonathan Beck, Gauthier Loron, Claire Masson, Marie-Laurence Poli-Merol, Eliane Guyot, Camille Guillot, Nathalie Bednarek, Caroline François
BACKGROUND: Depending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause. OBJECTIVE: Evaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28643321/global-end-diastolic-volume-could-be-more-appropiate-to-reduce-intraoperative-bleeding-than-central-venous-pressure-during-major-liver-transection
#5
Francisco Javier Redondo, Dawid Padilla, Ruben Villazala, Pedro Villaeiro, Victor Baladron, Natalia Bejerano
BACKGROUND: Central venous pressure often fails to identify the true value of cardiac preload. Our purpose is to investigate whether Global End-Diastolic Volume (GEDV) values can control hemodynamic parameters for the measurement of fluid volume, cardiac preload and blood loss during liver transection. METHODS: This was a prospective clinical study that included patients undergoing liver resection. All patients were monitored by means of PiCCO technology and 222 hemodynamic measurements were performed in 74 patients...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28577744/orthostatic-hypotension-a-review
#6
Adrien Joseph, Ruben Wanono, Martin Flamant, Emmanuelle Vidal-Petiot
Orthostatic hypotension, defined by a drop in blood pressure of at least 20mmHg for systolic blood pressure and at least 10mmHg for diastolic blood pressure within 3minutes of standing up, is a frequent finding, particularly in elderly patients. It is associated with a significant increase in morbidity and mortality. Although it is often multifactorial, the first favoring factor is medications. Other etiologies are divided in neurogenic orthostatic hypotension, characterized by autonomic failure due to central or peripheral nervous system disorders, and non-neurogenic orthostatic hypotension, mainly favoured by hypovolemia...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28569187/the-effects-of-acute-renal-denervation-on-kidney-perfusion-and-metabolism-in-experimental-septic-shock
#7
Emiel Hendrik Post, Fuhong Su, Koji Hosokawa, Fabio Silvio Taccone, Antoine Herpain, Jacques Creteur, Daniel De Backer, Jean-Louis Vincent
BACKGROUND: Perfusion deficits likely play an important role in the development of renal dysfunction in sepsis. Renal denervation may improve kidney perfusion and metabolism. METHODS: We randomized 14 female sheep to undergo bilateral surgical renal denervation (n = 7) or sham procedure (n = 7) prior to induction of sepsis. Renal blood flow (RBF) was measured with a pre-calibrated flowprobe. Laser Doppler probes were implanted to measure cortical and medullary perfusion...
May 31, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28550903/hemodynamic-effects-of-the-abdominal-aortic-and-junctional-tourniquet-in-a-hemorrhagic-swine-model
#8
Jason M Rall, James D Ross, Michael S Clemens, Jennifer M Cox, Theresea A Buckley, Jonathan J Morrison
BACKGROUND: Torso hemorrhage constitutes a leading cause of battlefield mortality. The Abdominal Aortic and Junctional Tourniquet (AAJT) uses a pneumatic bladder to compress the aorta reducing pelvic and lower extremity perfusion; however, concern exists over the risk of caval compression exacerbating hypotension after application. METHODS: Male swine (70-90 kg) were randomized into four groups of 10: presence or absence of hemorrhage and AAJT placement. After a 40% hemorrhage, a 15-min period of hypovolemia was observed before the AAJT application...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#9
Per Werner Moller, Berhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Martin Bloch, Soren Sondergaard, Stephan M Matthias Jakob, Jukka Takala, David Christian Berger
The relevance of right atrial pressure (RAP) as the back-pressure for venous return (QVR) and mean systemic filling pressure (MSFP) as up-stream pressure is controversial during dynamic changes of circulation. To examine the immediate response of QVR (sum of caval vein flows) to changes in RAP and pump function we used a closed chest, central cannulation, heart bypass porcine preparation (n=10) with veno-arterial extracorporeal membrane oxygenation (ECMO). MSFP was determined by clamping ECMO tubing with open or closed arterio-venous shunt at Euvolemia, Volume Expansion (9...
May 26, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28539354/cerebral-oxygenation-and-regional-cerebral-perfusion-responses-with-resistance-breathing-during-central-hypovolemia
#10
Victoria L Kay, Justin Daniel Sprick, Caroline A Rickards
Resistance breathing improves tolerance to central hypovolemia induced by lower body negative pressure (LBNP), but this is not related to protection of anterior cerebral blood flow (indexed by mean middle cerebral artery velocity, MCAv). We hypothesized that inspiratory resistance breathing improves tolerance to central hypovolemia by maintaining cerebral oxygenation (ScO2), and protecting cerebral blood flow in the posterior cerebral circulation (indexed by posterior cerebral artery velocity, PCAv). Eight subjects (4M/4F) completed two experimental sessions of a presyncopal-limited LBNP protocol (3 mmHg/min onset rate) with and without (Control) resistance breathing via an impedance threshold device (ITD)...
