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mean circulatory filling pressure

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https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#1
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29121301/tissue-doppler-assessment-of-diastolic-function-and-relationship-with-mortality-in-critically-ill-septic-patients-a-systematic-review-and-meta-analysis
#2
F Sanfilippo, C Corredor, A Arcadipane, G Landesberg, A Vieillard-Baron, M Cecconi, N Fletcher
Background: Myocardial dysfunction may contribute to circulatory failure in sepsis. There is growing evidence of an association between left ventricular diastolic dysfunction (LVDD) and mortality in septic patients. Utilizing echocardiography, we know that tissue Doppler imaging (TDI) variables e' and E/e' are reliable predictors of LVDD and are useful measurements to estimate left ventricular (LV) filling pressures. Methods: We conducted a systematic review and meta-analysis to investigate the association of e' and E/e' with mortality of patients with severe sepsis or septic shock...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29071420/venous-pressures-and-cardiac-filling-in-turtles-during-apnoea-and-intermittent-ventilation
#3
William Joyce, Catherine J A Williams, Dane A Crossley, Tobias Wang
The amount of blood pumped by the heart (cardiac output) must be matched to the amount of blood returning to the heart (venous return), but the factors determining cardiac filling are sparsely understood in ectothermic vertebrates. Stroke volume is affected by heart rate along with central and peripheral venous pressures. In the present study, we investigated the heart rate dependency of cardiac filling in turtles, along with the changes in venous pressures that accompany ventilation. Experimental reductions in heart rate of anaesthetised turtles (Trachemys scripta) by the specific bradycardic agent zatebradine (2-3 mg kg(-1)) resulted in an elevation of stroke volume that compensated cardiac output...
October 25, 2017: Journal of Comparative Physiology. B, Biochemical, Systemic, and Environmental Physiology
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#4
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28912258/frank-starling-mechanism-and-short-term-adjustment-of-cardiac-flow
#5
José Guilherme Chaui-Berlinck, Luiz Henrique Alves Monteiro
The Frank-Starling Law of the heart is a filling-force mechanism (FFm), a positive relationship between the distension of a ventricular chamber and its force of ejection, and such a mechanism is found across all the studied vertebrate lineages. The functioning of the cardiovascular system is usually described by means of the cardiac and vascular functions, the former related to the contractility of the heart and the latter related to the after-load imposed to the ventricle. The crossing of these functions is the so-called operation point, and the FFm is supposed to play a stabilizing role for the short-term variations in the working of the system...
September 14, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28550170/right-atrial-pressure-and-venous-return-during-cardiopulmonary-bypass
#6
Per W Moller, Bernhard Winkler, Samuel Hurni, Paul Philipp Heinisch, Andreas Bloch, Soren Sondergaard, Stephan M Jakob, Jukka Takala, David Berger
The relevance of right atrial pressure (RAP) as the backpressure for venous return (QVR) and mean systemic filling pressure as upstream 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 venoarterial extracorporeal membrane oxygenation. Mean systemic filling pressure was determined by clamping extracorporeal membrane oxygenation tubing with open or closed arteriovenous shunt at euvolemia, volume expansion (9...
August 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28360123/impact-of-positive-pressure-ventilation-on-mean-systemic-filling-pressure-in-critically-ill-patients-after-death
#7
Xavier Repessé, Cyril Charron, Guillaume Geri, Alix Aubry, Alexis Paternot, Julien Maizel, Michel Slama, Antoine Vieillard-Baron
Mean systemic filling pressure (Pms) defines the pressure measured in the venous-arterial system when the cardiac output is nil. Its estimation has been proposed in patients with beating hearts by building the venous return curve, using different pairs of right atrial pressure/cardiac output during mechanical ventilation. We raised the hypothesis according to which the Pms is altered by tidal ventilation and positive end-expiratory pressure (PEEP), which would challenge this extrapolation method based on cardiopulmonary interactions...
June 1, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28108065/assessment-of-central-venous-physiology-of-fontan-circulation-using-peripheral-venous-pressure
#8
Satoshi Masutani, Clara Kurishima, Akiko Yana, Seiko Kuwata, Yoichi Iwamoto, Hirofumi Saiki, Hirotaka Ishido, Hideaki Senzaki
OBJECTIVE: Elevated central venous pressure is a major cause of morbidity and mortality after the Fontan operation. The difference between mean circulatory filling pressure and central venous pressure, a driving force of venous return, is important in determining dynamic changes in central venous pressure in response to changes in ventricular properties or loading conditions. Thus, noninvasive central venous pressure and mean circulatory filling pressure estimation may contribute to optimal management in patients undergoing the Fontan operation...
