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https://www.readbyqxmd.com/read/28650929/oxygen-flow-pressure-targets-for-resuscitation-in-critical-hemodynamic-therapy
#1
Huaiwu He, Yun Long, Xiang Zhou, Xiaoting Wang, Hongmin Zhang, Wenzhao Chai, Na Cui, Hao Wang, Dawei Liu
Far from traditional "vital signs," the field of hemodynamic monitoring is developing rapidly. However, it is also easy to misunderstand hemodynamic therapy as merely hemodynamic monitoring and some concrete bundles or guidelines for circulation support. Here, we describe the concept of "critical hemodynamic therapy (CHT)" and clarify the concepts of the "therapeutic target" and "therapeutic endpoint" in clinical practice.Three main targets (Oxygen Delivery - Blood Flow - Perfusion Pressure, OFP) for resuscitation are reviewed in critically ill patients according to the sepsis guidelines and hemodynamic consensus...
June 23, 2017: Shock
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#2
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28648106/pressure-autoregulation-measurement-techniques-in-adult-tbi-part-i-a-scoping-review-of-intermittent-semi-intermittent-methods
#3
Frederick Adam Zeiler, Joseph Donnelly, Leanne Calviello, David Menon, Peter Smieleweski, Marek Czosnyka
To perform a systematic, scoping review of commonly described intermittent/semi-intermittent autoregulation measurement techniques in adult TBI. Nine separate systematic reviews were conducted for each intermittent technique: Computed tomographic perfusion (CTP)/Xenon-CT (Xe-CT), positron emission tomography (PET), magnetic resonance imaging (MRI), arterio-venous difference in oxygen (AVDO2) technique, thigh cuff deflation technique (TCDT), transient hyperemic response test (THRT), orthostatic hypotension test (OHT), mean flow index (Mx) and transfer function ARI (TF-ARI)...
June 24, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28646097/highly-suggestive-preliminary-evidence-that-the-renal-interstitium-contracts-in%C3%A2-vivo
#4
Omar Flores-Sandoval, María Eugenia Sánchez-Briones, Juan F López-Rodríguez, Miriam Z Calvo-Turrubiartes, Lilia Llamazares-Azuara, Manuel Rodríguez-Martínez
To learn more about controlling renal interstitial hydrostatic pressure (RIHP), we assessed its response to renal medullary direct interstitial volume expansion (rmDIVE = 100 μL bolus infusion/30 sec). Three experimental series (S) were performed in hydropenic, anesthetized, right-nephrectomized, acute left renal-denervated and renal perfusion pressure-controlled rats randomly assigned to groups in each S. S1: Rats without hormonal clamp were contrasted before and after rmDIVE induced via 0.9% saline solution bolus (SS group) or 2% albumin in SS bolus (2% ALB + SS group)...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28643998/survey-in-expert-clinicians-on-validity-of-automated-calculation-of-optimal-cerebral-perfusion-pressure
#5
Romy Steijn, Roy Stewart, Marek Czosnyka, Joseph Donnelly, Ari Ercole, Antony Absalom, Jan W Elting, Christina Haubrich, Peter Smielewski, Marcel Aries
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) targeting in traumatic brain injury (TBI) patients constitutes an active and controversial area of research. It has been suggested that an autoregulation guided CPP therapy may improve TBI outcome. Prerequisites of a CPPopt intervention study would be objective criteria for the CPPopt detection.. This study compared the agreement between automated and visual CPPopt detection. METHODS: Twenty-five clinicians from 18 centres worldwide, familiar with brain monitoring and using dedicated software, reviewed ten 4-hour CPPopt screenshots at 48 hrs after ictus in selected TBI patients...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28642732/autonomic-function-impairment-and-brain-perfusion-deficit-in-parkinson-s-disease
#6
Wei-Che Lin, Pei-Chin Chen, Chih-Cheng Huang, Nai-Wen Tsai, Hsiu-Ling Chen, Hung-Chen Wang, Kun-Hsien Chou, Meng-Hsiang Chen, Yi-Wen Chen, Cheng-Hsien Lu
INTRODUCTION: Autonomic disorders have been recognized as important Parkinson's disease (PD) components. Some vulnerable structures are related to the central autonomic network and have also been linked to autonomic function alterations. The aims of the study are to evaluate the severity of the autonomic dysfunction and the cortical hypoperfusion using arterial spin labeling (ASL) MRI. And then, possible relationships of significant between-group differences in perfusion pattern to clinical variables and autonomic functions were examined to determine the pharmaceutical effects of dopaminergic treatment on cerebral blood flow (CBF) in patients with PD...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28642340/cardiovascular-and-cerebral-hemodynamics-during-exercise-and-recovery-in-obese-individuals-as-a-function-of-their-fitness-status
#7
Mathieu Gayda, Gabriel Lapierre, Olivier Dupuy, Sarah Fraser, Louis Bherer, Martin Juneau, Vincent Gremeaux, Anil Nigam
The aim of this study was to compare cardiovascular hemodynamics and cerebral oxygenation/perfusion (COP) during and after maximal incremental exercise in obese individuals according to their aerobic fitness versus age-matched healthy controls (AMHC). Fifty-four middle-aged obese (OB) and 16 AMHC were recruited. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamics (impedance cardiography), and left frontal COP (near-infrared spectroscopy: NIRS) were measured continuously during a maximal incremental ergocycle test...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28639837/measuring-cerebrovascular-autoregulation-in-preterm-infants-using-near-infrared-spectroscopy-an-overview-of-the-literature
#8
Elisabeth M W Kooi, Elise A Verhagen, Jan Willem J Elting, Marek Czosnyka, Topun Austin, Flora Y Wong, Marcel J H Aries
The preterm born infant's ability to regulate its cerebral blood flow (CBF) is crucial in preventing secondary ischemic and hemorrhagic damage in the developing brain. The relationship between arterial blood pressure (ABP) and CBF estimates, such as regional cerebral oxygenation as measured by near-infrared spectroscopy (NIRS), is an attractive option for continuous non-invasive assessment of cerebrovascular autoregulation. Areas covered: The authors performed a literature search to provide an overview of the current literature on various current clinical practices and methods to measure cerebrovascular autoregulation in the preterm infant by NIRS...
