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https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#1
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#2
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/29756692/the-presence-of-elastic-compression-stockings-reduces-the-fluid-responsiveness-of-patients-in-the-operating-room
#3
Elie Zogheib, Julien Maizel, Nabil Cherradi, Ammar Benammar, Béatrice Labont, Abdel Hchikat, Michael Bernasinski, Faouzi Trojette, Michel Slama, Hervé Dupont
BACKGROUND: To investigate whether elastic compression stockings (ECS) can affect fluid responsiveness parameters before and during passive leg raising (PLR) maneuvers. METHODS: In the operating room (OR), we performed a prospective study including patients referred for cardiac surgery. Blood pressure (BP), ΔPP, heart rate (HR), central venous pressure (CVP), stroke volume (SV) and aortic blood flow (ABF) (by esophageal doppler) were measured according to four conditions: supine position without ECS (baseline 1), lower limbs raised to an angle of 45° (PLR 1), returned to the supine position with ECS (baseline 2), then a second PLR maneuver with ECS was performed (PLR 2)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29701760/optical-techniques-for-perfusion-monitoring-of-the-gastric-tube-after-esophagectomy-a-review-of-technologies-and-thresholds
#4
S M Jansen, D M de Bruin, M I van Berge Henegouwen, S D Strackee, D P Veelo, T G van Leeuwen, S S Gisbertz
Anastomotic leakage is one of the most severe complications after esophageal resection with gastric tube reconstruction. Impaired perfusion of the gastric fundus is seen as the main contributing factor for this complication. Optical modalities show potential in recognizing compromised perfusion in real time, when ischemia is still reversible. This review provides an overview of optical techniques with the aim to evaluate the (1) quantitative measurement of change in perfusion in gastric tube reconstruction and (2) to test which parameters are the most predictive for anastomotic leakage...
April 26, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29679768/comparison-of-proaqt-pulsioflex%C3%A2-and-oesophageal-doppler-for-intraoperative-haemodynamic-monitoring-during-intermediate-risk-abdominal-surgery
#5
Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria
OBJECTIVE: To compare cardiac index (CI) between Proaqt/PulsioFlex® and esophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI. METHODS: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min)...
April 18, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29649794/effects-of-volume-overload-and-current-techniques-for-the-assessment-of-fluid-status-in-patients-with-renal-disease
#6
Can Ekinci, Merve Karabork, Dimitrie Siriopol, Neris Dincer, Adrian Covic, Mehmet Kanbay
Volume overload is an important, may be the foremost, independent prognostic factor determining the outcome of hemodialysis patients. Therefore, it is crucial to measure fluid status of these patients and avoid volume overload. This review aims to evaluate volume overload, its effects on patients with renal diseases and current methodologies measuring volume status in the body. These techniques will be first classified as clinical evaluation and non-clinical and/or instrumental techniques, which includes biomarkers, ultrasonography, relative blood volume monitoring, bioimpedance, echocardiography, pulmonary artery catheterization, esophageal and/or suprasternal Doppler, and blood viscosity...
