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https://www.readbyqxmd.com/read/29450194/avoiding-arterial-hypotension-in-preterm-neonates-ahip-a-single-center-randomised-controlled-study-investigating-simultaneous-near-infrared-spectroscopy-measurements-of-cerebral-and-peripheral-regional-tissue-oxygenation-and-dedicated-interventions
#1
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#2
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29402354/comparison-of-direct-and-indirect-methods-of-measuring-arterial-blood-pressure-in-healthy-male-rhesus-macaques-macaca-mulatta
#3
Logan K France, Meghan S Vermillion, Caroline M Garrett
Blood pressure is a critical parameter for evaluating cardiovascular health, assessing effects of drugs and procedures, monitoring physiologic status during anesthesia, and making clinical decisions. The placement of an arterial catheter is the most direct and accurate method for measuring blood pressure; however, this approach is invasive and of limited use during brief sedated examinations. The objective of this study was to determine which method of indirect blood pressure monitoring was most accurate compared with measurement by direct arterial catheterization...
January 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29368625/perioperative-fluid-management-in-kidney-transplantation-a-black-box
#4
REVIEW
Maria Helena Calixto Fernandes, Thomas Schricker, Sheldon Magder, Roupen Hatzakorzian
The incidence of delayed graft function in patients undergoing kidney transplantation remains significant. Optimal fluid therapy has been shown to decrease delayed graft function after renal transplantation. Traditionally, the perioperative volume infusion regimen in this patient population has been guided by central venous pressure as an estimation of the patient's volume status and mean arterial pressure, but this is based on sparse evidence from mostly retrospective observational studies. Excessive volume infusion to the point of no further fluid responsiveness can damage the endothelial glycocalyx and is no longer considered to be the best approach...
January 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29367218/orthostatic-blood-pressure-recovery-patterns-in-suspected-syncope-in-the-emergency-department
#5
Veera K van Wijnen, Dik Ten Hove, Reinold O B Gans, Wybe Nieuwland, Arie M van Roon, Jan C Ter Maaten, Mark P M Harms
INTRODUCTION: Orthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring. METHODS: We performed a prospective cohort study in suspected patients with (pre)syncope in the ED of a tertiary care teaching hospital between January and August 2014...
January 24, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29359072/efficacy-and-safety-of-using-high-flow-nasal-oxygenation-in-patients-undergoing-rapid-sequence-intubation
#6
Santi Maurizio Raineri, Andrea Cortegiani, Giuseppe Accurso, Claudia Procaccianti, Filippo Vitale, Sabrina Caruso, Antonino Giarratano, Cesare Gregoretti
Objective: To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods: HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3)...
December 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29349824/reduced-left-ventricular-filling-following-blood-volume-extraction-does-not-result-in-compensatory-augmentation-of-cardiac-mechanics
#7
Rachel Lord, David MacLeod, Keith George, David Oxborough, Rob Shave, Mike Stembridge
An acute non-invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate (HR), whereas blood volume extraction reduces preload without HR changes. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (4 female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end-extraction following the controlled removal of 25% of total blood volume (1062 ± 342 ml)...
January 18, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29330589/impact-of-valve-less-vs-standard-insufflation-on-pneumoperitoneum-volume-inflammation-and-peritoneal-physiology-in-a-laparoscopic-sigmoid-resection-experimental-model
#8
Michele Diana, Eric Noll, Andras Legnèr, Seong-Ho Kong, Yu-Yin Liu, Luigi Schiraldi, Francesco Marchegiani, Jordan Bano, Bernard Geny, Anne-Laure Charles, Bernard Dallemagne, Véronique Lindner, Didier Mutter, Pierre Diemunsch, Jacques Marescaux
BACKGROUND: Standard insufflators compensate for intra-abdominal pressure variations with pressure spikes. Our aim was to evaluate the impact of a stable, low-pressure pneumoperitoneum induced by a valve-less insufflator, on working space, hemodynamics, inflammation, and peritoneal physiology, in a model of laparoscopic sigmoid resection. MATERIALS AND METHODS: Twelve pigs (47 ± 3.3 kg) were equipped for invasive hemodynamic monitoring and randomly assigned to Standard (n = 6) vs...
January 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29329761/n-terminal-pro-b-type-natriuretic-peptide-for-monitoring-after-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#9
Steffen D Kriechbaum, Christoph B Wiedenroth, Jan Sebastian Wolter, Regula Hütz, Moritz Haas, Andreas Breithecker, Fritz C Roller, Till Keller, Stefan Guth, Andreas Rolf, Christian W Hamm, Eckhard Mayer, Christoph Liebetrau
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an emerging interventional treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). The non-invasive monitoring of CTEPH patients is a clinical challenge. In this study we examined changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients undergoing BPA for inoperable CTEPH and related them to peri-procedural success. METHODS: In this study we analyzed a total of 51 consecutive patients who underwent BPA treatment and completed a 6-month follow-up (6-MFU) between March 2014 and March 2017...
December 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29318621/evaluation-of-oscillometric-blood-pressure-monitor-blt-m9000-vet-in-anaesthetised-healthy-adult-dogs
#10
P Zrimšek, J Sredenšek, M Vengušt, A Seliškar
To examine agreement in anaesthetised dogs between invasive blood pressure measurements and measurements obtained with an oscillometric blood pressure monitor. MATERIALS AND METHODS: Paired invasive and oscillometric measurements were taken in 24 dogs every 5 minutes during anaesthesia (9 to 37 measurements per dog). Agreement between measurement methods was explored using Bland-Altman plots. To determine the accuracy of the oscillometric measurements, the results were compared with the guidelines recommended by the American College of Veterinary Internal Medicine and the Association for the Advancement of Medical Instrumentation...