June 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28639723/changes-in-the-inspiratory-pattern-contribute-to-modulate-the-sympathetic-activity-in-sino-aortic-denervated-rats
#9
Mateus R Amorim, Leni G H Bonagamba, George M P R Souza, Davi J A Moraes, Benedito H Machado
The activity of pre-sympathetic neurons is under respiratory modulation and changes in the central respiratory network may impact on the baseline sympathetic activity and mean arterial pressure (MAP). It is well known that after baroreceptor afferents removal (sino-aortic denervation, SAD), rats present an unexpected normal levels of MAP. We hypothesized that changes in the respiratory pattern and in the respiratory modulation of the sympathetic activity contribute to keep the sympathetic outflow in a normal range of variation in absence of arterial baroreceptors in rats...
June 22, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28639425/high-resolution-anorectal-manometry-a-comparison-of-solid-state-and-water-perfused-catheters
#10
A M P Rasijeff, M Withers, J M Burke, W Jackson, S M Scott
BACKGROUND: Anorectal manometry is the most commonly performed investigation for assessment of anorectal dysfunction. Findings from previous studies comparing water-perfused (WP) and solid-state (SS) techniques in the anorectum are conflicting. We compared anal sphincter pressure at rest and during dynamic maneuvers (squeezing and coughing) in healthy volunteers using SS and WP high-resolution anorectal manometry (HR-ARM) employing equivalent catheter configurations, a standardized protocol, and identical data acquisition and analysis software...
June 22, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28639172/influence-of-cannulation-site-on-carotid-perfusion-during-extracorporeal-membrane-oxygenation-in-a-compliant-human-aortic-model
#11
Andreas Geier, Andreas Kunert, Günter Albrecht, Andreas Liebold, Markus Hoenicka
Blood oxygenized by veno-arterial extracorporeal membrane oxygenation (ECMO) can be returned to the aorta (central cannulation) or to peripheral arteries (axillar, femoral). Hemodynamic effects of these cannulation types were analyzed in a mock loop with an aortic model representative of normal anatomy and compliance under physiological pressures and flow rates. Pressures, flow rates, and contribution of ECMO flow to total flow as a measure of oxygen supply were monitored in the carotids. Steady or pulsatile ECMO flow, residual or no cardiac output, and intraaortic balloon pump counterpulsation were tested as independent factors...
June 21, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28638222/corticotropin-releasing-factor-stimulates-colonic-motility-via-muscarinic-receptors-in-the-rat
#12
Kyung-Jo Kim, Ki Bae Kim, Soon Man Yoon, Joung-Ho Han, Hee Bok Chae, Seon Mee Park, Sei Jin Youn
AIM: To measure exogenous corticotropin-releasing factor (CRF)-induced motility of the isolated rat colon and to demonstrate the effect of pharmacologic inhibition on CRF-induced motility. METHODS: The isolated vascularly-perfused rat colon was used. Luminal pressure was monitored via microtip catheter pressure transducers in the proximal and distal colon. At first, exogenous CRF was administered in a stepwise manner and the concentration of CRF yielding maximal colonic motility was selected...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#13
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637017/diagnostic-and-prognostic-values-of-cerebrospinal-fluid-cyfra-21-1-in-patients-with-leptomeningeal-carcinomatosis
#14
Jae-Won Hyun, Ji Hyun Park, Boo Gil Kang, Eun Young Park, Boram Park, Jungnam Joo, Jong Kuk Kim, Su-Hyun Kim, Jee Hyang Jeong, Hyang Woon Lee, Kee Duk Park, Kyung Gyu Choi, Sang-Hyun Hwang, Ho-Shin Gwak, Ho Jin Kim
OBJECTIVES: To investigate the diagnostic and prognostic values of cerebrospinal fluid (CSF) CYFRA 21-1 in patients with leptomeningeal carcinomatosis (LMC). METHODS: Concentration of CSF CYFRA 21-1 was detected using electro-chemiluminescent immunoassay. The difference in level of CYFRA 21-1 between 61 patients with LMC and 200 patients with other neurological disease was evaluated, and diagnostic performance of CSF CYFRA 21-1 was investigated. In LMC patients treated with ventriculo-lumbar perfusion (VLP) chemotherapy, prognostic performance of CSF CYFRA 21-1 was evaluated...
