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https://www.readbyqxmd.com/read/29679696/effect-of-neuromonitor-guided-titrated-care-on-brain-tissue-hypoxia-after-opioid-overdose-cardiac-arrest
#1
Jonathan Elmer, Katharyn L Flickinger, Maighdlin W Anderson, Allison Koller, Matthew Sundermann, Cameron Dezfulian, David O Okonkwo, Lori A Shutter, David Salcido, Clifton W Callaway, James J Menegazzi
INTRODUCTION: Brain tissue hypoxia may contribute to preventable secondary brain injury after cardiac arrest. We developed a porcine model of opioid overdose cardiac arrest and post-arrest care including invasive, multimodal neurological monitoring of regional brain physiology. We hypothesized brain tissue hypoxia is common with usual post-arrest care and can be prevented by modifying mean arterial pressure (MAP) and arterial oxygen concentration (PaO2 ). METHODS: We induced opioid overdose and cardiac arrest in sixteen swine, attempted resuscitation after 9 minutes of apnea, and randomized resuscitated animals to three alternating 6-hour blocks of standard or titrated care...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29663822/the-effect-of-intrathecal-sufentanil-preconditioning-against-myocardial-ischemia-reperfusion-injury
#2
Y Tire, G Sarkilar, H Esen, R Onoglu, S T Uzun
OBJECTIVES: We aimed to investigate the cardioprotective effect and hemodynamic response of intrathecally administered sufentanil on myocardial IR injury. BACKGROUND: Sufentanil, mu opioid receptor agonist, intravenously administered during clinical and experimental studies, has been shown to have a cardioprotective effect on myocardial ischemia-reperfusion injury. METHODS: Thirty-two New Zealand type rabbits, which were anesthetized, were divided into four equal groups: sham, ischemia-reperfusion, sufentanil and ischemia-reperfusion+sufentanil...
2018: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#3
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29629927/physiology-directed-cardiopulmonary-resuscitation-advances-in-precision-monitoring-during-cardiac-arrest
#4
Alexandra M Marquez, Ryan W Morgan, Catherine E Ross, Robert A Berg, Robert M Sutton
PURPOSE OF REVIEW: We review the recent advances in physiologic monitoring during cardiac arrest and offer an evidence-based framework for prioritizing physiologic targets during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Current CPR guidelines recommend a uniform approach for all patients in cardiac arrest, but newer data support a precision strategy that uses the individual patient's physiology to guide resuscitation. Coronary perfusion pressure and arterial DBP are associated with survival outcomes in recent animal and human studies...
April 6, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29623382/-the-heart-catheter-table-is-not-the-operating-table-intraindividual-comparison-of-pulmonary-artery-pressures
#5
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)...
April 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29621117/cerebral-multimodal-monitoring-in-sepsis-an-experimental-study
#6
Pedro Kurtz, Joana C d'Avila, Darwin Prado, Caroline Madeira, Charles Vargas-Lopes, Rogerio Panizzutti, Luciano Cesar Pontes Azevedo, Fernando A Bozza
Acute brain dysfunction is a complication of sepsis and its pathophysiology remains poorly understood. We studied the brain metabolism in a resuscitated animal model of sepsis. Twelve anesthetized, mechanically ventilated and invasively monitored pigs were allocated to a sham procedure (N = 5) or sepsis (N = 7). Sepsis was induced through fecal inoculation in the peritoneum. Fluid resuscitation was maintained during the entire study period. Animals were observed until spontaneous death or for a maximum of 24 hours...
April 4, 2018: Shock
https://www.readbyqxmd.com/read/29610936/impact-of-intravascular-thrombosis-on-failure-of-radial-arterial-catheters-in-critically-ill-patients-a-nested-case-control-study
#7
Yvan Fleury, Diego Arroyo, Caroline Couchepin, Helia Robert-Ebadi, Marc Righini, Johannes A Lobrinus, Bara Ricou, Nathalie Delieuvin Schmitt, Angèle Gayet-Ageron
PURPOSE: The patency of arterial catheters is essential for reliable invasive blood pressure monitoring. We sought to determine whether radial catheter failures were associated with intravascular thrombosis in critically ill adult patients. METHODS: This unmatched case-control study was conducted within a prospective cohort of patients admitted to an intensive care unit. The arterial catheter failure was the main outcome, which identified cases. Controls were patients with patent catheter until removal or 28 days of follow-up...
