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vasoactive infusions

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https://www.readbyqxmd.com/read/29038262/severe-infusion-related-adverse-events-and-renal-failure-in-patients-receiving-high-dose-intravenous-polymyxin-b
#1
Josiane F John, Diego R Falci, Maria Helena Rigatto, Renata D Oliveira, Thaysa G Kremer, Alexandre P Zavascki
Very high doses of polymyxin B (PMB) have been addressed in in vitro experiments against carbapenem-resistant Gram-negative bacilli as a strategy to improve bacterial killing and suppress resistance emergence. However, the toxicities of very high doses in patients are unknown. This is a retrospective cohort study assessing patients receiving >3mg/kg/day or a total dose ≥250mg/day of PMB. The main outcomes were severe infusion-related adverse event according to Common Terminology Criteria for Adverse Criteria and renal failure category of RIFLE criteria for acute kidney injury (AKI) during treatment...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29035000/use-of-sacubitril-valsartan-in-acute-decompensated-heart-failure-a-case-report
#2
Taison D Bell, Adrien J Mazer, P Elliott Miller, Jeffrey R Strich, Vandana Sachdev, Mary E Wright, Michael A Solomon
Refractory heart failure typically requires costly long-term, continuous intravenous inodilator infusions while patients await mechanical circulatory support or cardiac transplantation. The combined angiotensin receptor blocker-neprilysin inhibitor, sacubitril/valsartan, is a novel therapy that can increase levels of endogenous vasoactive peptides. This therapy has been recommended as an alternative agent in patients with chronic heart failure with reduced ejection fraction and New York Heart Association class II-III symptoms...
October 16, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28991483/vasoactive-intestinal-peptide-nanomedicine-for-the-management-of-inflammatory-bowel-disease
#3
Dulari Jayawardena, Arivarasu N Anbazhagan, Grace Guzman, Pradeep K Dudeja, Hayat Onyuksel
Inflammatory bowel disease (IBD) is a chronic relapsing disorder of the intestine, with increasing incidence worldwide. At present, the management of IBD is an unmet medical need due to the ineffectiveness of currently available drugs in treating all patients, and there is strong demand for novel therapeutics. In this regard, vasoactive intestinal peptide, a potent anti-inflammatory endogenous hormone, has shown promise in managing multiple immune disorders in animal models. However, when administered in the free form, VIP undergoes rapid degradation in vivo, and with continuous infusion, it causes severe dose limiting side effects...
October 19, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28986330/renal-and-femoral-venous-blood-flows-are-regulated-by-different-mechanisms-dependent-on-%C3%AE-adrenergic-receptor-subtypes-and-nitric-oxide-in-anesthetized-rats
#4
Alexandre C Fioretti, Cristiana A Ogihara, Eduardo M Cafarchio, Daniel P Venancio, Roberto Lopes de Almeida, Bruno B Antonio, Monica A Sato
Venous and arterial walls are responsive to sympathetic system and circulating substances, nevertheless, very few is known about the venous blood flow regulation simultaneously to arterial vascular beds. In this study, we compared the venous and arterial blood flow regulation in visceral and muscular beds upon injection of different doses of vasoactive drugs which act in arterial vascular beds. Anesthetized adult male Wistar rats underwent to right femoral artery and vein cannulation for hemodynamic recordings and infusion of drugs...
October 3, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28981166/terlipressin-current-and-emerging-indications-in-chronic-liver-disease
#5
REVIEW
Timothy Papaluca, Paul Gow
Terlipressin is an analogue of vasopressin that has potent vasoactive properties and has been available for use in most countries for nearly two decades. It has both established roles and emerging indications in the management of complications of decompensated chronic liver disease. We explore historic and emerging literature regarding the use of terlipressin for a range of indications including hepatorenal syndrome, portal hypertensive bleeding and disruptions in sodium homeostasis. Novel methods of infusion based terlipressin administration including the beneficial effect in reduction of adverse events are explored, in addition to new indications for the use of terlipressin in decompensated cirrhosis in an outpatient setting...