June 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28636634/cardiomyopathy-development-protection-after-myocardial-infarction-in-rats-successful-competition-for-major-dihydropyridines-common-metabolite-against-captopril
#15
Katarzyna A Mitręga, Adrianna M Spałek, Jerzy Nożyński, Maurycy Porc, Magdalena Stankiewicz, Tadeusz F Krzemiński
During the last 25 years angiotensin-converting enzyme inhibitors spectacularly conquered the field of cardiovascular diseases therapy. Nevertheless, lack of new studies concerning side effects associated with their chronic administration seems to be rather confusing. In our previous research, we proved that the main furnidipines' metabolite (M-2) possess multiple cardioprotective actions. Currently, we compared effects of post-infarction long-term oral treatment with M-2 and captopril on hemodynamic parameters and "ischemic cardiomyopathy" development in rats...
2017: PloS One
https://www.readbyqxmd.com/read/28636165/a-feasibility-and-safety-study-of-intracoronary-hemodilution-during-primary-coronary-angioplasty-in-order-to-reduce-reperfusion-injury-in-myocardial-infarction
#16
Michael McGarvey, Omar Ali, M Bilal Iqbal, Charles Ilsley, Joyce Wong, Carlo Di Mario, Simon Redwood, Tiffany Patterson, Dudley J Pennell, Paula Rogers, Miles Dalby
OBJECTIVES: We designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury. INTRODUCTION: Early revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage...
June 21, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28634780/echocardiographic-inferior-vena-cava-measurement-as-an-alternative-to-central-venous-pressure-measurement-in-neonates
#17
Muzamil Mustafa Mugloo, Seema Malik, Rubeena Akhtar
OBJECTIVES: To evaluate the correlation between echocardiographic inferior vena cava (IVC) measurements and central venous pressure (CVP) in neonates. Also, to evaluate the correlation between IVC measurements and gestational age (GA) and body weight (BW). METHODS: This cross sectional analytical study was conducted from June 2014 through June 2016 in a level III NICU. All neonates requiring intensive hemodynamic monitoring and having umbilical venous catheter (UVC) in place for clinical indications were enrolled in the study...
June 21, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28632534/administration-of-tetrahydrobiopterin-bh4-protects-the-renal-microcirculation-from-ischemia-and-reperfusion-injury
#18
Lokmane Rahmania, Diego Orbegozo, Fuhong Su, Fabio Silvio Taccone, Jean-Louis Vincent, Daniel De Backer
BACKGROUND: Abdominal aortic aneurysm surgery with suprarenal cross-clamping is often associated with renal injury. Although the mechanism underlying such injury is unclear, tissue ischemia and reperfusion, which induces endothelial dysfunction and decreases the availability of tetrahydrobiopterin (BH4), may play a role. We evaluated whether BH4 administration prevents renal ischemia/reperfusion injury in an animal model of aortic cross-clamping. METHODS: Nineteen anesthetized, mechanically ventilated, and invasively monitored adult sheep were randomized into 3 groups: sham animals (n = 5) that underwent surgical preparation but no aortic clamping; an ischemia/reperfusion group (n = 7), where the aorta was clamped above the renal arteries for 1 hour, and a BH4 group (n = 7), in which animals received 20 mg/kg of BH4 followed by aortic cross-clamp for 1 hour...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631554/the-effects-of-platelet-activating-factor-on-uterine-contractility-perfusion-hypoxia-and-pain-in-mice
#19
Kevin M Hellman, Peter Y Yu, Folabomi A Oladosu, Chaya Segel, Alice Han, Pottumarthi V Prasad, Tamas Jilling, Frank F Tu
It is widely hypothesized that menstrual pain is triggered by prostaglandin synthesis that evokes high-pressure uterine contractions and ischemia. However, the effects of molecules implicated in menstrual pain on uterine contractility, perfusion, and oxygenation in vivo have been rarely demonstrated. Studies in women that do not respond to nonsteroidal anti-inflammatory drugs (NSAIDs) have reported elevated levels of platelet-activating factor (PAF). To establish in vivo evidence of PAF's capability to impair uterine homeostasis and to elicit visceral pain, we examined the effects of the PAF receptor agonist (carbamyl PAF [CPAF]) in comparison to other molecules hypothesized to play a role in uterine pain in mice...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#20
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
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