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https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#1
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27857488/porosity-of-bleb-capsule-declines-rapidly-with-fluid-challenge
#2
Surinder S Pandav, Craig M Ross, Faisal Thattaruthody, Ritambhra Nada, Nirbhai Singh, Natasha Gautam, Stephen Beirne, Gordon G Wallace, Mark B Sherwood, Jonathan G Crowston, Michael Coote
INTRODUCTION: The porosity of the fibrous capsule around a glaucoma drainage device (GDD) may be the most important functional attribute. The factors that determine capsular porosity are not well understood. Failed GDD surgeries are usually associated with thick impervious capsules and components of aqueous have been implicated in this process. PURPOSE: In this study, we interrogated the effect of passage of nonaqueous fluid on capsular porosity in mature (but aqueous naïve) blebs in a previously reported GDD model (the "Center for Eye Research Australia Implant")...
September 2016: Journal of Current Glaucoma Practice
https://www.readbyqxmd.com/read/27850958/1322-correlation-of-systemic-hemodynamic-parameters-with-renal-regional-circulation-after-fluid-challenge
#3
Fethi Gül, Beliz Bilgili, Mustafa Kemal Arslantas, Secil Ozcan, Secil Ozcan, Ismail Cinel
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27837303/prediction-of-fluid-responsiveness-using-pulse-pressure-variation-in-infants-undergoing-ventricular-septal-defect-repair-with-median-sternotomy-or-minimally-invasive-right-thoracotomy
#4
Ding Han, Ya-Guang Liu, Yi Luo, Jia Li, Chuan Ou-Yang
Fluid management is challenging in infants after cardiopulmonary bypass. Pulse pressure variation (PPV) derived from pressure recording analytical method (PRAM) is based on lung-heart interaction during mechanical ventilation. A prospective observational study conducted in operating room tested PPV to predict fluid responsiveness in ventricular septal defect infants. Infants in open chest conditions with median sternotomy (n = 26) or minimally invasive right thoracotomy (n = 29) undergoing ventricular septal defect repair were enrolled...
November 11, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27829180/changes-of-central-venous-oxygen-saturation-define-fluid-responsiveness-in-patients-with-septic-shock-a-prospective-observational-study
#5
Biao Xu, Xiaobo Yang, Chunyao Wang, Wei Jiang, Li Weng, Xiaoyun Hu, Jinmin Peng, Bin Du
PURPOSE: To evaluate whether the changes of central venous oxygen saturation (Scvo2) after fluid challenge can define fluid responsiveness in patients with septic shock. METHODS: In this prospective observational study, septic shock patients with invasive cardiac output monitoring requiring fluid challenge were included. Cardiac index (CI) and Scvo2 were measured before and after fluid challenges. The changes of CI (ΔCI) and the changes of Scvo2 (ΔScvo2) were calculated and analyzed using Pearson correlation...
October 19, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27721980/fluid-responsiveness-prediction-using-vigileo-flotrac-measured-cardiac-output-changes-during-passive-leg-raise-test
#6
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/27720568/the-impact-of-push-dose-phenylephrine-use-on-subsequent-preload-expansion-in-the-ed-setting
#7
Madison B Schwartz, Jason A Ferreira, Patrick M Aaronson
BACKGROUND: The utilization of bolus-dose phenylephrine (PHE) has transitioned to the emergency department (ED) for the treatment of acutely hypotensive patients, despite a paucity of literature in this setting. METHODS: This was a single center retrospective chart review of the utilization of bolus-dosed PHE for acute hypotension in the ED at an academic non-forprofit hospital. The primary objective of this study is to report the frequency of patients that were initiated on a continuous vasopressor infusion (CVI) within 30 minutes after the first administration of bolus-dose PHE...
September 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27683608/hemodynamic-evidence-of-vascular-remodeling-in-combined-post-and-precapillary-pulmonary-hypertension
#8
Tufik R Assad, Evan L Brittain, Quinn S Wells, Eric H Farber-Eger, Stephen J Halliday, Laura N Doss, Meng Xu, Li Wang, Frank E Harrell, Chang Yu, Ivan M Robbins, John H Newman, Anna R Hemnes
Although commonly encountered, patients with combined postcapillary and precapillary pulmonary hypertension (Cpc-PH) have poorly understood pulmonary vascular properties. The product of pulmonary vascular resistance and compliance, resistance-compliance (RC) time, is a measure of pulmonary vascular physiology. While RC time is lower in postcapillary PH than in precapillary PH, the RC time in Cpc-PH and the effect of pulmonary wedge pressure (PWP) on RC time are unknown. We tested the hypothesis that Cpc-PH has an RC time that resembles that in pulmonary arterial hypertension (PAH) more than that in isolated postcapillary PH (Ipc-PH)...
