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pulmonary hypertension anesthesia

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https://www.readbyqxmd.com/read/29924007/intravenous-anesthesia-with-nitroglycerin-inhalation-for-surgical-abortion-in-a-patient-with-severe-congenital-heart-disease-and-low-oxygen-saturation-a-case-report
#1
Zhengfeng Gu, Lian Xin, Zhiping Wang, Jun Wang
INTRODUCTION: Congenital heart disease and pulmonary arterial hypertension are perilous to a gravida for the high morbidity and mortality. CASE PRESENTATION: We report an extremely rare case of a 27-year-old gravida with congenital heart disease and severe pulmonary arterial hypertension of 115 mmHg. Arterial blood gas analysis revealed her oxygen saturation (SpO2) of 67.8% and oxygen partial pressure of 40.0 mmHg, which were severely low. The patient was diagnosed as having gestation combined with congenital heart disease, severe pulmonary arterial hypertension, and hypoxemia...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29916227/comparison-between-iloprost-and-alprostadil-for-protection-against-ischemia-reperfusion-injury-in-a-rat-model
#2
Deniz Çevirme, Taylan Adademir, Eylül Kafalı Başaran, Ömer Faruk Şavluk, Ahmet Elibol, Gözde Erkanlı Şentürk, Hatice Akkaya, Bayram Yılmaz
Background/aim: Alprostadil and iloprost are successful agents used for both pulmonary hypertension and extremity ischemia treatment. Different systemic effects of these agents may change the preferences of clinical usage. Superiority of preventing ischemia/ reperfusion (IR) injury is a criterion for clinical preference of these agents. The present study was designed to compare the protective effects of alprostadil and iloprost in a rat model of IR injury. Materials and methods: Twenty-three male Sprague Dawley rats were used (aged 8-12 weeks, mean weight 230 ± 30 g)...
June 14, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29914654/outcomes-of-appendectomy-in-elderly-veteran-patients
#3
Oswaldo Renteria, Zain Shahid, Sergio Huerta
BACKGROUND: Some studies indicate that noncomplicated acute appendicitis might be treated exclusively with antibiotics instead of an appendectomy. This study was undertaken to assess outcomes in elderly veterans and to determine if operative intervention would lead to substantial complications such that a nonoperative strategy should be investigated. METHODS: A retrospective, single-institution analysis was conducted of patients who underwent an appendectomy at the VA North Texas Health Care System over a period of 12 years (from July 2005 to June 2017)...
June 16, 2018: Surgery
https://www.readbyqxmd.com/read/29894993/transbronchial-lung-cryobiopsy-in-interstitial-lung-diseases-best-practice
#4
Sara Colella, Maik Haentschel, Pallav Shah, Venerino Poletti, Jürgen Hetzel
The lung biopsy in interstitial lung disease (ILD) represents an important diagnostic step when the clinical and radiological data are insufficient for a firm diagnosis. A growing body of evidence suggests the utility of transbronchial lung cryobiopsy (TBLC) in the diagnostic algorithm of ILD as it allows, compared to transbronchial lung biopsy with conventional forceps, a better identification of complex histological patterns - such as usual interstitial pneumonia - and can provide information which has a clinical impact on the multidisciplinary discussion similar to that provided by surgical lung biopsy...
June 12, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29894348/eisenmenger-syndrome-in-pregnancy-when-is-it-time-for-ecmo-a-case-report
#5
Marie-Louise Meng, Annie Fu, Carolyn Westhoff, Matthew Bacchetta, Erika B Rosenzweig, Ruth Landau, Richard Smiley
We report the case of a 21-year-old primiparous woman at 22 weeks gestation who presented with a large uncorrected ventricular septal defect, severe pulmonary hypertension, and Eisenmenger syndrome. The patient elected for termination of pregnancy, which was performed under regional anesthesia. Hemodynamic changes apparently associated with uterine contraction immediately after termination resulted in increased right to left shunting across the ventricular septal defect requiring urgent venovenous extracorporeal membrane oxygenation...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29886609/-pulmonary-hypertensive-crisis-in-children-with-idiopathic-pulmonary-arterial-hypertension-undergoing-cardiac-catheterization-the-risk-factors-and-clinical-aspects
#6
C Zhang, Y Zhu, Q Q Li, H Gu
Objective: To investigate the risk factors, clinical features, treatments, and prevention of pulmonary hypertensive crisis (PHC) in children with idiopathic pulmonary arterial hypertension (IPAH) undergoing cardiac catheterization. Methods: This retrospective study included 67 children who were diagnosed with IPAH and underwent cardiac catheterization between April 2009 and June 2017 in Beijing Anzhen Hospital. The medical histories, clinical manifestations, treatments, and outcomes were characterized. Statistical analyses were performed using t test, χ(2) test and a multiple Logistic regression analysis...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29880427/dobutamine-and-nitroglycerin-versus-milrinone-for-perioperative-management-of-pulmonary-hypertension-in-mitral-valve-surgery-a-randomized-controlled-study
#7
Ashraf M Eskandr, Ahmed A Metwally, Montasser S Abu Elkassem, Sadik A Sadik, Ashraf E Elmiligy, Mohamed Mourad, Lamiaa Hussein
OBJECTIVE: To compare the effects of dobutamine and nitroglycerin to milrinone in young patients with severe pulmonary hypertension undergoing mitral valve replacement. DESIGN: A prospective randomized, double-blinded, controlled study. SETTING: Single university hospital. PARTICIPANTS: Forty patients had systolic pulmonary arterial pressure ≥60 mmHg and were scheduled for elective mitral valve replacement. The patients were divided randomly into 2 equal groups according to the drugs given during the study...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29871810/transcatheter-closure-of-large-atrial-septal-defects-asds-in-symptomatic-children-with-device-weight-ratio-%C3%A2-1-5
#8
Ali Houeijeh, Sebastien Hascoët, Hélène Bouvaist, Khaled Hadeed, Jérôme Petit, François Godart, Alain Fraisse
BACKGROUND: Atrial septal defects (ASDs) can be symptomatic in small children in cases of co-morbidities. Transcatheter closure remains controversial for large defects in small children. OBJECTIVE: To describe transcatheter closure of ASDs in children with device/weight ratio ≥1.5. METHODS: We retrospectively studied between January 2000 and January 2016 all cases of percutaneous ASD closure with device/weight ratio ≥1.5 in 6 European centres...
