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vasoactive infusions

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https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#1
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#2
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27869709/cerebral-microvascular-and-systemic-effects-following-intravenous-administration-of-the-perfluorocarbon-emulsion-perftoran
#3
Rania Abutarboush, Biswajit K Saha, Saad H Mullah, Francoise G Arnaud, Ashraful Haque, Chioma Aligbe, Georgina Pappas, Charles R Auker, Richard M McCarron, Paula F Moon-Massat, Anke H Scultetus
Oxygen-carrying perfluorocarbon (PFC) fluids have the potential to increase tissue oxygenation during hypoxic states and to reduce ischemic cell death. Regulatory approval of oxygen therapeutics was halted due to concerns over vasoconstrictive side effects. The goal of this study was to assess the potential vasoactive properties of Perftoran by measuring brain pial arteriolar diameters in a healthy rat model. Perftoran, crystalloid (saline) or colloid (Hextend) solutions were administered as four sequential 30 min intravenous (IV) infusions, thus allowing an evaluation of cumulative dose-dependent effects...
November 18, 2016: Journal of Functional Biomaterials
https://www.readbyqxmd.com/read/27849867/225-short-term-peripheral-vasoactive-infusions-in-pediatrics-where-is-the-harm
#4
Jason Patregnani, Anthony Sochet, Darren Klugman
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27833559/the-opioid-sparing-effect-of-perioperative-dexmedetomidine-plus-sufentanil-infusion-during-neurosurgery-a-retrospective-study
#5
Shiyu Su, Chunguang Ren, Hongquan Zhang, Zhong Liu, Zongwang Zhang
Background: Approximately 60% of patients experience moderate-to-severe pain after neurosurgery, which primarily occurs in the first 24-72 h. Despite this, improved postoperative analgesia solutions after neurosurgery have not yet been devised. This retrospective study was conducted to evaluate the effect of intra- and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the quality of postoperative analgesia in patients undergoing neurosurgery. Methods: One hundred and sixty-three post-neurosurgery patients were divided into two groups: Group D (DEX infusion at 0...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#6
Suchitra Ranjit, Rajeswari Natraj, Sathish Kumar Kandath, Niranjan Kissoon, Balasubramaniam Ramakrishnan, Paul E Marik
AIMS: We previously reported that vasodilatation was common in pediatric septic shock, regardless of whether they were warm or cold, providing a rationale for early norepinephrine (NE) to increase venous return (VR) and arterial tone. Our primary aim was to evaluate the effect of smaller fluid bolus plus early-NE versus the American College of Critical Care Medicine (ACCM) approach to more liberal fluid boluses and vasoactive-inotropic agents on fluid balance, shock resolution, ventilator support and mortality in children with septic shock...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27721980/fluid-responsiveness-prediction-using-vigileo-flotrac-measured-cardiac-output-changes-during-passive-leg-raise-test
#7
Anton Krige, Martin Bland, Thomas Fanshawe
BACKGROUND: Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are used to predict the need for subsequent fluid loading. This requires a device that can measure CO changes rapidly. The Vigileo™ monitor, using third-generation software, allows continuous CO monitoring. The aim of this study was to compare changes in CO (measured with the Vigileo device) during a PLR manoeuvre to calculate the accuracy for predicting fluid responsiveness...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27716691/the-efficacy-of-pre-emptive-dexmedetomidine-versus-amiodarone-in-preventing-postoperative-junctional-ectopic-tachycardia-in-pediatric-cardiac-surgery
#8
Nagat S El-Shmaa, Doaa El Amrousy, Wael El Feky
OBJECTIVE: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. DESIGN: This is a prospective, controlled study. SETTING: This study was carried out at a single university hospital. SUBJECTS AND METHODS: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27687422/in-vitro-antimicrobial-activity-of-commonly-used-vasoactive-drugs
#9
Ozgun Cuvas Apan, Teoman Zafer Apan, Alparslan Apan
STUDY OBJECTIVE: Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. DESIGN: Prospective study. SETTING: Clinical microbiology laboratory of a university hospital. MEASUREMENTS: Growth of the microorganisms Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans in saline dilutions of adrenaline at 1, 10, and 100 μg/mL; noradrenaline at 1, 10, and 100 μg/mL; and dopamine at 0...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27677909/risk-of-hyponatremia-in-patients-with-aneurysmal-subarachnoid-hemorrhage-treated-with-exogenous-vasopressin-infusion
#10
Nancy Marr, Jessica Yu, Demetrios J Kutsogiannis, Sherif Hanafy Mahmoud
BACKGROUND: Vasopressin is one of the vasopressors used to augment blood pressure in subarachnoid hemorrhage (SAH) patients with clinically significant vasospasm. The purpose of the present study was to determine whether the administration of vasopressin to a population of SAH patients was an independent predictor of developing hyponatremia. METHODS: A retrospective review on the health records of 106 patients admitted to the University of Alberta Hospital Neurosciences ICU, Edmonton AB, Canada, with SAH from June 2013 to December 2015 was conducted...