September 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/27591389/inferior-vena-cava-diameter-variation-compared-with-pulse-pressure-variation-as-predictors-of-fluid-responsiveness-in-patients-with-sepsis
#9
Pongdhep Theerawit, Thotsaporn Morasert, Yuda Sutherasan
BACKGROUND: Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking. This is the reason for the present study. MATERIALS AND METHODS: We conducted a prospective observational study in patients with sepsis requiring fluid challenge...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27575357/clinical-relevance-of-fluid-challenge-in-patients-evaluated-for-pulmonary-hypertension
#10
Michele D'Alto, Emanuele Romeo, Paola Argiento, Yoshiki Motoji, Anna Correra, Giovanni Maria Di Marco, Agostino Mattera Iacono, Rosaria Barracano, Antonello D'Andrea, Gaetano Rea, Berardo Sarubbi, Maria Giovanna Russo, Robert Naeije
BACKGROUND: A fluid challenge may help to the differential diagnosis between pre- and post-capillary pulmonary hypertension (PH). However the test is still in need of standardization and better defined clinical relevance. METHODS AND RESULTS: Two-hundred-twelve patients referred for PH underwent a right heart catheterization with measurements before and after rapid infusion of 7 ml/kg of saline. PH was defined by a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg and post-capillary PH by a wedged PAP (PAWP) > 15 mmHg...
August 26, 2016: Chest
https://www.readbyqxmd.com/read/27555129/middle-cerebral-artery-blood-flow-velocity-during-beach-chair-position-for-shoulder-surgery-under-general-anesthesia
#11
Jean-Luc Hanouz, Anne-Lise Fiant, Jean-Louis Gérard
OBJECTIVES: The goal of the present study was to examine changes of middle cerebral artery (VMCA) blood flow velocity in patients scheduled for shoulder surgery in beach chair position. DESIGN: Prospective observational study. SETTING: Operating room, shoulder surgery. PATIENTS: Fifty-three consecutive patients scheduled for shoulder surgery in beach chair position. INTERVENTIONS: Transcranial Doppler performed after induction of general anesthesia (baseline), after beach chair positioning (BC1), during surgery 20minutes (BC2), and after back to supine position before stopping anesthesia (supine)...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27552511/selective-laser-trabeculoplasty-reduces-intraocular-pressure-peak-in-response-to-the-water-drinking-test
#12
Nathan M Kerr, Henry R Lew, Simon E Skalicky
PURPOSE: To determine the effect of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) peak and fluctuation induced by the water drinking test (WDT) in patients with open-angle glaucoma and ocular hypertension. METHODS: Patients with open-angle glaucoma or ocular hypertension underwent the WDT before and after SLT within a 12-month period. No other changes to therapeutic regimen were permitted. IOP was measured with a Goldmann applanation tonometer at baseline and every 15 minutes for 45 minutes following a fluid challenge of 800 mL over 15 minutes...
September 2016: Journal of Glaucoma
https://www.readbyqxmd.com/read/27536694/fluid-management-for-critically-ill-patients-a-review-of-the-current-state-of-fluid-therapy-in-the-intensive-care-unit
#13
REVIEW
Erin Frazee, Kianoush Kashani
BACKGROUND: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients...
June 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27464280/-state-of-the-art-intensive-care-therapy-of-septic-patients
#14
Sebastian Reith, Jan Rudolf Ortlepp
After recognition of the diagnosis sepsis early resuscitation of the patient is mandatory. Patients should have a mean arterial pressure (MAP) ≥65 mmHg. Patients with hypotension should receive initial fluid challenge with approximately 30 mL/kg of balanced electrolyte solutions. However, iatrogenic volume overload should be avoided. If MAP remains < 65mmHg despite adequate volume norepinephrine is the first choice catecholamine. Oxygen should be delivered when oxygen saturation is below 90% to avoid hypoxemia...
July 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27454378/negative-fluid-balance-in-sepsis-when-and-how
#15
Bruno Adler Maccagnan Pinheiro Besen, Leandro Utino Taniguchi
Fluid resuscitation plays a fundamental role in the treatment of septic shock. Administration of inappropriately large quantities of fluid may lead to volume overload, which is increasingly recognized as an independent risk factor for morbidity and mortality in critical illness. In the early treatment of sepsis, timely fluid challenges should be given to optimize organ perfusion, but continuous positive fluid balance is discouraged. In fact, achievement of a negative fluid balance during treatment of sepsis is associated with better outcomes...
