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hemodynamic optimization

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https://www.readbyqxmd.com/read/28650932/incremental-value-of-right-atrial-strain-for-early-diagnosis-of-hemodynamic-deterioration-in-pulmonary-hypertension-a-new-noninvasive-tool-for-a-more-comprehensive-diagnostic-paradigma
#1
Cristina Piccinino, Ailia Giubertoni, Jacopo Zanaboni, Miriam Gravellone, Daniele Sola, Roberta Rosso, Lorena Ferrarotti, Paolo Nicola Marino
AIMS: Increased right atrial size is related to adverse prognosis in pulmonary hypertension. The potential incremental value of right atrial function assessment is still unclear. We tested the relationship between right atrial two-dimensional speckle-tracking echocardiography impairment and hemodynamic, functional and clinical deterioration in patients with pulmonary hypertension. METHODS: We prospectively evaluated 36 patients (27 female, 9 male; mean age 68 ± 13 years) with suspected pulmonary hypertension undergoing right heart catheterization and 16 matched controls...
June 24, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28649147/multiblock-high-order-large-eddy-simulation-of-powered-fontan-hemodynamics-towards-computational-surgery
#2
Yann T Delorme, Mark D Rodefeld, Steven H Frankel
Children born with only one functional ventricle must typically undergo a series of three surgeries to obtain the so-called Fontan circulation in which the blood coming from the body passively flows from the Vena Cavae (VCs) to the Pulmonary Arteries (PAs) through the Total Cavopulmonary Connection (TCPC). The circulation is inherently inefficient due to the lack of a subpulmonary ventricle. Survivors face the risk of circulatory sequelae and eventual failure for the duration of their lives. Current efforts are focused on improving the outcomes of Fontan palliation, either passively by optimizing the TCPC, or actively by using mechanical support...
January 17, 2017: Computers & Fluids
https://www.readbyqxmd.com/read/28649146/a-predictive-framework-to-elucidate-venous-stenosis-cfd-shape-optimization
#3
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Mary Hammes, Fredric Coe
The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency...
July 1, 2017: Computer Methods in Applied Mechanics and Engineering
https://www.readbyqxmd.com/read/28647997/-endovascular-management-and-classification-of-the-dissecting-aneurysms-of-the-vertebral-artery
#4
Y Z Zang, Z G Wang, C W Wang, X Ding, X F Wang, L L Wang
Objective: To summarize the classifications and optimize endovascular treatment of the dissecting aneurysms of the vertebral artery (DAVA). Methods: The clinical information of 39 cases of DAVA treated with endovascular methods in our department between January 2007 and September 2016 were analyzed retrospectively.According to the location of the aneurysm in relation to the posterior inferior cerebellar artery (PICA), the aneurysms were classified into three types: type pre-PICA, located proximally to the PICA; type in-PICA, located at the PICA origin; and type post-PICA located distally to the PICA...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28642976/prognostic-role-of-a-new-risk-index-for-the-prediction-of-30-day-cardiovascular-mortality-in-patients-with-acute-pulmonary-embolism-the-age-mean-arterial-pressure-index-amapi
#5
Marco Zuin, Gianluca Rigatelli, Claudio Picariello, Mauro Carraro, Pietro Zonzin, Loris Roncon
Acute pulmonary embolism (PE) is the third cause of cardiovascular (CV) mortality. We evaluated a new risk index, named Age-Mean Arterial Pressure Index (AMAPI), to predict 30-day CV mortality in patients with acute PE. Data of 209 patients (44.0% male and 56.0% female, mean age 70.58 ± 14.14 years) with confirmed acute PE were retrospectively analysed. AMAPI was calculated as the ratio between age and mean arterial pressure (MAP), which was defined as [systolic blood pressure + (2 × diastolic blood pressure)]/3...