2018: Blood Purification
https://www.readbyqxmd.com/read/29622985/the-value-of-three-dimensional-color-doppler-trans-esophageal-echocardiography-in-predicting-the-number-of-mitraclip-devices-needed-during-the-procedure
#7
Hani M Mahmoud, Ali M Al-Ameen, Mohamed H Hassan, Tarek Badr, Hesham Nieem, Ahmed A Shaheen, Abdullah E Ghabashi
Purpose: During MitraClip procedure, one or more clips might be needed to effectively reduce the mitral regurgitation (MR). Three-dimensional vena-contracta (3D-VC) assessed by color Doppler three-dimensional trans-esophageal echocardiography (3D-TEE) was proven to be well correlated with MR severity. However, its role in predicting the number of MitraClip devices needed during the procedure was not fully determined. Aim of this study is to assess the predictive value of 3D-VC area & length in determining the number of clips needed during the procedure...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29621027/cardiac-output-monitoring-how-to-choose-the-optimal-method-for-the-individual-patient
#8
Bernd Saugel, Jean-Louis Vincent
PURPOSE OF REVIEW: To review the different methods available for the assessment of cardiac output (CO) and describe their specific indications in intensive care and perioperative medicine. RECENT FINDINGS: In critically ill patients, persistent circulatory shock after initial resuscitation is an indication for the assessment of CO to monitor the response to fluids and vasoactive agents. In patients with circulatory shock associated with right ventricular dysfunction, pulmonary artery hypertension, or acute respiratory distress syndrome, invasive CO monitoring using indicator dilution methods is indicated...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29606730/effect-of-different-analgesic-techniques-on-hemodynamic-variables-recorded-with-an-esophageal-doppler-monitor-during-ovariohysterectomy-in-dogs
#9
Ignacio Sández, María Soto, Daniel Torralbo, Eva Rioja
This study compared the efficacy of intravenous (IV) fentanyl and ketamine with lumbosacral epidural lidocaine in dogs undergoing ovariohysterectomy. Dogs with esophageal Doppler monitoring ( n = 112) were included in this retrospective study. All dogs were premedicated with dexmedetomidine and methadone, induced with IV propofol or alfaxalone and maintained using isoflurane and IV fentanyl, IV ketamine, or epidural lidocaine. Heart rate (HR), mean arterial pressure (MAP), expired fraction of isoflurane (ETIso), stroke distance (SD), minute distance (MD), peak velocity (PV) and mean acceleration (MA) were recorded before and after ligation of the ovarian pedicle (OvP)...
April 2018: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/29391766/beneficial-long-term-effect-of-a-phosphodiesterase-5-inhibitor-in-cirrhotic-portal-hypertension-a-case-report-with-8-years-follow-up
#10
Peter Deibert, Adhara Lazaro, Zoran Stankovic, Denise Schaffner, Martin Rössle, Wolfgang Kreisel
Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored...
January 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29223688/comparison-of-color-flow-with-standard-ultrasound-for-the-detection-of-endotracheal-intubation
#11
Michael Gottlieb, Dallas Holladay, Anthony Serici, Shital Shah, Damali Nakitende
INTRODUCTION: Intubation is a frequently performed procedure in emergency medicine that is associated with significant morbidity and mortality when unrecognized esophageal intubation occurs. However, it may be difficult to visualize the endotracheal tube (ETT) in some patients. This study assessed whether the addition of color Doppler was able to improve the ability to visualize the ETT location. METHODS: This study was performed in a cadaver lab using three different cadavers chosen to represent varying neck circumference...
November 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29118563/cardiac-dysfunction-as-an-early-predictor-of-portal-hypertension-in-chronic-hepatitis-c
#12
Cecilia Marconi, Mattia Bellan, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Lisa Franzosi, Mario Pirisi
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28960499/differences-in-salivary-secretory-function-between-patients-with-erosive-esophagitis-and-those-with-nonerosive-reflux-disease
#13
Noriaki Manabe, Ken Haruma, Hiroaki Kusunoki, Tomoari Kamada, Jiro Hata
BACKGROUND AND AIM: It has been speculated that impaired salivary flow contributes to abnormal acid clearance in patients with erosive esophagitis (EE). For easy and objective assessment of salivary function, we developed a salivary gland blood flow measurement technique using continuous-wave Doppler sonography. In the present study, we evaluated the salivary secretory function in patients with EE and those with nonerosive reflux disease (NERD) using this method. METHODS: Doppler waveform analysis was performed on the facial artery to assess blood inflow to the submandibular gland of 30 healthy subjects (HS)...
April 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28864498/new-ultrasonographic-screening-method-for-oropharyngeal-dysphagia-tissue-doppler-imaging
#14
Noriaki Manabe, Ken Haruma, Rui Nakato, Hiroaki Kusunoki, Tomoari Kamada, Jiro Hata
Ultrasound tissue Doppler imaging (US-TDI) has been used to diagnose regional wall motion (WM) abnormalities in coronary artery disease but has not been applied to oropharyngeal diseases. This study aimed first to validate an US-TDI method to assess cervical esophageal (CE) WM and secondly to use the method to evaluate CE WM in patients with oropharyngeal dysphagia (OD). First, we enrolled 22 healthy men (mean age: 59.7 yr) who all underwent both US-TDI and videofluoroscopy (VF) and then esophageal high-resolution manometry (HRM) in the same week...