July 21, 2016: Shock
https://www.readbyqxmd.com/read/27451877/ultrasonographic-measurements-of-the-inferior-vena-cava-variation-as-a-predictor-of-fluid-responsiveness-in-patients-undergoing-anesthesia-for-surgery
#16
Xiaobao Zhang, Jiying Feng, Pin Zhu, Hengfei Luan, Yong Wu, Zhibin Zhao
BACKGROUND: Both hypovolemia and hypervolemia are connected with increased morbidity and mortality in the treatment and prognosis of patients. An accurate assessment of volume state allows the optimization of organ perfusion and oxygen supply. Recently, ultrasonography has been used to detect hypovolemia in critically ill patients and perioperative patients. The objective of our study was to assess the correlation between inferior vena cava (IVC) variation obtained with ultrasound and stroke volume variation (SVV) measured by the Vigileo/FloTrac monitor, as fluid responsiveness indicators, in patients undergoing anesthesia for surgery...
July 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27388345/multicountry-survey-of-emergency-and-critical-care-medicine-physicians-fluid-resuscitation-practices-for-adult-patients-with-early-septic-shock
#17
Lauralyn McIntyre, Brian H Rowe, Timothy S Walsh, Alasdair Gray, Yaseen Arabi, Anders Perner, Anthony Gordon, John Marshall, Deborah Cook, Alison Fox-Robichaud, Sean M Bagshaw, Robert Green, Irwin Schweitzer, Alexis Turgeon, Ryan Zarychanski, Shane English, Michaël Chassé, Ian Stiell, Dean Fergusson
OBJECTIVES: Evidence to guide fluid resuscitation evidence in sepsis continues to evolve. We conducted a multicountry survey of emergency and critical care physicians to describe current stated practice and practice variation related to the quantity, rapidity and type of resuscitation fluid administered in early septic shock to inform the design of future septic shock fluid resuscitation trials. METHODS: Using a web-based survey tool, we invited critical care and emergency physicians in Canada, the UK, Scandinavia and Saudi Arabia to complete a self-administered electronic survey...
2016: BMJ Open
https://www.readbyqxmd.com/read/27381295/experimental-and-theoretical-investigations-of-non-newtonian-electro-osmotic-driven-flow-in-rectangular-microchannels
#18
Yi Huang, Juzheng Chen, TeckNeng Wong, Jong-Leng Liow
With the development of microfluidics, electro-osmotic (EO) driven flow has gained intense research interest as a result of its unique flow profile and the corresponding benefits in its application in the transportation of sensitive samples. Sensitive samples, such as DNA, are incapable of enduring strong flow shear induced by conventional hydrodynamic driven methods. EO driven flow is thus a niche area. However, even though there are a few research studies focusing on bio-fluidic samples related to EO driven flow, the majority of them are merely theoretical modeling without solid evidence from experiments due to the inherent complex rheological behavior of the bio-fluids...
July 20, 2016: Soft Matter
https://www.readbyqxmd.com/read/27350563/development-of-pulmonary-hypertension-in-heart-failure-with-preserved-ejection-fraction
#19
REVIEW
Grant Farr, Keyur Shah, Roshi Markley, Antonio Abbate, Fadi N Salloum, Dan Grinnan
Pulmonary hypertension (PH) is common in patients with heart failure with preserved ejection fraction (HFpEF). While PH-HFpEF may affect more than a million patients in the United States alone, it has been difficult to study its epidemiology and response to treatment due to difficulty in properly defining the illness. While chronic remodeling of the pulmonary vasculature is related to chronic passive congestion of the pulmonary circulation from the pulmonary veins, there are likely other contributors to the development of PH-HFpEF...
July 2016: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/27306799/a-systematic-review-of-pulse-pressure-variation-and-stroke-volume-variation-to-predict-fluid-responsiveness-during-cardiac-and-thoracic-surgery
#20
Federico Piccioni, Filippo Bernasconi, Giulia T A Tramontano, Martin Langer
This systematic review aims to summarize the published data on the reliability of pulse pressure variation (PPV) and stroke volume variation (SVV) to predict fluid responsiveness in an open-chest setting during cardio-thoracic surgery. The analysis included studies reporting receiver operating characteristics or correlation coefficients between PPV/SVV and change in any hemodynamic variables after a fluid challenge test in open-chest conditions. The literature search included seven studies. Increase in cardiac index and stroke volume index after a fluid challenge were the most adopted end-point variables...
June 15, 2016: Journal of Clinical Monitoring and Computing
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