April 2, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29607557/maternal-hemodynamics-fetal-biometry-and-dopplers-in-pregnancies-followed-up-for-suspected-fetal-growth-restriction
#8
Llinos A Roberts, Hua Zen Ling, Liona Poon, Kypros H Nicolaides, Nikos A Kametas
OBJECTIVES: To assess whether in a cohort of patients with small for gestational age (SGA) foetuses with estimated fetal weight ≤10th percentile, maternal hemodynamics, fetal biometry and Dopplers at presentation, can predict the subsequent development of abnormal fetal Dopplers or delivery with birthweight <3rd percentile. METHODS: The study population comprised of 86 singleton pregnancies with SGA fetuses presenting at a median gestational age of 32 (range 26-35) weeks...
April 1, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29593197/noninvasive-continuous-blood-pressure-monitoring-by-the-clearsight-system-during-robot-assisted-laparoscopic-radical-prostatectomy
#9
Yoko Sakai, Tsutsumi Yasuo M, Takuro Oyama, Chiaki Murakami, Nami Kakuta, Katsuya Tanaka
Robot-assisted laparoscopic radical prostatectomy (RALRP) is commonly performed in the surgical treatment of prostate cancer. However, the steep Trendelenburg position (25) and pneumoperitoneum required for this procedure can sometimes cause hemodynamic changes. Although blood pressure is traditionally monitored invasively during RALRP, the ClearSight system (BMEYE, Amsterdam, The Netherlands) enables a totally noninvasive and simple continuous blood pressure and cardiac output monitoring based on finger arterial pressure pulse contour analysis...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29593185/effectiveness-of-using-non-invasive-continuous-arterial-pressure-monitoring-with-clearsight-in-hemodynamic-monitoring-during-living-renal-transplantation-in-a-recipient-a-case-report
#10
Nami Kakuta, Yasuo M Tsutsumi, Chiaki Murakami, Yoko Sakai, Takuro Oyama, Asuka Kasai, Katsuyoshi Kume, Katsuya Tanaka
We investigated the effectiveness of the ClearSight system for hemodynamic management during kidney transplantation for a recipient. The recipient was to receive a kidney transplant from his mother under general anesthesia. We used continuous noninvasive finger-cuff-based monitoring of blood pressure, provided by the ClearSight system, and stroke volume variation to predict fluid responsiveness. We used of a balanced anesthetic technique and stringent monitoring standards to ensure a successful outcome for the patient...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29587655/impedance-cardiography-as-tool-for-continuous-hemodynamic-monitoring-during-cesarean-section-randomized-prospective-double-blind-study
#11
Alessandro D'Ambrosio, Antonella Cotoia, Renata Beck, Potito Salatto, Lada Zibar, Gilda Cinnella
BACKGROUND: Impedance Cardiography (ICG) is a non-invasive tool for continuous hemodynamic monitoring. Aims of our study were to assess the utility of ICG to evaluate the hemodynamic impact of 6 mg (GL6) vs 8 mg (GL8) levobupivacaine combined with fentanyl in healthy patients undergoing elective cesarean section; secondary, to compare the duration and quality of analgesia and anesthesia. METHODS: Sixty-two women receiving combined spinal-epidural (CSE) for elective cesarean delivery were randomly allocated to GL6 or GL8 groups...
March 27, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29579815/utility-of-transcranial-doppler-in-the-coordination-of-transplants-10-years-of-experience
#12
A Cacciatori, M Godino, R Mizraji
Transcranial Doppler (TCD) integrated to multimodal neuromonitoring of neurocritical patients is a useful tool in the clinical follow-up. A retrospective and descriptive study of 194 patients who were admitted into the intensive care unit (ICU) was carried out from December 2007 to February 2017. We analyzed the distribution of study frequencies with respect to the pathologies that motivated them, the characteristics of patients who evolved to brain death (BD), and most frequent patterns of cerebral circulatory arrest...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29573263/effect-of-pre-operative-methylprednisolone-on-orthostatic-hypotension-during-early-mobilization-after-total-hip-arthroplasty
#13
V Lindberg-Larsen, P B Petersen, Ø Jans, T Beck, H Kehlet
BACKGROUND: Orthostatic hypotension (OH) and intolerance (OI) are common after total hip arthroplasty (THA) and may delay early mobilization. The pathology of OH and OI includes a dysregulated post-operative vasopressor response, by a hitherto unknown mechanism. We hypothesized that OI could be related to the inflammatory stress response which is inhibited by steroid administration. Consequently, this study evaluated the effect of a pre-operative high-dose methylprednisolone on OH and OI early after THA...
