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https://www.readbyqxmd.com/read/28323719/passive-leg-raising-for-assessment-of-volume-responsiveness-a-review
#1
Jaume Mesquida, Guillem Gruartmoner, Ricard Ferrer
PURPOSE OF REVIEW: To evaluate the existing evidence on the passive leg raising (PLR) test for fluid responsiveness prediction. RECENT FINDINGS: It has been well established that either insufficient or excessive fluid administration derives in worse outcomes in critically ill patients, highlighting that a more accurate assessment of fluid management is required. Accordingly, several cardiovascular indices have been tested to improve our ability to predict patients' response to fluid loading at the bedside, the so-called functional hemodynamic monitoring...
March 20, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28320151/takotsubo-cardiomyopathy-in-amyotrophic-lateral-sclerosis
#2
Seok-Jin Choi, Yoon-Ho Hong, Je-Young Shin, Byung-Nam Yoon, Sung-Yeon Sohn, Chan Soon Park, Jung-Joon Sung
OBJECTIVE: To investigate the frequency, features, and prognosis of takotsubo cardiomyopathy (TTC) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We reviewed detailed clinical, laboratory, and cardiovascular data from 64 ALS patients (38 men and 26 women) who underwent echocardiographic evaluation for various reasons at a single referral center between January 2011 and December 2015. RESULTS: TTC was diagnosed in 9 ALS patients (4 men and 5 women)...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28236396/challenges-in-sepsis-care-new-sepsis-definitions-and-fluid-resuscitation-beyond-the-central-venous-pressure
#3
REVIEW
Maureen A Seckel, Thomas Ahrens
There are two important recent changes in sepsis care. The first key change is the 2016 Sepsis-3 definitions from the recent consensus workgroup with new sepsis and septic shock definitions. Useful tools for assessing patients that have a greater risk of mortality include Sequential Organ Failure Assessment (SOFA) in intensive care units and quick SOFA outside intensive care units. The second change involves management of fluid resuscitation and measures of volume responsiveness. Measures such as blood pressure and central venous pressure are not reliable...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28186263/change-in-end-tidal-carbon-dioxide-outperforms-other-surrogates-for-change-in-cardiac-output-during-fluid-challenge
#4
K Lakhal, M A Nay, T Kamel, B Lortat-Jacob, S Ehrmann, B Rozec, T Boulain
No abstract text is available yet for this article.
February 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28131863/early-oxytocin-inhibition-of-salt-intake-after-furosemide-treatment-in-rats
#5
Sheri L Core, Kathleen S Curtis
Body fluid homeostasis requires a complex suite of physiological and behavioral processes. Understanding of the role of the central nervous system (CNS) in integrating these processes has been advanced by research employing immunohistochemical techniques to assess responses to a variety of body fluid challenges. Such techniques have revealed sex/estrogen differences in CNS activation in response to hypotension and hypernatremia. In contrast, it has been difficult to conclusively identify specific CNS areas and neurotransmitter systems that are activated by hyponatremia using these techniques...
January 25, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28124862/fluid-management-in-thoracic-anesthesia
#6
Mert Şentürk, Mukadder Orhan Sungur, Zerrin Sungur
Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The "safe zone" between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between peroperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. Multiple hit hypothesis and endothelial glycocalyx in addition to revised Starling equation can help us understand this dilemma...
January 25, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28039242/non-invasive-assessment-of-fluid-responsiveness-using-cnap%C3%A2-technology-is-interchangeable-with-invasive-arterial-measurements-during-major-open-abdominal-surgery
#7
J Renner, M Gruenewald, M Hill, L Mangelsdorff, H Aselmann, C Ilies, M Steinfath, O Broch
BACKGROUND: Dynamic variables of fluid responsiveness (FR), such as pulse pressure variation (PPV), have been shown to predict the response to a fluid challenge accurately. A recently introduced non-invasive technology based on the volume-clamp method (CNAP™) offers the ability to measure PPV continuously (PPVCNAP). However, the accuracy regarding the prediction of FR in the operating room has to be proved. METHODS: We compared PPVCNAP with an invasive approach measuring PPV using the PiCCO technology (PPVPiCCO)...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27984249/predicting-fluid-responsiveness-in-acute-liver-failure-a-prospective-study
#8
Vinod Kumar Audimoolam, Mark J W McPhail, Chris Willars, William Bernal, Julia A Wendon, Maurizio Cecconi, Georg Auzinger
BACKGROUND: The profound hemodynamic changes seen in acute liver failure (ALF) resemble the hyperdynamic state found in the later stages of septic shock. Vasopressor support frequently is required after initial volume therapy. Markers of preload dependency have not been studied in this patient group. Dynamic maneuvers such as passive leg raising or end-expiratory hold, which have shown good predictive accuracy in a general intensive care unit population, cannot be considered safe in this cohort because of the concerns of intracranial hypertension...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27932196/a-mini-volume-loading-test-mvlt-using-2-5-mlkg-1-boluses-of-crystalloid-for-indication-of-perioperative-changes-in-hydration-status
#9
Audrius Andrijauskas, Christer H Svensen, Narūnas Porvaneckas, Jūratė Šipylaitė, Edgaras Stankevičius, Darius Činčikas, Valentinas Uvarovas, Saulė Švedienė, Igoris Šatkauskas, Saulius Vosylius, Giedrius Kvederas
BACKGROUND AND OBJECTIVE: A mini volume loading test (mVLT) evaluating hemodilution during step-wise crystalloid infusion has established that the arterio-capillary plasma dilution difference is inversely correlated to the body hydration level of subjects. This observational study aimed to test whether this can be replicated in a perioperative setting using a 2.5-mLkg(-1) boluses. MATERIALS AND METHODS: The mVLT was performed before induction of regional anesthesia and 24h later...
2016: Medicina
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#10
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
#11
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
#12
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
#13
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...
January 2017: 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
#14
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...
April 2017: 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
#15
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
#16
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...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27683608/hemodynamic-evidence-of-vascular-remodeling-in-combined-post-and-precapillary-pulmonary-hypertension
#17
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
#18
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
#19
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
#20
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
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