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https://www.readbyqxmd.com/read/29684655/effect-of-fluid-challenge-on-renal-resistive-index-after-major-orthopaedic-surgery-a-prospective-observational-study-using-doppler-ultrasonography
#1
Fabrice Ferré, Philippe Marty, Cédric Folcher, Matt Kurrek, Vincent Minville
BACKGROUND: A postoperative renal resistive index (RRI) > 0.70 has the best threshold to early predict acute kidney injury (AKI). The response of RRI to a postoperative fluid challenge (FC) is unknown. The aim of our study was to assess the impact of a FC on RRI in suspected hypovolaemia patients after orthopaedic surgery. DESIGN: In this single-centre observational study, we prospectively screened 156 patients in the recovery room after having undergone a hip or knee replacement...
April 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29679768/comparison-of-proaqt-pulsioflex%C3%A2-and-oesophageal-doppler-for-intraoperative-haemodynamic-monitoring-during-intermediate-risk-abdominal-surgery
#2
Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria
OBJECTIVE: To compare cardiac index (CI) between Proaqt/PulsioFlex® and esophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI. METHODS: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min)...
April 18, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29664782/challenge-of-the-mini-fluid-challenge-filling-twice-without-creating-a-self-fulfilling-prophecy-design
#3
Simon Tilma Vistisen, Thomas W L Scheeren
No abstract text is available yet for this article.
May 2018: Anesthesiology
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#4
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29559180/fluid-challenge-predicts-clinical-worsening-in-pulmonary-arterial-hypertension
#5
Michele D'Alto, Yoshiki Motoji, Emanuele Romeo, Paola Argiento, Giovanni Maria Di Marco, Agostino Mattera Iacono, Antonello D'Andrea, Gaetano Rea, Paolo Golino, Robert Naeije
AIM: A fluid challenge with rapid saline infusion during right heart catheterization has been shown to be useful for the differential diagnosis between pre- and post-capillary pulmonary hypertension. The aim of this study was to evaluate the prognostic relevance of fluid challenge-induced changes in pulmonary hemodynamics in patients with pulmonary arterial hypertension (PAH). METHODS: Overall, 118 PAH patients (mean age 57 ± 15 years, 80 female) underwent hemodynamic measurements before and after rapid saline infusion (7 mL/kg in 10 min) and were followed up for 19 ± 4 months...
March 7, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29518407/aging-affects-isoproterenol-induced-water-drinking-astrocyte-density-and-central-neuronal-activation-in-female-brown-norway-rats
#6
Rachel N Hardy, Zinar D Simsek, Brandon Curry, Sheri L Core, Terry Beltz, Baojian Xue, Alan K Johnson, Robert L Thunhorst, Kathleen S Curtis
Age-dependent impairments in the central control of compensatory responses to body fluid challenges have received scant experimental attention, especially in females. In the present study, we found that water drinking in response to β-adrenergic activation with isoproterenol (30 μg/kg, s.c.) was reduced by more than half in aged (25 mo) vs. young (5 mo) ovariectomized female Brown Norway rats. To determine whether this age-related decrease in water intake was accompanied by changes in central nervous system areas associated with fluid balance, we assessed astrocyte density and neuronal activation in the SFO, OVLT, SON, AP and NTS of these rats using immunohistochemical labeling for GFAP and c-fos, respectively...
March 5, 2018: Physiology & Behavior
https://www.readbyqxmd.com/read/29427013/assessment-of-fluid-responsiveness-in-spontaneously-breathing-patients-a-systematic-review-of-literature
#7
REVIEW
Renato Carneiro de Freitas Chaves, Thiago Domingos Corrêa, Ary Serpa Neto, Bruno de Arruda Bravim, Ricardo Luiz Cordioli, Fabio Tanzillo Moreira, Karina Tavares Timenetsky, Murillo Santucci Cesar de Assunção
Patients who increase stoke volume or cardiac index more than 10 or 15% after a fluid challenge are usually considered fluid responders. Assessment of fluid responsiveness prior to volume expansion is critical to avoid fluid overload, which has been associated with poor outcomes. Maneuvers to assess fluid responsiveness are well established in mechanically ventilated patients; however, few studies evaluated maneuvers to predict fluid responsiveness in spontaneously breathing patients. Our objective was to perform a systematic review of literature addressing the available methods to assess fluid responsiveness in spontaneously breathing patients...
February 9, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29424795/evaluation-of-vasopressin-for-vasoplegic-shock-in-patients-with-preoperative-left-ventricular-dysfunction-after-cardiac-surgery-a-propensity-score-analysis
#8
Yongqing Cheng, Tuo Pan, Min Ge, Tao Chen, Jiaxin Ye, Lichong Lu, Cheng Chen, Qiuyan Zong, Yi Ding, Dongjin Wang
PURPOSE: Postoperative vasoplegic shock after cardiac surgery seems to be a frequent complication with poor outcomes. We hypothesized that vasopressin may increase the risk of poor outcomes in patients with preoperative Left Ventricular Dysfunction (pLVD) rather than norepinephrine. The aim of this study was to assess whether vasopressin is superior to norepinephrine to improve outcomes in patients with pLVD after cardiac surgery. METHODS: This retrospective cohort study included 1,156 patients with postoperative vasoplegic shock (mean arterial pressure <65 mmHg resistant to fluid challenge and cardiac index >2...