March 24, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29560351/cardiac-output-monitoring-by-pulse-contour-analysis-the-technical-basics-of-less-invasive-techniques
#14
REVIEW
Jörn Grensemann
Routine use of cardiac output (CO) monitoring became available with the introduction of the pulmonary artery catheter into clinical practice. Since then, several systems have been developed that allow for a less-invasive CO monitoring. The so-called "non-calibrated pulse contour systems" (PCS) estimate CO based on pulse contour analysis of the arterial waveform, as determined by means of an arterial catheter without additional calibration. The transformation of the arterial waveform signal as a pressure measurement to a CO as a volume per time parameter requires a concise knowledge of the dynamic characteristics of the arterial vasculature...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29558859/accuracy-of-an-oscillometric-blood-pressure-monitor-in-anesthetized-pigs
#15
Rachel Reed, Michele Barletta, Janet Grimes, Jennifer Mumaw, Hea Jin Park, Steeve Giguère, Michael Azain, Xi Fang, Jane Quandt
The purpose of this study is to evaluate the accuracy of an oscillometric blood pressure monitor in anesthetized pigs. Invasive blood pressure (IBP) and noninvasive blood pressure (NIBP) measurements were taken using a DRE Waveline Pro multiparameter monitor at four different time points in 17 pigs undergoing injectable anesthesia. NIBP measurements were taken on both the thoracic and pelvic limbs. Bland Altman analysis was used to assess agreement between methods and a linear mixed-effects model was used to evaluate the effect of cuff position and blood pressure on bias...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29543186/online-angiography-image-based-ffr-assessment-during-coronary-catheterization-a-single-center-study
#16
Ran Kornowski, Hana Vaknin-Assa, Abid Assali, Gabriel Greenberg, Orna Valtzer, Ifat Lavi
OBJECTIVES: To assess the diagnostic performance of angiography-derived fractional flow reserve (FFRangio) measurements in patients with stable coronary artery disease when used online in the catheterization laboratory during routine coronary angiography. BACKGROUND: FFR, an index of the hemodynamic severity of coronary stenosis, is derived from invasive measurements using a pressure-monitoring guidewire and hyperemic stimulus. While FFR is the gold standard, it remains under-utilized...
March 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29538409/cerebral-vasoreactivity-in-response-to-a-head-of-bed-position-change-is-altered-in-patients-with-moderate-and-severe-obstructive-sleep-apnea
#17
Clara Gregori-Pla, Gianluca Cotta, Igor Blanco, Peyman Zirak, Martina Giovannella, Anna Mola, Ana Fortuna, Turgut Durduran, Mercedes Mayos
MOTIVATION: Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA...
2018: PloS One
https://www.readbyqxmd.com/read/29516119/non-invasive-arterial-pressure-monitoring-revisited
#18
Frederic Michard, Daniel I Sessler, Bernd Saugel
No abstract text is available yet for this article.
March 7, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29510691/a-preliminary-study-evaluating-cardiac-output-measurement-using-pressure-recording-analytical-method-pram-in-anaesthetized-dogs
#19
Angela Briganti, Flavia Evangelista, Paola Centonze, Annaliso Rizzo, Francesco Bentivegna, Antonio Crovace, Francesco Staffieri
BACKGROUND: Haemodynamic variations normally occur in anaesthetized animals, in relation to the animal status, administered drugs, sympathetic and parasympathetic tone, fluid therapy and surgical stimulus. The possibility to measure some cardiovascular parameters, such as cardiac output (CO), during anaesthesia would be beneficial for both the anaesthesia management and its outcome. New techniques for the monitoring of CO are aimed at finding methods which are non invasive, accurate and with good trending ability, which can be used in a clinical setting...
March 6, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29492556/a-waveform-archiving-system-for-the-ge-solar-8000i-bedside-monitor
#20
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
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