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https://www.readbyqxmd.com/read/29344708/treatment-of-combined-traumatic-brain-injury-and-hemorrhagic-shock-with-fractionated-blood-products-versus-fresh-whole-blood-in-a-rat-model
#1
Akiva Leibowitz, Evgeni Brotfain, Leonid Koyfman, Moti Klein, Shmuel Hess, Alexander Zlotnik, Matthew Boyko
INTRODUCTION: Treatment of combined traumatic brain injury and hemorrhagic shock, poses a particular challenge due to the possible conflicting consequences. While restoring diminished volume is the treatment goal for hypovolemia, maintaining adequate cerebral perfusion pressure and avoidance of secondary damage remains a treatment goal for the injured brain. Various treatment modalities have been proposed, but the optimal resuscitation fluid and goals have not yet been clearly defined...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29340998/on-pacing-trials-while-scanning-brain-hemodynamics-the-case-of-the-snarc-effect
#2
Sabrina Brigadoi, Sara Basso Moro, Roberta Falchi, Simone Cutini, Roberto Dell'Acqua
Experimental designs used to describe psychological effects on overt human behavior are seldom suited to localize their corresponding neural substrates based on the analysis of stimulus-evoked brain hemodynamic responses. This is because stimuli in behavioral studies are usually separated by intertrial intervals (ITIs) in the order of 1 second or so following a behavioral response, which is notoriously too brief a time to detect a corresponding hemodynamic response. In fact, a solution commonly adopted in neuroimaging studies is to prolong the ITI up to several seconds...
January 16, 2018: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/29338059/hemodynamic-characteristics-of-hyperplastic-remodeling-lesions-in-cerebral-aneurysms
#3
Kazuhiro Furukawa, Fujimaro Ishida, Masanori Tsuji, Yoichi Miura, Tomoyuki Kishimoto, Masato Shiba, Hiroshi Tanemura, Yasuyuki Umeda, Takanori Sano, Ryuta Yasuda, Shinichi Shimosaka, Hidenori Suzuki
BACKGROUND & PURPOSE: Hyperplastic remodeling (HR) lesions are sometimes found on cerebral aneurysm walls. Atherosclerosis is the results of HR, which may cause an adverse effect on surgical treatment for cerebral aneurysms. Previous studies have demonstrated that atherosclerotic changes had a correlation with certain hemodynamic characteristics. Therefore, we investigated local hemodynamic characteristics of HR lesions of cerebral aneurysms using computational fluid dynamics (CFD). METHODS: Twenty-four cerebral aneurysms were investigated using CFD and intraoperative video recordings...
2018: PloS One
https://www.readbyqxmd.com/read/29336676/vasopressors-in-sepsis
#4
Kristin P Colling, Kaysie L Banton, Greg J Beilman
BACKGROUND: Sepsis accounts for 10% of intensive care unit admissions and significant healthcare costs. Although the mortality rate from sepsis has been decreasing with better critical care, early identification of septic patients, and prompt interventions, the mortality rate remains 20%-30%. METHOD: Review of the English-language literature. RESULTS: Norepinephrine is the first-line vasopressor in shock and is associated with a lower mortality rate as well as fewer adverse effects...
January 16, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29331957/mitral-valve-anatomic-predictors-of-hemodynamic-success-with-transcatheter-mitral-valve-repair
#5
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29331056/exploring-the-advantages-of-multiband-fmri-with-simultaneous-eeg-to-investigate-coupling-between-gamma-frequency-neural-activity-and-the-bold-response-in-humans
#6
Makoto Uji, Ross Wilson, Susan T Francis, Karen J Mullinger, Stephen D Mayhew
We established an optimal combination of EEG recording during sparse multiband (MB) fMRI that preserves high-resolution, whole-brain fMRI coverage while enabling broad-band EEG recordings which are uncorrupted by MRI gradient artefacts (GAs). We first determined the safety of simultaneous EEG recording during MB fMRI. Application of MB factor = 4 produced <1°C peak heating of electrode/hardware during 20 min of GE-EPI data acquisition. However, higher SAR sequences require specific safety testing, with greater heating observed using PCASL with MB factor = 4...