January 10, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29312664/invasive-monitoring-of-blood-pressure-a-radiant-future-for-brachial-artery-as-an-alternative-to-radial-artery-catheterisation
#11
EDITORIAL
Karim Lakhal, Vincent Robert-Edan
No abstract text is available yet for this article.
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29311754/correlation-between-cerebral-hemodynamic-and-perfusion-pressure-changes-in-non-human-primates
#12
A Ruesch, M A Smith, G Wollstein, I A Sigal, S Nelson, J M Kainerstorfer
The mechanism that maintains a stable blood flow in the brain despite changes in cerebral perfusion pressure (CPP), and therefore guaranties a constant supply of oxygen and nutrients to the neurons, is known as cerebral autoregulation (CA). In a certain range of CPP, blood flow is mediated by a vasomotor adjustment in vascular resistance through dilation of blood vessels. CA is known to be impaired in diseases like traumatic brain injury, Parkinson's disease, stroke, hydrocephalus and others. If CA is impaired, blood flow and pressure changes are coupled and the oxygen supply might be unstable...
February 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/29286944/update-of-a-systematic-review-of-autoresuscitation-after-cardiac-arrest
#13
Laura Hornby, Sonny Dhanani, Sam D Shemie
OBJECTIVES: There has been a growth in publications focusing on the phenomena of autoresuscitation in recent years. In 2010, we systematically reviewed the medical literature with the primary objective of summarizing the evidence on the timing of autoresuscitation. Healthcare professionals have continued to voice concerns regarding the potential for autoresuscitation. With this in mind, the objective of this brief report is to update the results of our original review of autoresuscitation...
December 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#14
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29261549/continuous-noninvasive-arterial-pressure-monitoring-using-the-vascular-unloading-technique-cnap-system-in-obese-patients-during-laparoscopic-bariatric-operations
#15
Dorothea E Rogge, Julia Y Nicklas, Sebastian A Haas, Daniel A Reuter, Bernd Saugel
BACKGROUND: Increasing rates of obesity create new challenges for hemodynamic monitoring in the perioperative phase. Continuous monitoring of arterial pressure (AP) is important in severely obese patients who are at particular risk for cardiovascular complications. Innovative technologies for continuous noninvasive AP monitoring are now available. In this study, we aimed to compare continuous noninvasive AP measurements using the vascular unloading technique (CNAP system; CNSystems, Graz, Austria) compared with invasive AP measurements (radial arterial catheter) in severely obese patients during laparoscopic bariatric surgery...
December 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29251031/correlation-between-time-lag-of-arterial-plethysmographic-waveforms-and-systemic-vascular-resistance-a-prospective-study
#16
Radhakrishnan Muthuchellappan, Ramesh V J, Umamaheswara Rao Ganne S, Thennarasu K, Anjana Jacob, Sripathy G, Bhadrinarayan V, Mohanvelu K
Blood pressure (BP), a surrogate of cardiac output (CO), is also dependent on systemic vascular resistance (SVR). But SVR is not routinely monitored in daily clinical practice. We hypothesise that the time difference between the peripheral arterial waveform and the finger plethysmographic waveform (time lag index - TLi) could indicate the systemic vascular resistance. In this study, we correlated TLi with the systemic vascular resistance measured by minimally invasive CO monitor (pulse contour analysis). SVR changes in response to administration of mannitol were studied...
December 18, 2017: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/29240626/first-report-of-biventricular-percutaneous-impella-ventricular-assist-device-use-in-pediatric-patients
#17
Javier J Lasa, Daniel A Castellanos, Susan W Denfield, William J Dreyer, Sebastian C Tume, Henri Justino, Athar M Qureshi
There is a growing interest in the use of percutaneously delivered ventricular assist devices (PVAD) in the pediatric patient population. A 16 year old female and 18 year old male both status post heart transplantation presented with evidence of graft rejection and acute severe global systolic and diastolic heart failure necessitating hemodynamic catheterization and inotropic support. Both underwent percutaneous Impella CP LVAD (Abiomed, Danvers, MA) placement with close monitoring of right ventricular function...
December 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29204771/comparison-of-blood-pressure-monitoring-by-applanation-tonometry-and-invasively-assessed-blood-pressure-in-cardiological-patients
#18
G Greiwe, S Hoffmann, L Herich, M S Winkler, C J Trepte, C R Behem, M Petzoldt, D A Reuter, S A Haas
The aim of this study was to evaluate the accuracy and precision of non-invasive continuous blood pressure measurement by applanation tonometry (AT) in awake or anaesthetised cardiological intensive care patients. Patients suffering from highly impaired left ventricular function atrial fibrillation or severe aortic valve stenosis were included into the study. Arterial blood pressure was recorded by applanation tonometry (T-Line 400, Tensys Medical®, USA) and an arterial line in awake or anaesthetised patients...
December 4, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29204425/continuous-non-invasive-arterial-pressure-assessment-during-surgery-to-improve-outcome
#19
REVIEW
Alena Stenglova, Jan Benes
Blood pressure (BP) is one of the most important variables evaluated during almost every medical examination. Most national anesthesiology societies recommend BP monitoring at least once every 5 min in anesthetized subjects undergoing surgical procedures. In most cases, BP is monitored non-invasively using oscillometric cuffs. Although the risk of arterial cannulation is not very high, the invasive BP monitoring is usually indicated only in the case of high-risk patients or in complex surgical procedures...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29203173/evaluation-of-the-dynamic-predictors-of-fluid-responsiveness-in-dogs-receiving-goal-directed-fluid-therapy
#20
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
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