June 22, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28641799/the-continued-search-for-physiological%C3%A2-pacing-where-are-we-now
#6
REVIEW
Pugazhendhi Vijayaraman, Pierre Bordachar, Kenneth A Ellenbogen
Cardiac pacing is an effective treatment for patients with bradycardia due to sinus node dysfunction or atrioventricular block. Despite decades of technological advances, the optimal ventricular pacing site to mimic normal human ventricular physiology and best hemodynamic response remains elusive. Beginning with atrial synchronous right ventricular (RV) apical pacing, the search has continued through alternate RV pacing sites, minimizing RV pacing, biventricular pacing, left ventricular (LV) pacing, and His-bundle pacing...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28636165/a-feasibility-and-safety-study-of-intracoronary-hemodilution-during-primary-coronary-angioplasty-in-order-to-reduce-reperfusion-injury-in-myocardial-infarction
#7
Michael McGarvey, Omar Ali, M Bilal Iqbal, Charles Ilsley, Joyce Wong, Carlo Di Mario, Simon Redwood, Tiffany Patterson, Dudley J Pennell, Paula Rogers, Miles Dalby
OBJECTIVES: We designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury. INTRODUCTION: Early revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage...
June 21, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28632582/the-effect-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-multiple-injuries-model
#8
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
BACKGROUND: Despite clinical reports of poor outcomes, the degree to which resuscitative endovascular balloon occlusion of the aorta (REBOA) exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared with partial aortic occlusion (PAO) or no intervention. METHODS: Twenty-one swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28625244/-establishment-of-porcine-model-of-prolonged-cardiac-arrest-and-cardiopulmonary-resuscitation-electrically-induced-by-ventricular-fibrillation
#9
Cai Wen, Heng Li, Xiaozhu Zhai, Youde Ding, Huatao Zhou, Zhiming Ouyang, Zhengfei Yang, Longyuan Jiang, Wanchun Tang, Tao Yu
OBJECTIVE: To investigate the optimal injury time point of cardiac arrest (CA) induced electrically, and establish a reproducible prolonged CA and cardiopulmonary resuscitation (CPR) model in pigs. METHODS: Forty healthy domestic male pigs were randomly divided into four groups, which were ventricular fibrillation (VF) 8, 10, 11, and 12 minutes groups, each group for 10 animals. In these groups, VF was induced by alternating current delivered to right ventricular endocardium and untreated for 8, 10, 11, and 12 minutes, respectively, followed by 6 minutes of CPR procedure...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624566/4d-phase-contrast-mri-protocol-optimization-using-patient-specific-3d-printed-replicas-for-in-vivo-imaging-before-and-after-flow-diverter-placement
#10
Christof Karmonik, Jeff R Anderson, Saba Elias, Richard Klucznik, Orlando Diaz, Y Jonathan Zhang, Robert G Grossman, Gavin W Britz
PURPOSE: Hemodynamics in cerebral aneurysms is currently investigated towards its clinical efficacy using non-standardized computational simulation techniques. At the same time, flow patterns and velocities are accessible by 4D phase contrast magnetic resonance imaging (4D pcMRI). Complexity of protocol design and imaging duration has limited the use of this technique in clinical imaging. A new approach is presented to overcome these limitations. MATERIAL AND METHODS: 3D replicas of two cerebral aneurysms were fabricated by fused deposition prototyping (3D printing) and imaged using 4D pcMRI while connected to an MRI compatible continuous flow loop...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28617696/should-hyperoxia-be-avoided-during-sepsis-an-experimental-study-in-ovine-peritonitis
#11
Xinrong He, Fuhong Su, Keliang Xie, Fabio Silvio Taccone, Katia Donadello, Jean-Louis Vincent
OBJECTIVES: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock. DESIGN: Randomized animal study. SETTING: University hospital animal research laboratory. SUBJECTS: Fourteen adult female sheep...