January 13, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29328496/hypotension-risk-based-on-vasoactive-agent-discontinuation-order-in-patients-in-the-recovery-phase-of-septic-shock
#7
Gretchen L Sacha, Simon W Lam, Abhijit Duggal, Heather Torbic, Anita J Reddy, Seth R Bauer
STUDY OBJECTIVES: Patients with septic shock often require vasoactive agents for hemodynamic support; however, the optimal approach to discontinuing these agents once patients reach the recovery phase is currently unknown. The objective of this evaluation was to compare the incidence of hypotension within 24 hours based on the discontinuation order of norepinephrine (NE) and vasopressin (AVP) in patients in the recovery phase of septic shock. DESIGN: Retrospective cohort study...
January 12, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29328023/features-of-formation-of-collateral-circulation-in-patients-with-subclavian-steal-syndrome
#8
I Kopolovets, P Štefanič, V Rusyn, Š Tóth, V Mashura, P Berek
To date in patients with subclavian steal syndrome diagnosis is only grade of stenosis or localization of occlusion described. Authors recommend to take into account also type of a collateral compensation of cerebral circulation for selection of an optimal treatment The objective of the research was to study the features of formation of collateral circulation in patients with subclavian steal syndrome. The authors described changes in the direction of blood flow in the extracranial vessels of 42 patients with subclavian steal syndrome...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29327314/computational-modeling-for-cardiac-resynchronization-therapy
#9
Angela W C Lee, Caroline Mendonca Costa, Marina Strocchi, Christopher A Rinaldi, Steven A Niederer
Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) patients with an electrical substrate pathology causing ventricular dyssynchrony. However 40-50% of patients do not respond to treatment. Cardiac modeling of the electrophysiology, electromechanics, and hemodynamics of the heart has been used to study mechanisms behind HF pathology and CRT response. Recently, multi-scale dyssynchronous HF models have been used to study optimal device settings and optimal lead locations, investigate the underlying cardiac pathophysiology, as well as investigate emerging technologies proposed to treat cardiac dyssynchrony...
January 11, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29325586/high-frequency-percussive-ventilation-increases-alveolar-recruitment-in-early-acute-respiratory-distress-syndrome-an-experimental-physiological-and-ct-scan-study
#10
Thomas Godet, Matthieu Jabaudon, Raïko Blondonnet, Aymeric Tremblay, Jules Audard, Benjamin Rieu, Bruno Pereira, Jean-Marc Garcier, Emmanuel Futier, Jean-Michel Constantin
BACKGROUND: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). METHODS: Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory...
January 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29324512/exercise-capacity-in-patients-with-the-total-artificial-heart
#11
Justin M Canada, Ronald K Evans, Antonio Abbate, Ross Arena, Daniel G Tang, Vigneshwar Kasirajan, Keyur B Shah
There is a dearth of information regarding the functional abilities of patients with the total artificial heart (TAH). Increased utilization of the TAH and patient discharge to home with the portable unit necessitates a shift in focus to quality of life, which includes quantifying and ultimately optimizing functional capacity. To date, only single-patient case studies have described the exercise response of the TAH patient. Fourteen patients with the TAH underwent cardiopulmonary exercise testing with concurrent analysis of TAH device function...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29323409/in-vitro-comparison-of-two-neonatal-ecmo-circuits-using-a-roller-or-centrifugal-pump-with-three-different-in-line-hemoconcentrators-for-maintaining-hemodynamic-energy-delivery-to-the-patient
#12
Madison Force, Morgan Moroi, Shigang Wang, David A Palanzo, Allen R Kunselman, Akif Ündar
The objective of this study was to compare three different hemoconcentrators (Hemocor HPH 400, Mini, and Junior) with two different neonatal ECMO circuits using a roller or a centrifugal pump at different pseudo-patient pressures and flow rates in terms of hemodynamic properties. This evidence-based research is necessary to optimize the ECMO circuitry for neonates. The circuits used a 300-mL soft-shell reservoir as a pseudo-patient approximating the blood volume of a 3 kg neonate, two blood pumps, and a Quadrox-iD Pediatric oxygenator with three different in-line hemoconcentrators (Hemocor HPH 400, Mini, and Junior)...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29322433/biological-aortic-valve-replacement-advantages-and-optimal-indications-of-stentless-compared-to-stented-valve-substitutes-a-review
#13
REVIEW
Reza Tavakoli, Pichoy Danial, Ahmed Hamid Oudjana, Peiman Jamshidi, Max Gassmann, Pascal Leprince, Guillaume Lebreton
Controversy still surrounds the optimal biological valve substitute for aortic valve replacement. In light of the current literature, we review advantages and optimal indications of stentless compared to stented aortic bio-prostheses. Recent meta-analyses, prospective randomized controlled trials and retrospective studies comparing the most frequently used stentless and stented aortic bio-prostheses were analyzed. In the present review, the types and implantation techniques of the bio-prosthesis that are seldom taken into account by most studies and reviews were integrated in the interpretation of the relevant reports...