October 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28941540/adjunctive-steroid-therapy-for-treatment-of-pediatric-septic-shock
#6
REVIEW
Jerry J Zimmerman
Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28940567/perioperative-fluid-and-hemodynamic-management-within-an-enhanced-recovery-pathway
#7
REVIEW
Michael W Manning, William Jonathan Dunkman, Timothy E Miller
Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to demonstrate benefits when compared to a restrictive strategy within an optimized enhanced recovery protocol. The ideal monitors, hemodynamic goals, and fluid administration strategy are not well established but may be less important than rational application of thoughtful fluid management strategies...
September 22, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28929376/divergent-coronary-flow-responses-to-uridine-adenosine-tetraphosphate-in-atherosclerotic-apoe-knockout-mice
#8
Bunyen Teng, Hicham Labazi, Changyan Sun, Yan Yang, Xiaorong Zeng, S Jamal Mustafa, Zhichao Zhou
Uridine adenosine tetraphosphate (Up4A) exerts potent relaxation in porcine coronary arteries that is reduced following myocardial infarction, suggesting a crucial role for Up4A in the regulation of coronary flow (CF) in cardiovascular disorders. We evaluated the vasoactive effects of Up4A on CF in atherosclerosis using ApoE knockout (KO) mice ex vivo and in vivo. Functional studies were conducted in isolated mouse hearts using the Langendorff technique. Immunofluorescence was performed to assess purinergic P2X1 receptor (P2X1R) expression in isolated mouse coronary arteries...
September 20, 2017: Purinergic Signalling
https://www.readbyqxmd.com/read/28924736/vasoactive-agents-for-hepatorenal-syndrome-a-mixed-treatment-comparison-network-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#9
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: Hepatorenal syndrome (HRS) is a common complication among patients with cirrhosis, primarily attributable to vasodilation of renal vessels. Vasoactive agents are commonly used to treat HRS. The present network meta-analysis compares the vasoactive agents used in HRS. METHODS: We searched electronic databases for appropriate randomized controlled clinical trials in patients with HRS, comparing active interventions with either placebo or standard of care...
September 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28918509/effects-of-tetramethylpyrazine-phosphate-on-pancreatic-islet-microcirculation-in-sd-rats
#10
X Xu, L Wu, Z Q Lu, P Xia, X P Zhu, X Gao
PURPOSES: Abnormal islet microcirculation impetus the insulin production and accelerates progression of Type 1 and 2 diabetes. In this study, we investigated whether tetramethylpyrazine phosphate (TMPP), a vasoactive substance, could regulate the islet microcirculation and insulin concentration and improve glycaemia in SD rats. METHODS: SD rats were randomly divided into two groups, the control and TMPP groups. Each group was further divided into three subgroups according to the intravenous injection of either saline, 15 or 30% glucose...
September 16, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28905639/clinical-manifestations-of-kawasaki-disease-shock-syndrome
#11
Le Ma, Ya-Yuan Zhang, Hai-Guo Yu
A case-control study was performed to ascertain clinical features of children who had been diagnosed as Kawasaki disease shock syndrome (KDSS), a severe condition related to Kawasaki disease (KD). Hospitalized patients were selected in Nanjing Children's Hospital. Demographic characteristics, clinical presentation, laboratory data, cardiovascular findings, and therapies were analyzed. Compared with the control group, KDSS patients were older and had more serious skin rash. The proportions of leukocytosis, neutrophilia, and hypoalbuminemia was higher, as was the level of while blood cell count, C-reactive protein, brain natriuretic peptide, and ferroprotein...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28899749/cyp4a-cyp2c-modulation-of-the-interaction-of-calcium-channel-blockers-with-cyclosporine-on-edhf-mediated-renal-vasodilations-in-rats
#12
Safaa H Hammoud, Amal G Omar, Assaad A Eid, Mahmoud M El-Mas
The endothelium-derived hyperpolarizing factor (EDHF) serves as a back-up mechanism that compensates for reduced nitric oxide (NO)/prostanoids bioavailability. Here we investigated whether (i) under conditions of vascular endothelium dysfunction, the immunosuppressant drug cyclosporine (CSA) upregulates EDHF-dependent renal vasodilations through altering CYP4A/CYP2C signaling, and (ii) calcium channel blockers modulate the CSA/EDHF/CYP interaction. Rats were treated with CSA, verapamil, nifedipine, or their combinations for 7days...
