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https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#1
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#2
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28391426/comparison-of-stroke-volume-measurement-between-non-invasive-bioreactance-and-esophageal-doppler-in-patients-undergoing-major-abdominal-pelvic-surgery
#3
Gennaro De Pascale, Mervyn Singer, David Brealey
PURPOSE: Bioreactance is a non-invasive technology for measuring stroke volume (SV) in the operating room and critical care setting. We evaluated how the NICOM(®) bioreactance device performed against the CardioQ(®) esophageal Doppler monitor in patients undergoing major abdominal-pelvic surgery, focusing on the effect of different hemodynamic interventions. METHODS: SVNICOM and SVODM were simultaneously measured intraoperatively, including before and after interventions including fluid challenge, vasopressor boluses, peritoneal gas insufflation/removal, and Trendelenburg/reverse Trendelenburg patient positioning...
April 8, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28380062/different-effects-of-fluid-loading-with-saline-gelatine-hydroxyethyl-starch-or-albumin-solutions-on-acid-base-status-in-the-critically-ill
#4
Angélique M E Spoelstra-de Man, Annemieke Smorenberg, A B Johan Groeneveld
INTRODUCTION: Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. METHODS: We studied the effect of fluid resuscitation of normal saline and the colloids gelatine 4%, hydroxyethyl starch (HES) 6%, and albumin 5% on acid-base balance in 115 clinically hypovolemic critically ill patients during a 90 minute filling pressure-guided fluid challenge by a post-hoc analysis of a prospective randomized clinical trial...
2017: PloS One
https://www.readbyqxmd.com/read/28366285/a-review-of-hemodynamic-monitoring-techniques-methods-and-devices-for-the-emergency-physician
#5
Abdullah E Laher, Matthew J Watermeyer, Sean K Buchanan, Nicole Dippenaar, Nelly Clotilde Tchouambou Simo, Feroza Motara, Muhammed Moolla
The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363617/exploring-the-best-predictors-of-fluid-responsiveness-in-patients-with-septic-shock
#6
Nianfang Lu, Xiuming Xi, Li Jiang, Degang Yang, Kai Yin
OBJECTIVE: To evaluate respiratory variations in carotid and brachial peak velocity and other hemodynamic parameters to predict responsiveness to fluid challenge. METHODS: A prospective observational study was performed on mechanically ventilated patients with septic shock. Outcomes included the measurements of central venous pressure, intrathoracic blood volume index, stroke volume variation (SVV), pleth variability index(PVI), and ultrasound assessments of respiratory variations in inferior vena cava diameter (ΔIVC), carotid Doppler peak velocity (ΔCDPV), and brachial artery peak velocity (ΔVpeak brach)...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28359519/pulmonary-hypertension-in-heart-failure-pathophysiology-pathobiology-and-emerging%C3%A2-clinical%C3%A2-perspectives
#7
REVIEW
Marco Guazzi, Robert Naeije
Pulmonary hypertension is a common hemodynamic complication of heart failure. Interest in left-sided pulmonary hypertension has increased remarkably in recent years because its development and consequences for the right heart are now seen as mainstay abnormalities that begin in the early stages of the disease and bear unfavorable prognostic insights. However, some knowledge gaps limit our ability to influence this complex condition. Accordingly, attention is now focused on: 1) establishing a definitive consensus for a hemodynamic definition, perhaps incorporating exercise and fluid challenge; 2) implementing the limited data available on the pathobiology of lung capillaries and small arteries; 3) developing standard methods for assessing right ventricular function and, hopefully, its coupling to pulmonary circulation; and 4) searching for effective therapies that may benefit lung vessels and the remodeled right ventricle...
April 4, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28323719/passive-leg-raising-for-assessment-of-volume-responsiveness-a-review
#8
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...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28320151/takotsubo-cardiomyopathy-in-amyotrophic-lateral-sclerosis
#9
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
#10
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
#11
K Lakhal, M A Nay, T Kamel, B Lortat-Jacob, S Ehrmann, B Rozec, T Boulain
Background.: During fluid challenge, volume expansion (VE)-induced increase in cardiac output (Δ VE CO) is seldom measured. Methods.: In patients with shock undergoing strictly controlled mechanical ventilation and receiving VE, we assessed minimally invasive surrogates for Δ VE CO (by transthoracic echocardiography): fluid-induced increases in end-tidal carbon dioxide (Δ VE E'CO2 ); pulse (Δ VE PP), systolic (Δ VE SBP), and mean systemic blood pressure (Δ VE MBP); and femoral artery Doppler flow (Δ VE FemFlow)...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28131863/early-oxytocin-inhibition-of-salt-intake-after-furosemide-treatment-in-rats
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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