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https://www.readbyqxmd.com/read/29147790/-etomidate-for-intravenous-induction-of-anaesthesia
#1
C Dumps, D Bolkenius, E Halbeck
The pharmacological and historical knowledge about the currently available intravenous induction hypnotics form the basis for the daily work of anesthetists. Side effects of using hypnotic induction agents must be anticipated and adequately treated. Decades of experience with using intravenous induction hypnotics have led to theoretical requirements for an ideal narcotic agent with a best possible side effect profile. In the absence of this optimal hypnotic induction agent, a careful selection of one or a combination of narcotic drugs is necessary to meet the needs of the respective risk constellation of the patient...
November 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29145824/observations-on-significant-hemodynamic-changes-caused-by-a-high-concentration-of-epidurally-administered-ropivacaine-correlation-and-prediction-study-of-stroke-volume-variation-and-central-venous-pressure-in-thoracic-epidural-anesthesia
#2
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim
BACKGROUND: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. METHODS: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0...
November 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29133076/comparison-of-the-hemodynamic-tolerance-and-the-biological-parameters-of-four-acetate-free-hemodialysis-methods
#3
George Kosmadakis, Enrique Da Costa Correia, Julie Albaret, Frédéric Somda, Didier Aguilera
PURPOSE: Acetate in hemodialysis solutions exerts inflammatory, vasodilatatory and cardio-depressive effects. Citrate has been proposed as an optimal substitute. The aim of the present trial was the comparison of the hemodynamic and biological parameters on a group of patients dialysed consecutively with 4 acetate-free haemodialysis techniques. METHODS: In a prospective crossover manner, we measured the hemodynamic and biological effects of four acetate-free hemodialysis methods: he acetate-free biofiltration with variable potassium (AFBK) and three methods with a citrate buffer: onventional hemodialysis (HD), on-line hemodiafiltration (HDF) and on-line hemofiltration (HF)...
November 10, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29131886/determinant-factors-for-arterial-hemodynamics-in-hypertension-theoretical-insights-from-a-computational-model-based-study
#4
Fuyou Liang, Debao Guan, Jordi Alastruey
Hypertension is a well-documented predictive factor for cardiovascular events. Clinical studies have extensively demonstrated the differential hemodynamic consequences of various anti-hypertensive drugs, but failed to clearly elucidate the underlying mechanisms due to the difficulty in performing a quantitative deterministic analysis based on clinical data that carry confounding information stemming from inter-patient differences and the nonlinearity of cardiovascular hemodynamics. In the present study, a multi-scale model of the cardiovascular system was developed to quantitatively investigate the relationships between hemodynamic variables and cardiovascular properties under hypertensive conditions, aiming to establish a theoretical basis for assisting in the interpretation of clinical observations or optimization of therapy...
November 13, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29126049/large-scale-subject-specific-cerebral-arterial-tree-modeling-using-automated-parametric-mesh-generation-for-blood-flow-simulation
#5
Mahsa Ghaffari, Kevin Tangen, Ali Alaraj, Xinjian Du, Fady T Charbel, Andreas A Linninger
In this paper, we present a novel technique for automatic parametric mesh generation of subject-specific cerebral arterial trees. This technique generates high-quality and anatomically accurate computational meshes for fast blood flow simulations extending the scope of 3D vascular modeling to a large portion of cerebral arterial trees. For this purpose, a parametric meshing procedure was developed to automatically decompose the vascular skeleton, extract geometric features and generate hexahedral meshes using a body-fitted coordinate system that optimally follows the vascular network topology...
October 24, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29120543/-right-heart-failure-important-forold-and-young-patientsa-challenge-from-the-acute-to-the-chronic
#6
Latifa Jedday, Véronique Trombert, Philippe Meyer, Georg Ehret, Jean-Luc Reny, Clémence Cuvelier
The prevalence of the right heart failure (RHF) is poorly known. However, RHF is often a consequence of left heart failure due to an interdependance between both ventricles. RHF should be indentified because of prognostic relevance. RHF is defined by the inability to maintain adequate cardiac output through the lung circulation. It can result from volume overload, pressure overload, or a disorder of systolic function. Adaptive mechanisms such as dilation or hyper-trophy will maintain adequate hemodynamics. Once these mechanisms become insufficient, congestive signs and hemodynamic consequences will appear...