September 27, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27632680/cytokine-release-syndrome-after-chimeric-antigen-receptor-t-cell-therapy-for-acute-lymphoblastic-leukemia
#11
Julie C Fitzgerald, Scott L Weiss, Shannon L Maude, David M Barrett, Simon F Lacey, J Joseph Melenhorst, Pamela Shaw, Robert A Berg, Carl H June, David L Porter, Noelle V Frey, Stephan A Grupp, David T Teachey
OBJECTIVE: Initial success with chimeric antigen receptor-modified T cell therapy for relapsed/refractory acute lymphoblastic leukemia is leading to expanded use through multicenter trials. Cytokine release syndrome, the most severe toxicity, presents a novel critical illness syndrome with limited data regarding diagnosis, prognosis, and therapy. We sought to characterize the timing, severity, and intensive care management of cytokine release syndrome after chimeric antigen receptor-modified T cell therapy...
September 14, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27500722/treatment-of-pediatric-septic-shock-with-the-surviving-sepsis-campaign-guidelines-and-picu-patient-outcomes
#12
Jennifer K Workman, Stefanie G Ames, Ron W Reeder, E Kent Korgenski, Susan M Masotti, Susan L Bratton, Gitte Y Larsen
OBJECTIVES: The Surviving Sepsis Campaign recommends rapid recognition and treatment of severe sepsis and septic shock. Few reports have evaluated the impact of these recommendations in pediatrics. We sought to determine if outcomes in patients who received initial care compliant with the Surviving Sepsis Campaign time goals differed from those treated more slowly. DESIGN: Single center retrospective cohort study. SETTING: Emergency department and PICU at an academic children's hospital...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27454377/sepsis-in-solid-organ-transplant-patients
#13
Antônio Tonete Bafi, Daniere Yurie Vieira Tomotani, Flávio Geraldo Rezende de Freitas
The growing population of solid organ transplant (SOT) recipients is at a significantly increased risk for developing infections. In some patients, the infection can lead to a dysregulated systemic inflammatory response with acute organ dysfunction. SOT recipients with sepsis tend to have less fever and leukocytosis instances. Moreover, they have diminished symptoms and attenuated clinical and radiologic findings. The current management of sepsis is similar to general patients. It relies mainly on early recognition and treatment, including appropriate administration of antibiotics and resuscitation with intravenous fluids and vasoactive drugs when needed...
July 21, 2016: Shock
https://www.readbyqxmd.com/read/27435406/the-impact-of-hematocrit-on-oxygenation-sensitive-cardiovascular-magnetic-resonance
#14
Dominik P Guensch, Gobinath Nadeshalingam, Kady Fischer, Aurelien F Stalder, Matthias G Friedrich
BACKGROUND: Oxygenation-sensitive (OS) Cardiovascular Magnetic Resonance (CMR) is a promising utility in the diagnosis of heart disease. Contrast in OS-CMR images is generated through deoxyhemoglobin in the tissue, which is negatively correlated with the signal intensity (SI). Thus, changing hematocrit levels may be a confounder in the interpretation of OS-CMR results. We hypothesized that hemodilution confounds the observed signal intensity in OS-CMR images. METHODS: Venous and arterial blood from five pigs was diluted with lactated Ringer solution in 10 % increments to 50 %...