January 1, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28838434/management-of-portal-hypertension-after-liver-transplantation
#15
D Korda, P Á Deák, G Kiss, Z Gerlei, L Kóbori, D Görög, I Fehérvári, L Piros, Z Máthé, A Doros
INTRODUCTION: Post-transplantation portal hypertension has severe complications, such as esophageal varix bleeding, therapy refractory ascites, extreme splenomegaly, and graft dysfunction. The aim of our study was to analyze the effectiveness of the therapeutic strategies and how to visualize the procedure. METHODS: A retrospective study involving liver transplantation patients from the Semmelweis University Department of Transplantation and Surgery was performed between 2005 and 2015...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28727542/single-session-high-intensity-focused-ultrasound-treatment-for-persistent-or-relapsed-graves-disease-preliminary-experience-in-a-prospective-study
#16
Brian Hung-Hin Lang, Yu-Cho Woo, Ian Yat-Hin Wong, Keith Wan-Hang Chiu
Purpose To evaluate the safety and efficacy of ultrasonography (US)-guided high-intensity focused ultrasound (HIFU) ablation as a treatment for medically refractory Graves disease (GD). Materials and Methods After ethics approval, a prospective trial (NCT02685514) was performed from November 2015 to February 2016. Thirty patients underwent ablation of the entire right and left thyroid lobes, with areas near the tracheal-esophageal groove and common carotid artery left unablated. Serum thyroid-stimulating hormone (TSH), free T4 (FT4), antithyroid autoantibodies, and TSH receptor (TSHR) antibody levels were evaluated afterward, and US color Doppler, US volumetry, and eye assessment were performed...
December 2017: Radiology
https://www.readbyqxmd.com/read/28702754/endoscopic-cyanoacrylate-injection-with-post-injection-audible-doppler-assessment-of-gastric-varices-a-single-institution-experience
#17
Tom D Catron, George B Smallfield, Le Kang, Richard K Sterling, Mohammad S Siddiqui
BACKGROUND AND AIMS: Gastric varices (GV) have higher rates of morbidity and mortality from hemorrhage than esophageal varices. Several studies have shown the safety and efficacy of cyanoacrylate (CA) injection for acute gastric variceal hemorrhage. We report data from our experience with CA injection for GV before and after routine use of post-injection audible Doppler assessment (ADA) for GV obturation and describe long-term outcomes after this therapy. METHODS: We retrospectively identified patients who had documented GV, underwent CA injection, and had at least 2 weeks of follow-up...
November 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28700473/diagnostic-value-of-plasma-ngal-and-intraoperative-diuresis-for-aki-after-major-gynecological-surgery-in-patients-treated-within-an-intraoperative-goal-directed-hemodynamic-algorithm-a-substudy-of-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Oliver Hunsicker, Aarne Feldheiser, Andreas Weimann, David Liehre, Jalid Sehouli, Klaus-Dieter Wernecke, Claudia Spies
Data on early markers for acute kidney injury (AKI) after noncardiovascular surgery are still limited. This study aimed to determine the diagnostic value of plasma neutrophil-gelatinase-associated lipocalin (pNGAL) and intraoperative diuresis for AKI in patients undergoing major abdominal surgery treated within a goal-directed hemodynamic algorithm.This study is a post-hoc analysis of a randomized controlled pilot trial comparing intravenous solutions within a hemodynamic goal-directed algorithm based on the esophageal Doppler in patients undergoing epithelial ovarian cancer surgery...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28543052/norepinephrine-reduces-arterial-compliance-less-than-phenylephrine-when-treating-general-anesthesia-induced-arterial-hypotension
#19
COMPARATIVE STUDY
F Vallée, O Passouant, A Le Gall, J Joachim, J Mateo, A Mebazaa, E Gayat
INTRODUCTION: During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. METHODS: Patients scheduled for a neurosurgical procedure under general anesthesia were prospectively included...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#20
RANDOMIZED CONTROLLED TRIAL
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
August 2017: Anesthesia and Analgesia
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