April 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27836099/-management-of-cardiogenic-shock-results-from-a-survey-in-france-and-belgium
#9
S Champion, N Deye
PURPOSE: Physician survey on cardiogenic shock management; recommendations for the management of patients with cardiogenic shock are based mostly on experts' opinion. METHODS: Overall 1585 emails were sent to "senior" intensive care physicians from France and Belgium from September 2014 to march 2015. Response rate was 10% (157 respondents). Agreement was assessed based on RAND/UCLA methodology. RESULTS: Continuous monitoring of cardiac output, vascular filling, noninvasive ventilation were deemed appropriate...
April 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27768204/in-vitro-performance-investigation-of-syncardia%C3%A2-freedom%C3%A2-driver-via-patient-simulator-mock-loop
#10
Riccardo Toninato, Silvia Scuri, Vincenzo Tarzia, Gino Gerosa, Francesca M Susin
PURPOSE: The gold standard therapy for patients with advanced heart failure is heart transplant. The gap between donors and patients in waiting lists promoted the development of circulatory support devices, such as the total artificial heart (TAH). Focusing on in vitro tests performed with CardioWest™ TAH (CW) driven by the SynCardia Freedom® portable driver (FD) the present study goals are: i) prove the reliability of a hydraulic circuit used as patient simulator to replicate a quasi-physiological scenario for various hydrodynamic conditions, ii) investigate the hydrodynamic performance of the CW FD, iii) help clinicians in possible interpretation of clinical cases outcomes...
November 29, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27445352/improved-cardiac-filling-facilitates-the-postprandial-elevation-of-stroke-volume-in-python-regius
#11
Sanne Enok, Gabriella S P C Leite, Cléo A C Leite, Hans Gesser, Michael S Hedrick, Tobias Wang
To accommodate the pronounced metabolic response to digestion, pythons increase heart rate and elevate stroke volume, where the latter has been ascribed to a massive and fast cardiac hypertrophy. However, numerous recent studies show that heart mass rarely increases, even upon ingestion of large meals, and we therefore explored the possibility that a rise in mean circulatory filling pressure (MCFP) serves to elevate venous pressure and cardiac filling during digestion. To this end, we measured blood flows and pressures in anaesthetized Python regius The anaesthetized snakes exhibited the archetypal tachycardia as well as a rise in both venous pressure and MCFP that fully account for the approximate doubling of stroke volume...
October 1, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27319091/-the-contribution-of-vascular-capacity-and-blood-volume-to-maintain-stable-blood-circulation-during-general-anesthesia
#12
REVIEW
Kenji Shigemi
To maintain proper cardiac preload is one of the most effective procedures for the systemic circulation remaining stable. In particular, the balance between vascular capacity and total blood volume must be maintained within appropriate range by the administration of fluids, blood and/or vasoactive drugs with mean circulatory filling pressure (Pmcf), central venous pressure (CVP) or stroke volume variation (SVV). End-diastolic left ventricular volume (Ved) is theoretically the best index of cardiac preload; however, without transesophageal echocardbalanceiogram we cannot directly monitor Ved during anesthesia...
May 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26588480/from-cardiac-output-to-blood-flow-auto-regulation-in-shock
#13
REVIEW
Hollmann D Aya, Andrea Carsetti, Simone Bazurro, Davide Bastoni, Manu L N G Malbrain, Maurizio Cecconi
Shock is defined as a state in which the circulation is unable to deliver sufficient oxygen to meet the demands of the tissues, resulting in cellular dysoxia and organ failure. In this process, the factors that govern the circulation at a haemodynamic level and oxygen delivery at a microcirculatory level play a major role. This manuscript aims to review the blood flow regulation from macro- and micro-haemodynamic point of view and to discuss new potential therapeutic approaches for cardiovascular instability in patients in cardiovascular shock...
2015: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/26567491/hemodynamics-of-acute-right-heart-failure-in-mechanically-ventilated-patients-with-acute-respiratory-distress-syndrome
#14
REVIEW
Barbara McLean
In critically ill patients with circulatory shock, the role of the left ventricle has long been appreciated and the object of measurement and therapeutic targeting. The right ventricle is often under appreciated and dysfunction may be overlooked. Generally, the right ventricle operates passively to support the ejection of the left ventricular diastolic volume. A loss of right ventricular wall compliance secondary to pulmonary pressures may result in an alteration in the normal pressure-volume relationship, ultimately affecting the stroke volume and cardiac output...