February 7, 2018: Shock
https://www.readbyqxmd.com/read/29398109/long-term-dentin-remineralization-by-poly-amido-amine-and-rechargeable-calcium-phosphate-nanocomposite-after-fluid-challenges
#9
Kunneng Liang, Shimeng Xiao, Junling Wu, Jiyao Li, Michael D Weir, Lei Cheng, Mark A Reynolds, Xuedong Zhou, Hockin H K Xu
OBJECTIVE: Previous studies investigated short-term dentin remineralization; studies on long-term dentin remineralization after fluid challenges mimicking fluids in oral environment are lacking. The objective of this study was to develop a long-term remineralization method to via poly(amido amine) (PAMAM) and rechargeable composite containing nanoparticles of amorphous calcium phosphate (NACP) after fluid challenges for the first time. METHODS: NACP composite was immersed at pH 4 to exhaust its calcium (Ca) and phosphate (P) ions, and then recharged with Ca and P ions, to test the remineralization of the exhausted and recharged NACP composite...
February 2, 2018: Dental Materials: Official Publication of the Academy of Dental Materials
https://www.readbyqxmd.com/read/29380189/respiratory-changes-in-subclavian-vein-diameters-predicts-fluid-responsiveness-in-intensive-care-patients-a-pilot-study
#10
Raphaël Giraud, Paul S Abraham, Pauline Brindel, Nils Siegenthaler, Karim Bendjelid
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. Cardiac output (CO) and dynamic parameters [stroke volume variation (SVV) and pulse pressure variation (PPV)] measured by transpulmonary thermodilution and pulse contour analysis (PiCCO™) as well as classical hemodynamic parameters were recorded at baseline and after FC...
January 29, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29367093/a-mini-fluid-challenge-of-150ml-predicts-fluid-responsiveness-using-modelflow-r-pulse-contour-cardiac-output-directly-after-cardiac-surgery
#11
Annemieke Smorenberg, Thomas G V Cherpanath, Bart F Geerts, Robert B P de Wilde, Jos R C Jansen, Jacinta J Maas, A B Johan Groeneveld
STUDY OBJECTIVE: The mini-fluid challenge may predict fluid responsiveness with minimum risk of fluid overloading. However, the amount of fluid as well as the best manner to evaluate the effect is unclear. In this prospective observational pilot study, the value of changes in pulse contour cardiac output (CO) measurements during mini-fluid challenges is investigated. DESIGN: Prospective observational study. SETTING: Intensive Care Unit of a university hospital...
January 19, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29343170/accuracy-of-ultrasonographic-measurements-of-inferior-vena-cava-to-determine-fluid-responsiveness-a-systematic-review-and-meta-analysis
#12
Daniele Orso, Irene Paoli, Tommaso Piani, Francesco L Cilenti, Lorenzo Cristiani, Nicola Guglielmo
OBJECTIVE: Fluid responsiveness is the ability to increase the cardiac output in response to a fluid challenge. Only about 50% of patients receiving fluid resuscitation for acute circulatory failure increase their stroke volume, but the other 50% may worsen their outcome. Therefore, predicting fluid responsiveness is needed. In this purpose, in recent years, the assessment of the inferior vena cava (IVC) through ultrasound (US) has become very popular. The aim of our work was to systematically review all the previously published studies assessing the accuracy of the diameter of IVC or its respiratory variations measured through US in predicting fluid responsiveness...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29340792/internal-jugular-vein-variability-predicts-fluid-responsiveness-in-cardiac-surgical-patients-with-mechanical-ventilation
#13
Guo-Guang Ma, Guang-Wei Hao, Xiao-Mei Yang, Du-Ming Zhu, Lan Liu, Hua Liu, Guo-Wei Tu, Zhe Luo
BACKGROUND: To evaluate the efficacy of using internal jugular vein variability (IJVV) as an index of fluid responsiveness in mechanically ventilated patients after cardiac surgery. METHODS: Seventy patients were assessed after cardiac surgery. Hemodynamic data coupled with ultrasound evaluation of IJVV and inferior vena cava variability (IVCV) were collected and calculated at baseline, after a passive leg raising (PLR) test and after a 500-ml fluid challenge. Patients were divided into volume responders (increase in stroke volume ≥ 15%) and non-responders (increase in stroke volume < 15%)...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29338148/novel-applications-of-bedside-monitoring-to-plumb-patient-hemodynamic-state-and-response-to-therapy
#14
Fabio Guarracino, Pietro Bertini, Michael R Pinsky