November 8, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29117205/hypoxia-preconditioned-mesenchymal-stem-cells-ameliorate-ischemia-reperfusion-induced-lung-injury
#7
Yung-Yang Liu, Chi-Huei Chiang, Shih-Chieh Hung, Chih-Feng Chian, Chen-Liang Tsai, Wei-Chih Chen, Haibo Zhang
BACKGROUND: Hypoxia preconditioning has been proven to be an effective method to enhance the therapeutic action of mesenchymal stem cells (MSCs). However, the beneficial effects of hypoxic MSCs in ischemia/reperfusion (I/R) lung injury have yet to be investigated. In this study, we hypothesized that the administration of hypoxic MSCs would have a positive therapeutic impact on I/R lung injury at molecular, cellular, and functional levels. METHODS: I/R lung injury was induced in isolated and perfused rat lungs...
2017: PloS One
https://www.readbyqxmd.com/read/29105685/-cardiogenic-shock-from-pharmacological-treatment-to-mechanical-circulatory-support
#8
Ilaria Battistoni, Marco Marini, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Massimo Iacoviello, Renata De Maria, Alessandro Navazio, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a state of critical end-organ hypoperfusion due to reduced cardiac output, despite adequate filling status. The development of multiorgan dysfunction is believed to be the major contributor to the high early mortality. Little evidence exists as to which vasopressor or inotrope should best be used for early treatment; however, customized pharmacological therapy, tailored on hemodynamic monitoring, is essential to achieve normal peripheral perfusion. Moreover, an increasing number of mechanical circulatory support devices are available for hemodynamic support in patients with CS but, at present, data derived from randomized clinical trials on the effectiveness, safety, differential indications for mechanical support devices, and optimal implant timing are limited...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29104834/a-case-of-spontaneous-isolated-celiac-artery-dissection-with-pseudoaneurysm-formation
#9
John Kim, Lamar H Moree, Michael J Muehlberger
Spontaneous isolated celiac artery dissection is a rare disease and patients without evidence of significant complications often resolve with medical therapy alone; however, the extension of the dissection can lead to more serious complications including aneurysmal dilatation, complete occlusion, and rupture of a visceral artery. In these patients, optimal management has not yet been clearly defined and treatment primarily depends on clinical presentation and lesions identified on imaging studies. This case report demonstrates the conservative management of spontaneous celiac artery dissection...
August 27, 2017: Curēus
https://www.readbyqxmd.com/read/29102209/minimally-invasive-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-will-this-be-the-future
#10
Pradeep Nambiar, Sanjay Kumar, Chander Mohan Mittal, Kailash Saksena
OBJECTIVE: The aim was to show that total arterial revascularization via a left minithoracotomy using bilateral internal thoracic arteries was not only feasible but also a safe and reproducible procedure with excellent midterm outcomes. METHODS: From August 2011 to August 2016, 819 patients underwent off-pump minimally invasive multivessel coronary artery bypass grafting using bilateral internal thoracic arteries harvested through a 2-inch left minithoracotomy incision, and complete revascularization of the myocardium was performed using the left internal thoracic artery-right internal thoracic artery Y composite conduit...
September 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29101573/transcatheter-atrial-septal-defect-closure-in-an-infant-body-weight-6-4%C3%A2-kg-using-the-gore-cardioform-septal-occluder-gcso
#11
Roman Scheidmann, Thomas Paul, Matthias Sigler
INTRODUCTION: Transcatheter closure has become the treatment of choice for secundum atrial septal defects (ASD II), but particularly in small children, there is concern regarding procedure-related complications. CASE DESCRIPTION: We report on a 10-month-old infant, body weight of 6.4 kg, with a large ASD who was referred for failure to thrive and dyspnea on exertion. Echocardiography showed two neighboring ASDs centrally located within an atrial septum with a length of 27 mm resulting in significant left-to-right shunting...
November 3, 2017: Molecular and Cellular Pediatrics
https://www.readbyqxmd.com/read/29094607/predictors-of-survival-and-ability-to-wean-from-short-term-mechanical-circulatory-support-device-following-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#12
A Reshad Garan, Christina Eckhardt, Koji Takeda, Veli K Topkara, Kevin Clerkin, Justin Fried, Amirali Masoumi, Ryan T Demmer, Pauline Trinh, Melana Yuzefpolskaya, Yoshifumi Naka, Dan Burkhoff, Ajay Kirtane, Paolo C Colombo, Hiroo Takayama
BACKGROUND: Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. METHODS: All patients > 18 years old treated at our institution with extra-corporeal membrane oxygenation or short-term surgical ventricular assist device for AMI-CS were studied...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29094293/blood-pump-design-variations-and-their-influence-on-hydraulic-performance-and-indicators-of-hemocompatibility
#13
L Wiegmann, S Boës, D de Zélicourt, B Thamsen, M Schmid Daners, M Meboldt, V Kurtcuoglu
Patients with ventricular assist devices still suffer from high rates of adverse events. Since many of these complications are linked to the flow field within the pump, optimization of the device geometry is essential. To investigate design aspects that influence the flow field, we developed a centrifugal blood pump using industrial guidelines. We then systematically varied selected design parameters and investigated their effects on hemodynamics and hydraulic performance using computational fluid dynamics...