May 22, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29845684/obstetric-outcomes-in-pregnancy-with-pulmonary-hypertension-a-retrospective-study-of-78-cases-at-one-center
#9
Cai-Xia Zhu, Wei Xiong, Han-Qing Chen, Gang Niu, Zi-Lian Wang
OBJECTIVE: To identify the vary of obstetric outcomes by the severity of pulmonary hypertension (PH). METHODS: A retrospective study involved pregnancies with PH in one certain academic institution. Total 78 pregnancies with PH were classified into three groups according the mean pulmonary arterial systolic pressure: mean pulmonary arterial systolic pressure 30-49 mm Hg (mild-PH group), mean pulmonary arterial systolic pressure 50-69 mm Hg (moderate-PH group) and mean pulmonary arterial systolic pressure ≥ 70 mm Hg (severe-PH group)...
May 29, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29805492/association-of-hemodynamics-during-caesarean-section-outcomes-after-caesarean-section-and-hormone-changes-with-different-anesthesia-in-pregnant-women-with-severe-pulmonary-arterial-hypertension
#10
Yun Wang, Haiyan Xu, Haiyan Li, Yan Liu, Qingling Bai
In the present study we aimed to analyze the effects of different anesthesia methods on the hemodynamics of caesarean section, outcomes after caesarean section and hormone changes in pregnancy complicated with severe pulmonary arterial hypertension (PAH). A total of 75 pregnancy complicated with severe PAH that were treated in Jining First People's Hospital from January 2016 to January 2017 were selected. Three groups were set according to the anesthesia methods, including the subarachnoid combined epidural anesthesia group (group I, n=25), the epidural anesthesia group (group II, n=25) and the general anesthesia group (group III, n=25)...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#11
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#12
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#13
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29708913/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#14
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29702994/a-case-report-regarding-general-anesthesia-management-of-a-patient-with-pulmonary-vein-stenosis-that-underwent-balloon-dilatation-and-stent-implantation
#15
Fangzhou Li, Guoyan Qiao, Peng Liang, Jin Liu
RATIONALE: Pulmonary vein stenosis (PVS) is a rare cardiovascular deformity that can lead to high mortality if left untreated. Patients frequently experience multiple complications such as hemoptysis, pulmonary hypertension, bronchial venous rupture and cardiac insufficiency. Currently, pulmonary vein stenosis balloon dilatation (stent implantation) is the only treatment, and this can be performed under local or general anesthesia. However, a case report on the general anesthesia management of PVS has not been previously reported...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29652270/pulmonary-hypertension-and-cardiac-anesthesia-anesthesiologist-s-perspective
#16
REVIEW
Manjula Sudeep Sarkar, Pushkar M Desai
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#17
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29629260/acute-right-ventricular-failure-postintubation-in-a-mitral-stenosis-patient
#18
Sridhar Reddy Musuku, Saroj Pani, John Cagino
Mitral stenosis (MS) is prevalent in 0.02-0.2% of the population in developed countries. The pathophysiology of MS results in elevated left atrial pressures and over-time results in pulmonary hypertension (HTN) which ultimately affects the right ventricle. In addition, MS restricts the diastolic filling of the left ventricle. Therefore, during induction patients with MS are limited by their ability to increase cardiac output by increasing stroke volume. Anesthesia goals in severe MS are to avoid sudden changes in heart rate, as well as systemic and pulmonary artery pressures...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#19
M U Ziegler, H Reinelt
BACKGROUND: Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI)...
May 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29611831/anesthetic-management-for-concomitant-correction-of-congenital-cardiac-defects-and-long-o-ring-tracheal-stenosis-a-role-for-heliox-report-of-2-cases
#20
Sylvain Mauron, David Longchamp, Marie-Hélène Perez, René Prêtre, Kishore Sandu, Stefano Di Bernardo, Yann Boegli, Mirko Dolci
We present 2 infants with the rare association of long congenital tracheal stenosis, ventricular septal defect, and pulmonary hypertension. We describe a step-by-step assessment of the patients and the necessary procedures for a successful concomitant repair of both cardiac and tracheal malformations. The use of a helium-oxygen mixture (heliox) for the induction of anesthesia and pre-cardiopulmonary bypass is discussed.
March 15, 2018: A&A practice
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