December 2015: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/26523797/hemodynamic-consequences-of-laparoscopy-for-patients-on-mechanical-circulatory-support
#15
Heidi Reich, Danny Ramzy, Lawrence Czer, Fardad Esmailian, Jaime Moriguchi, Kai Ihnken, Taizoon Yusufali, Nicola D'Attellis, Francisco Arabia, Alagappan Annamalai
BACKGROUND: Technologic advances and superior survival with mechanical circulatory support (MCS) have led to an expanding population that develops intraabdominal conditions requiring intervention. Whether laparoscopy can be performed without detrimental effects on hemodynamics and device function is not well described. MATERIALS AND METHODS: Effects of laparoscopy performed on MCS were retrospectively assessed. Intraoperative hemodynamics and device function were compared with the same time interval 24 hours prior to surgery using intrapatient paired t tests...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/26369130/perfluorodecalin-filled-poly-n-butyl-cyanoacrylate-nanocapsules-as-potential-artificial-oxygen-carriers-preclinical-safety-and-biocompatibility
#16
Julia Laudien, Christoph Groß-Heitfeld, Christian Mayer, Herbert de Groot, Michael Kirsch, Katja B Ferenz
With regard to the development of artificial blood substitutes, perfluorodecalin-filled poly(n-butyl-cyanoacrylate) nanocapsules are already discussed for the use as artificial oxygen carriers. The aim of the present study was to thoroughly investigate the preclinical safety and biocompatibility of the perfluorodecalin-filled poly(n-butyl-cyanoacrylate) nanocapsules prepared by interfacial polymerization. Nanocapsules were assessed for physical and microbial stability. Subsequent to intravenous infusion to anesthetized rats, effects on systemic parameters, microcirculation, circulatory in vivo half-life, acid base/metabolic status, organ damage and biodistribution were evaluated using inter alia 19F-NMR spectroscopy and in vivo microscopy...
August 2015: Journal of Nanoscience and Nanotechnology
https://www.readbyqxmd.com/read/25943641/haemodynamic-assessment-in-pregnancy-and-pre-eclampsia-a-guytonian-approach
#17
Timothy M Crozier, Euan M Wallace, W Geoffrey Parkin
OBJECTIVES: Hypertensive disorders of pregnancy continue to be amongst the leading causes of maternal morbidity and mortality. There is debate about the optimal monitoring and treatment for these women, particularly in regard to circulatory and fluid management. A restrictive fluid strategy is advocated, which conflicts with the prevailing view that the circulating volume is contracted in pre-eclampsia. This belief has been erroneously reinforced by use of the central venous pressure (CVP) as a measure of the volume state...
April 2015: Pregnancy Hypertension
https://www.readbyqxmd.com/read/25815596/preservation-of-renal-blood-flow-by-the-antioxidant-euk-134-in-lps-treated-pigs
#18
Sheldon Magder, Dimitrios G Parthenis, Imad Al Ghouleh
Sepsis is associated with an increase in reactive oxygen species (ROS), however, the precise role of ROS in the septic process remains unknown. We hypothesized that treatment with EUK-134 (manganese-3-methoxy N,N'-bis(salicyclidene)ethylene-diamine chloride), a compound with superoxide dismutase and catalase activity, attenuates the vascular manifestations of sepsis in vivo. Pigs were instrumented to measure cardiac output and blood flow in renal, superior mesenteric and femoral arteries, and portal vein. Animals were treated with saline (control), lipopolysaccharide (LPS; 10 µg·kg-1·h-1), EUK-134, or EUK-134 plus LPS...
2015: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/25406899/adrenergic-receptor-genotype-influences-heart-failure-severity-and-%C3%AE-blocker-response-in-children-with-dilated-cardiomyopathy
#19
Sushma Reddy, Alan Fung, Cedric Manlhiot, Elif Seda Selamet Tierney, Wendy K Chung, Elizabeth Blume, Beth D Kaufman, Elizabeth Goldmuntz, Steven Colan, Seema Mital
BACKGROUND: Adrenergic receptor (ADR) genotypes are associated with heart failure (HF) and β-blocker response in adults. We assessed the influence of ADR genotypes in children with dilated cardiomyopathy (DCM). METHODS: Ninety-one children with advanced DCM and 44 with stable DCM were genotyped for three ADR genotypes associated with HF risk in adults: α2cdel322-325, β1Arg389, and β2Arg16. Data were analyzed by genotype and β-blocker use. Mean age at enrollment was 8...
February 2015: Pediatric Research
https://www.readbyqxmd.com/read/25345482/hemodynamic-response-to-exercise-and-head-up-tilt-of-patients-implanted-with-a-rotary-blood-pump-a-computational-modeling-study
#20
Einly Lim, Robert Francis Salamonsen, Mahdi Mansouri, Nicholas Gaddum, David Glen Mason, Daniel L Timms, Michael Charles Stevens, John Fraser, Rini Akmeliawati, Nigel Hamilton Lovell
The present study investigates the response of implantable rotary blood pump (IRBP)-assisted patients to exercise and head-up tilt (HUT), as well as the effect of alterations in the model parameter values on this response, using validated numerical models. Furthermore, we comparatively evaluate the performance of a number of previously proposed physiologically responsive controllers, including constant speed, constant flow pulsatility index (PI), constant average pressure difference between the aorta and the left atrium, constant average differential pump pressure, constant ratio between mean pump flow and pump flow pulsatility (ratioP I or linear Starling-like control), as well as constant left atrial pressure ( P l a ¯ ) control, with regard to their ability to increase cardiac output during exercise while maintaining circulatory stability upon HUT...
February 2015: Artificial Organs
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