June 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28617162/the-use-of-stroke-volume-variation-to-guide-donor-management-is-associated-with-increased-organs-transplanted-per-donor
#12
Benjamin Bergstrom, J Salvador de la Cruz, Mitch Sally, Scott Louis, Melissa Friedman, Floyd Petersen, Darren Malinoski
BACKGROUND: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#13
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28611348/early-detection-of-subclinical-aortic-valve-endocarditis-with-the-cardiomems-heart-failure-system
#14
Sinan Sarsam, Georgy Kaspar, Shukri David, Marcel Zughaib
BACKGROUND The CardioMEMS Heart Failure System is a well validated tool to optimize management of systolic and diastolic heart failure and has been shown to reduce the risk of hospitalization by 37%. We are reporting a unique case of acute aortic valve insufficiency as a first sign of endocarditis, detected early in a patient with the CardioMEMS device. CASE REPORT A 79-year-old man with dual bioprosthetic mitral and aortic valve replacement and non-ischemic cardiomyopathy had a CardioMEMS Heart Failure System implanted 2 months following valve replacement surgery...
June 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28611078/midterm-egfr-and-adverse-pregnancy-outcomes-the-clinical-significance-of-gestational-hyperfiltration
#15
Sehoon Park, Seung Mi Lee, Joong Shin Park, Joon-Seok Hong, Ho Jun Chin, Ki Young Na, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
BACKGROUND AND OBJECTIVES: Although hemodynamic adaptation plays a crucial role in maintaining gestation, the clinical significance of midterm renal hyperfiltration (MRH) on pregnancy outcomes is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was an observational cohort study. Women with a singleton pregnancy and a serum creatinine measurement during their second trimester were followed at two university hospitals in Korea between 2001 and 2015. Those with substantial renal function impairment or who delivered during the second trimester were not considered...
June 13, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28607340/perioperative-hemodynamic-optimization-based-on-a-totally-non-invasive-monitoring-device-waiting-for-more-convincing-evidence
#16
Agostino Roasio
No abstract text is available yet for this article.
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#17
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28598990/neurological-failure-in-icu-patients-with-hematological-malignancies-a-prospective-cohort-study
#18
Chiara Marzorati, Djamel Mokart, Frederic Pène, Virginie Lemiale, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Dominique Benoit, Giuseppe Citerio, Elie Azoulay, Stephane Legriel
BACKGROUND: Epidemiological studies of neurological complications in patients with hematological malignancies are scant. The objective of the study was to identify determinants of survival in patients with hematological malignancy and neurological failure. METHODS: Post hoc analysis of a prospective study of adults with hematological malignancies admitted for any reason to one of 17 university or university-affiliated participating ICUs in France and Belgium (2010-2012)...
2017: PloS One
https://www.readbyqxmd.com/read/28593456/impact-of-hemodynamic-goal-directed-resuscitation-on-mortality-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis
#19
Maria Cronhjort, Olof Wall, Erik Nyberg, Ruifeng Zeng, Christer Svensen, Johan Mårtensson, Eva Joelsson-Alm
The effect of hemodynamic optimization in critically ill patients has been challenged in recent years. The aim of the meta-analysis was to evaluate if a protocolized intervention based on the result of hemodynamic monitoring reduces mortality in critically ill patients. We performed a systematic review and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions. The study was registered in the PROSPERO database (CRD42015019539). Randomized controlled trials published in English, reporting studies on adult patients treated in an intensive care unit, emergency department or equivalent level of care were included...
June 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28591965/-predictive-value-of-early-changes-in-sublingual-microcirculation-on-organ-failure-of-patients-with-septic-shock
#20
Xue-Ying Zeng, Xue-Lian Liao, Yan Kang, Yao Chen, Wan-Hong Yin, Liang Zhao
OBJECTIVES: To determine the predictive value of early changes in sublingual microcirculation on organ failure of patients with septic shock. METHODS: Side-streamdark field imaging (SDF) videomicroscopy was performed to assess sublingual microcirculation of 34 adult patients at 0 h, 6 h and 24 h after they were diagnosed with septic shock.The patients were subject to sequential organ failure assessment (SOFA24 h-0 h). The patients with ΔSOFA24 h-0 h≥1 (deteriorated conditions) were compared with those with ΔSOFA24 h-0 h<1 in regard to sublingual microcirculation and the traditional hemodynamic indicators such as heart rate, mean arterial pressure, central venous pressure, urine output and lactate...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
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