2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27397449/sodium-bicarbonate-use-and-the-risk-of-hypernatremia-in-thoracic-aortic-surgical-patients-with-metabolic-acidosis-following-deep-hypothermic-circulatory-arrest
#15
Kamrouz Ghadimi, Jacob T Gutsche, Harish Ramakrishna, Samuel L Setegne, Kirk R Jackson, John G Augoustides, E Andrew Ochroch, Stuart J Weiss, Joseph E Bavaria, Albert T Cheung
OBJECTIVE: Metabolic acidosis after deep hypothermic circulatory arrest (DHCA) for thoracic aortic operations is commonly managed with sodium bicarbonate (NaHCO 3 ). The purpose of this study was to determine the relationships between total NaHCO 3 dose and the severity of metabolic acidosis, duration of mechanical ventilation, duration of vasoactive infusions, and Intensive Care Unit (ICU) or hospital length of stay (LOS). METHODS: In a single center, retrospective study, 87 consecutive elective thoracic aortic operations utilizing DHCA, were studied...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27319091/-the-contribution-of-vascular-capacity-and-blood-volume-to-maintain-stable-blood-circulation-during-general-anesthesia
#16
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/27293983/the-success-rate-of-pediatric-in-hospital-cardiopulmonary-resuscitation-in-ahvaz-training-hospitals
#17
Shideh Assar, Mohsen Husseinzadeh, Abdul Hussein Nikravesh, Hannaneh Davoodzadeh
Research Objective. This study determined the outcome of cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest and factors influencing it in two training hospitals in Ahvaz. Method. Patients hospitalized in the pediatric wards and exposed to CPR during hospital stay were included in the study (September 2013 to May 2014). The primary outcome of CPR was assumed to be the return of spontaneous circulation (ROSC) and the secondary outcome was assumed to be survival to discharge. The neurological outcome of survivors was assessed using the Pediatric Cerebral Performance Category (PCPC) method...
2016: Scientifica
https://www.readbyqxmd.com/read/27291070/shock-treatment-in-a-cohort-of-scandinavian-intensive-care-units-in-2014
#18
COMMENT
M Kollind, F Wickbom, E Wilkman, M S C Snäckestrand, A Holmén, A Oldner, A Perner, A Åneman, M S Chew
BACKGROUND: Shock is common in intensive care units, and treatment includes fluids, vasopressor and/or inotropic drugs, guided by hemodynamic monitoring. The aim of this study was to identify current practice for treatment of shock in Scandinavian intensive care units. METHODS: Seven-day inception cohort study in 43 intensive care units in Scandinavia. Patients ≥ 15 years old receiving more than 4 h of cardiovascular acting drug infusion were included. The use of fluids, vasopressor and inotropic drugs, type of monitoring, and target values were recorded...
August 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27258938/insulin-plays-a-permissive-role-for-the-vasoactive-effect-of-gip-regulating-adipose-tissue-metabolism-in-humans
#19
Meena Asmar, Lene Simonsen, Ali Asmar, Jens Juul Holst, Flemming Dela, Jens Bülow
CONTEXT AND OBJECTIVE: Glucose-dependent insulinotropic polypeptide (GIP) in combination with hyperinsulinemia increases blood flow and triglyceride (TAG) clearance in subcutaneous (sc) abdominal adipose tissue in lean humans. The present experiments were performed to further investigate the role of insulin for the vasoactive effect of GIP in adipose tissue metabolism and whether the vasodilatory effect of GIP is dependent on C-peptide. METHODS: Six lean healthy subjects were studied...
August 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27219253/the-effect-of-norepinephrine-and-dopamine-on-radial-forearm-flap-partial-tissue-oxygen-pressure-and-microdialysate-metabolite-measurements-a-randomized-controlled-trial
#20
Lassi Raittinen, Minna T Kääriäinen, Jenny F Lopez, Juhani Pukander, Jussi Laranne
BACKGROUND: Patients undergoing ablative and reconstructive head and neck surgery with a microvascular flap have multiple factors that potentially decrease postoperative mean arterial pressure, which may endanger flap survival. The safety of vasopressor use has long been a topic of discussion. The authors analyzed the effect of vasopressors on microvascular flap perfusion after head and neck cancer reconstruction. METHODS: A total of 27 patients were enrolled in a randomized, controlled, clinical trial...
June 2016: Plastic and Reconstructive Surgery
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