November 1, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29090247/perioperative-red-blood-cell-transfusion-in-orofacial-surgery
#14
REVIEW
So-Young Park, Kwang-Suk Seo, Myong-Hwan Karm
In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation...
September 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/29089969/patients-with-st-segment-elevation-of-myocardial-infarction-miss-out-on-early-reperfusion-when-to-undergo-delayed-revascularization
#15
Wen Zheng, Cheuk-Man Yu, Jing Liu, Wu-Xiang Xie, Miao Wang, Yu-Jiao Zhang, Jian Sun, Shao-Ping Nie, Dong Zhao
OBJECTIVE: There are still a high proportion of patients with ST-segment elevation myocardial infarction (STEMI) missing out early reperfusion even in the primary percutaneous coronary intervention (PCI) era. Most of them are stable latecomers, but the optimal time to undergo delayed PCI for stable ones remains controversial. METHODS: We investigated all STEMI patients who underwent delayed PCI (2-28 days after STEMI) during 2007-2010 in Beijing and excluded patients with hemodynamic instability...
August 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#16
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29081017/validation-of-central-and-peripheral-non-invasive-hemodynamic-variables-using-an-oscillometric-method
#17
Darío Echeverri, Alejandro Pizano, Jaime Cabrales, Karen Moreno
INTRODUCTION: Peripheral and central blood pressures are parameters of arterial stiffness and important cardiovascular risk markers. Today, there are non-invasive methods that measure these pressures. AIM: To validate the non-invasive oscillometric method, compared with invasive pressure measurements obtained by cardiac catheterization. METHODS: An open, prospective cohort clinical study in 100 patients, 64 ± 11 years old. The measurement of peripheral and central blood pressures obtained using the Arteriograph(®) system oscillometric method, (TensioMed, Budapest-Hungary, Ltd...
October 28, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/29076654/the-respiratory-system-in-pediatric-chronic-heart-disease
#18
REVIEW
Sotiria C Apostolopoulou
Cardiovascular disease in the pediatric population closely affects the respiratory system inducing water retention in the lungs and pulmonary edema, airway compression by cardiovascular structures, restrictive pulmonary physiology as a result of hemodynamic changes and surgical repair, susceptibility to respiratory infections, development of pulmonary hypertension, thrombosis, or hemorrhage. Chronic heart failure and congenital heart disease are characterized by various respiratory manifestations and symptoms mimicking lung disease, which are frequently difficult to diagnose and treat...
December 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29074341/the-clinical-significance-of-endocardial-endothelial-dysfunction
#19
REVIEW
Sonja Smiljic
Endocardial endothelium (EE) is essential in the embryonic development of the heart, the optimal contractility and rhythm as well as the remodeling of the heart. Endocardial endothelium affect the contractility of cardiomyocytes through paracrine signaling substances such as nitric oxide (NO), endothelin (ET-1), prostaglandins (PGI2, PGF2, PGE2) and angiotensin II (ANG II). Typical lesions of endocardial endothelium have been described in atrial fibrillation, ischemia/reperfusion injury, cardiac hypertrophy, heart failure, sepsis, myocardial infarction, inflammation and thrombosis...
September 21, 2017: Medicina
https://www.readbyqxmd.com/read/29073779/mitochondrial-nad-nadh-redox-state-and-diabetic-cardiomyopathy
#20
Jessica M Berthiaume, Jacob G Kurdys, Danina M Muntean, Mariana G Rosca
SIGNIFICANCE: Diabetic cardiomyopathy is a frequent complication occurring even in well-controlled asymptomatic diabetic patients, and may advance to heart failure. Recent advances: The diabetic heart is characterized by a state of "metabolic rigidity" involving enhanced rates of fatty acid uptake and mitochondrial oxidation as the predominant energy source, and exhibits mitochondrial electron transport chain defects. These alterations promote redox state changes evidenced by a decreased NAD+/NADH ratio associated with an increase in acetyl-CoA/CoA ratio...
October 26, 2017: Antioxidants & Redox Signaling
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