May 24, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#11
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28512647/early-esophagogastroduodenoscopy-is-associated-with-better-outcomes-in-upper-gastrointestinal-bleeding-a-nationwide-study
#12
Sushil K Garg, Chimaobi Anugwom, James Campbell, Vaibhav Wadhwa, Nancy Gupta, Rocio Lopez, Sukhman Shergill, Madhusudhan R Sanaka
Background and study aims We analyzed NIS (National Inpatient Sample) database from 2007 - 2013 to determine if early esophagogastroduodenoscopy (EGD) (24 hours) for upper gastrointestinal bleeding improved the outcomes in terms of mortality, length of stay and costs. Patients and methods Patients were classified as having upper gastrointestinal hemorrhage by querying all diagnostic codes for the ICD-9-CM codes corresponding to upper gastrointestinal bleeding. For these patients, performance of EGD during admission was determined by querying all procedural codes for the ICD-9-CM codes corresponding to EGD; early EGD was defined as having EGD performed within 24 hours of admission and late EGD was defined as having EGD performed after 24 hours of admission...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28511448/rectus-sheath-haematoma-secondary-to-enoxaparin-injection-a-rare-case-report
#13
Sidharth Agarwal, Yamanur P Lamani, Bhimanagouda V Goudar, Eshwar B Kalburgi, Bheemappa K Bhavi
Rectus sheath haematoma is a well-documented condition with an elusive diagnosis. It is an uncommon complication of anti-coagulation therapy, which can have a mortality of upto 25%. The patient discussed here is a 40-year-old female who was on Inj. Enoxaparin, who developed severe abdominal pain and hypovolemia after three days of treatment. Ultrasonography and CT scan showed a large rectus sheath haematoma on the right side, which was crossing the midline towards the left side. Inj. Enoxaparin was stopped and the patient was posted for surgery...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28506580/-hyponatremic-hypertensive-syndrome-successfully-treated-by-endovascular-therapy-a-case-report
#14
G Rigault, B Franko, O Chabre, M-A Quemerai, B Nemoz, P Zaoui
INTRODUCTION: Hyponatremic-hypertensive syndrome (HHS) is characterized by hypertension and hyponatremia. CASE PRESENTATION: We report a case of HHS in a 73-year-old woman, revealed by a hyponatremia leading to status epilepticus, without initial hypertension due to hypovolemia. She was successfully treated by endovascular therapy without any long-term supplementation or anti-hypertensive medication. CONCLUSION: Physiopathology hypothesis of HHS implicate pressure natriuresis, in this case, hypertension is not initially found and we discuss other hyponatremia mechanisms...
May 12, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28502073/early-impact-of-abdominal-compartment-syndrome-on-liver-kidney-and-lung-damage-in-a-rodent-model
#15
Ricardo Lima, Pedro L Silva, Vera L Capelozzi, Mariana G Oliveira, Maria Cristina E Santana, Fernanda F Cruz, Paolo Pelosi, Alberto Schanaider, Manu L N G Malbrain, Patricia R M Rocco
BACKGROUND: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. METHODS: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28497338/decreased-spontaneous-baroreflex-sensitivity-as-an-early-marker-for-progression-of-haemorrhage
#16
Kavita Yadav, Akanksha Singh, Smriti Badhwar, Ashok Kumar Jaryal, Poonam Coshic, Kabita Chatterjee, K K Deepak
INTRODUCTION: Blood donation provides an ideal setup for assessment of cardiovascular responses to mild hypovolemia for understanding the underlying mechanisms. AIM: To evaluate cardiovascular responses in time and magnitude by estimating the spontaneous baroreflex sensitivity (BRS) during and after donation of 450 ml of blood. METHODS: Continuous beat-to-beat blood pressure and lead II ECG was recorded before, during and after blood donation in 54 healthy volunteers (age 34...
May 11, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28492488/redistribution-of-cerebral-blood-flow-during-severe-hypovolemia-and-reperfusion-in-a-sheep-model-critical-role-of-%C3%AE-1-adrenergic-signaling
#17
René Schiffner, Sabine Juliane Bischoff, Thomas Lehmann, Florian Rakers, Sven Rupprecht, Juliane Reiche, Georg Matziolis, Harald Schubert, Matthias Schwab, Otmar Huber, Martin Schmidt
BACKGROUND: Maintenance of brain circulation during shock is sufficient to prevent subcortical injury but the cerebral cortex is not spared. This suggests area-specific regulation of cerebral blood flow (CBF) during hemorrhage. METHODS: Cortical and subcortical CBF were continuously measured during blood loss (≤50%) and subsequent reperfusion using laser Doppler flowmetry. Blood gases, mean arterial blood pressure (MABP), heart rate and renal blood flow were also monitored...
May 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28491316/pituitary-abscess-in-an-hiv-1-infected-patient
#18
Hiroyuki Yamazaki, Masayuki Kobayashi, Anamaria Daniela Sarca, Akifumi Takaori-Kondo
OBJECTIVES: Pituitary abscess is a rare occurrence among pituitary conditions, but one which carries life-threatening potential. An immunocompromised status is a risk factor for the development of a pituitary abscess; however, literature describes only one case among HIV-infected patients. METHODS AND RESULTS: We present here a case of pituitary abscess in an HIV-1-positive patient, who demonstrated a shock status, disturbance of consciousness and generalized skin rash with laboratory findings of hypovolemia, acute inflammatory reaction and blood electrolyte abnormality...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#19
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28463939/validation-of-a-noninvasive-monitor-to-continuously-trend-individual-responses-to-hypovolemia
#20
Steven L Moulton, Jane Mulligan, Maria Antoinette Santoro, Khanh Bui, Gregory Z Grudic, David MacLeod
BACKGROUND: Humans are able to compensate for significant blood loss with little change in traditional vital signs, limiting early detection and intervention. We hypothesized that the Compensatory Reserve Index (CRI), a new hemodynamic parameter that trends changes in intravascular volume relative to the individual patient's response to hypovolemia, would accurately trend each subject's progression from normovolemia to decompensation (systolic blood pressure < 80) and back to normovolemia in humans...
July 2017: Journal of Trauma and Acute Care Surgery
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