November 1, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28898586/transcerebral-net-exchange-of-vasoactive-peptides-and-catecholamines-during-lipopolysaccharide-induced-systemic-inflammation-in-healthy-humans
#13
Ronan M G Berg, Sarah Taudorf, Damian Miles Bailey, Rasmus Holmboe Dahl, Carsten Lundby, Kirsten Møller
The systemic inflammatory response triggered by lipopolysaccharide (LPS) is associated with cerebral vasoconstriction, but the underlying mechanisms are unknown. We therefore examined whether a four-hour intravenous LPS infusion (0.3 ng kg<sup>-1</sup>) induces any changes in the transcerebral net exchange of the vasoactive peptides endothelin-1 (ET-1) and calcitonin-gene related peptide (CGRP) and catecholamines in human volunteers. Cerebral blood flow was measured by the Kety-Schmidt technique, and paired arterial-to-jugular venous blood samples were obtained for estimating the transcerebral exchange of ET-1, CGRP and catecholamines by the Fick principle in twelve volunteers before and after LPS...
September 12, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#14
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28862394/efficacy-and-safety-of-a-calcium-sensitizer-levosimendan-in-patients-with-right-heart-failure-due-to-pulmonary-hypertension
#15
Rong Jiang, Qin-Hua Zhao, Wen-Hui Wu, Rui Zhang, Ping Yuan, Su-Gang Gong, Jing He, Ci-Jun Luo, Hong-Ling Qiu, Lan Wang, Jin-Ming Liu
BACKGROUND: Despite using vasoactive and pulmonary hypertension (PH) specific therapies, the in-hospital mortality of severe PH with right heart failure (RHF) is high. We conducted a prospective analysis evaluating the efficacy and safety of levosimendan in PH patients with severe acute RHF. METHODS: Forty-five PH patients hospitalized between January 2016 and November 2016 were recruited into a single arm, prospective, open-label study. Levosimendan was administered at the rate of ...
September 1, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#16
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28759483/alarm-limits-for-intraoperative-drug-infusions-a-report-from-the-multicenter-perioperative-outcomes-group
#17
MULTICENTER STUDY
Mitchell F Berman, Nikhil Iyer, Leon Freudzon, Shuang Wang, Robert E Freundlich, Michelle Housey, Sachin Kheterpal
BACKGROUND: Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. METHODS: We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28750598/hemodynamic-instability-secondary-to-vasopressin-withdrawal-in-septic-shock
#18
Brittany D Bissell, Carolyn Magee, Peter Moran, Melissa L Thompson Bastin, Alexander H Flannery
RATIONALE: Vasopressors such as norepinephrine are first line for support of mean arterial pressure (MAP) in the management of septic shock. Their use, however, is commonly associated with many adverse events. These detriments frequently trigger the use of alternative, noncatecholamine therapies, including vasopressin. Vasopressin deficiency is a known physiologic consequence of septic shock, and while guidelines recommend vasopressin in addition to norepinephrine, no consensus exists on the duration of deficiency or ideal time of cessation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#19
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28729387/leg-blood-flow-is-impaired-during-small-muscle-mass-exercise-in-patients-with-copd
#20
U W Iepsen, G W Munch, M Rugbjerg, C K Ryrsø, N H Secher, Y Hellsten, P Lange, B K Pedersen, P Thaning, S P Mortensen
Skeletal muscle blood flow is regulated to match the oxygen demand and dysregulation could contribute to exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). We measured leg hemodynamics and metabolites from vasoactive compounds in muscle interstitial fluid and plasma at rest, during one-legged knee-extensor exercise, and during arterial infusions of sodium nitroprusside (SNP) and acetylcholine (ACh), respectively. Ten patients with moderate to severe COPD and eight age- and sex-matched healthy controls were studied...
September 1, 2017: Journal of Applied Physiology
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