Hemodynamic monitoring is essential during the treatment of the critically ill in order to address the hemodynamic alterations and assess the response to treatment. Traditionally classified causes of shock and underlying pathophysiological mechanisms are often neglected by resuscitative strategies included in the guidelines. Most of hemodynamic management focuses on the ability to early recognise patients susceptible to increase cardiac output (CO) and mean arterial pressure (MAP) after a defined fluid challenge by eliciting Starling's law of the heart, and less is known of the ones presenting in shock and not volume responsive...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29261735/docosahexaenoic-acid-but-not-eicosapentaenoic-acid-improves-septic-shock-induced-arterial-dysfunction-in-rats
#15
Alexandra Boivin, Mélanie Burban, Raphaël Clere-Jehl, Pierrick Le Borgne, Hamid Merdji, Cyril Auger, Valérie Schini-Kerth, Ferhat Meziani, Julie Helms
INTRODUCTION: Long chain n-3 fatty acid supplementation may modulate septic shock-induced host response to pathogen-induced sepsis. The composition of lipid emulsions for parenteral nutrition however remains a real challenge in intensive care, depending on their fatty acid content. Because they have not been assessed yet, we aimed at determining the respective effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) during septic shock-induced vascular dysfunction. METHODS: In a peritonitis-induced septic shock model, rats were infused with EPA, DHA, an EPA/DHA mixture or 5% dextrose (D5) during 22 hours...
2017: PloS One
https://www.readbyqxmd.com/read/29203173/evaluation-of-the-dynamic-predictors-of-fluid-responsiveness-in-dogs-receiving-goal-directed-fluid-therapy
#16
Maja J Drozdzynska, Yu-Mei Chang, Giacomo Stanzani, Ludovic Pelligand
OBJECTIVES: Goal-directed fluid therapy (GDFT) based on pulse pressure variation (PPV) was used in anaesthetized dogs undergoing abdominal surgeries. The aims were 1) to evaluate the success rate of the PPV ≥13% in detecting fluid responsiveness [delta stroke volume (ΔSV) ≥10%]; 2) to assess the correlation between PPV, systolic pressure variation (SPV), Plethysmograph Variability Index (PVI) and central venous pressure (CVP) and 3) to establish the threshold value for the PVI that would predict a PPV value of ≥13% and indirectly discriminate responders from nonresponders to fluid therapy...
January 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29174912/behavioral-responses-and-fluid-regulation-in-male-rats-after-combined-dietary-sodium-deficiency-and-water-deprivation
#17
Kimberly J Lucia, Kathleen S Curtis
Most investigators use a single treatment such as water deprivation or dietary sodium deficiency to evaluate thirst or sodium appetite, which underlie behavioral responses to body fluid challenges. The goal of the present experiments was to assess the effects of combined treatments in driving behaviors. Therefore, we evaluated the effect of combined overnight water deprivation and dietary sodium deficiency on water intake and salt intake by adult male rats in 2-bottle (0.5M NaCl and water) tests. Overnight water deprivation alone increased water intake, and 10days of dietary sodium deficiency increased 0...
February 1, 2018: Physiology & Behavior
https://www.readbyqxmd.com/read/29171669/volume-responsiveness-assessed-by-passive-leg-raising-and-a-fluid-challenge-a-critical-review-focused-on-mean-systemic-filling-pressure
#18
K Cooke, R Sharvill, S Sondergaard, A Aneman
This review applied cardiovascular principles relevant to the physiology of venous return in interpreting studies on the utility of a passive leg-raising manoeuvre to identify patients who do (responders) or do not respond to a subsequent intravenous volume challenge with an increase in cardiac output. Values for cardiac output, mean arterial and central venous pressure, and the calculated cardiovascular variables mean systemic filling pressure analogue, heart efficiency, cardiac power indexed by volume state and volume efficiency, before and after passive leg raising as well as before and after fluid volume challenge, were extracted from published studies...
March 2018: Anaesthesia
https://www.readbyqxmd.com/read/29149433/predictive-values-of-pulse-pressure-variation-and-stroke-volume-variation-for-fluid-responsiveness-in-patients-with-pneumoperitoneum
#19
Marko Zlicar, Vesna Novak-Jankovic, Rok Blagus, Maurizio Cecconi
Animal studies suggest that dynamic predictors remain useful in patients with pneumoperitoneum, but human data is conflicting. Our aim was to determine predictive values of pulse pressure variation (PPV) and stroke volume variation (SVV) in patients with pneumoperitoneum using LiDCORapid™ haemodynamic monitor. Standardised fluid challenges of colloid were administered to patients undergoing laparoscopic procedures, one fluid challenge per patient. Intra-abdominal pressure was automatically held at 12 mmHg...
November 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#20
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
February 2018: Critical Care Medicine
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