January 10, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29319396/detrimental-effect-of-systemic-vascular-risk-factors-on-brain-hemodynamic-function-assessed-with-mri
#14
Kevin S King, Min Sheng, Peiying Liu, Christopher D Maroules, Craig D Rubin, Ron M Peshock, Roderick W McColl, Hanzhang Lu
Background and purpose Vascular risk factors have been associated with decreased cerebral blood flow (CBF) but this is etiologically nonspecific and may result from vascular insufficiency or a response to decreased brain metabolic activity. We apply new MRI techniques to measure oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen consumption (CMRO2), hypothesizing that decreased CBF related to these vascular risk factors will be associated with increased OEF, confirming a primary vascular insufficiency...
January 1, 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29311349/early-detection-of-subclinical-myocardial-damage-in-chronic-aortic-regurgitation-and-strategies-for-timely-treatment-of-asymptomatic-patients
#15
REVIEW
Joe K T Lee, Anna Franzone, Jonas Lanz, George C M Siontis, Stefan Stortecky, Christoph Gräni, Eva Roost, Stephan Windecker, Thomas Pilgrim
A series of hemodynamic and pathological responses occur in chronic aortic regurgitation, which eventually result in myocardial fibrosis and irreversible left ventricular dysfunction. According to guidelines, valvular surgery is recommended with the development of symptoms, left ventricular systolic dysfunction, or left ventricular dilatation. The optimal timing of surgical intervention has recently been questioned with documentation of irreversible myocardial damage resulting in incomplete left ventricular recovery and adverse clinical outcomes after surgery...
January 9, 2018: Circulation
https://www.readbyqxmd.com/read/29296626/a-rabbit-model-for-testing-helper-dependent-adenovirus-mediated-gene-therapy-for-vein-graft-atherosclerosis
#16
Lianxiang Bi, Bradley K Wacker, Emma Bueren, Ervin Ham, Nagadhara Dronadula, David A Dichek
Coronary artery bypass vein grafts are a mainstay of therapy for human atherosclerosis. Unfortunately, the long-term patency of vein grafts is limited by accelerated atherosclerosis. Gene therapy, directed at the vein graft wall, is a promising approach for preventing vein graft atherosclerosis. Because helper-dependent adenovirus (HDAd) efficiently transduces grafted veins and confers long-term transgene expression, HDAd is an excellent candidate for delivery of vein graft-targeted gene therapy. We developed a model of vein graft atherosclerosis in fat-fed rabbits and demonstrated long-term (≥20 weeks) persistence of HDAd genomes after graft transduction...
December 15, 2017: Molecular Therapy. Methods & Clinical Development
https://www.readbyqxmd.com/read/29290490/-suboptimal-care-and-severe-bacterial-infection-in-the-french-caribbean-area
#17
E Goisque, E Launay, B Vrignaud, E Jolivet, F Henaff, C Gras-Leguen
OBJECTIVE: To study the frequency and types of suboptimal care in initial management of children suffering from a severe bacterial infection (SBI), in a French region where little is known about pediatric SBI epidemiology. METHOD: Retrospective single-center study over a 6-year period. Children between 3 months and 15 years of age, deceased or surviving and admitted to the pediatric intensive care unit of the university-affiliated hospital of Martinique for a community-onset SBI were included in this study...
December 28, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29288129/a-low-rank-multivariate-general-linear-model-for-multi-subject-fmri-data-and-a-non-convex-optimization-algorithm-for-brain-response-comparison
#18
Tingting Zhang, Minh Pham, Jianhui Sun, Guofen Yan, Huazhang Li, Yinge Sun, Marlen Z Gonzalez, James A Coan
The focus of this paper is on evaluating brain responses to different stimuli and identifying brain regions with different responses using multi-subject, stimulus-evoked functional magnetic resonance imaging (fMRI) data. To jointly model many brain voxels' responses to designed stimuli, we present a new low-rank multivariate general linear model (LRMGLM) for stimulus-evoked fMRI data. The new model not only is flexible to characterize variation in hemodynamic response functions (HRFs) across different regions and stimulus types, but also enables information "borrowing" across voxels and uses much fewer parameters than typical nonparametric models for HRFs...
December 26, 2017: NeuroImage
https://www.readbyqxmd.com/read/29287808/clinical-implications-of-hemodynamic-assessment-during-left-ventricular-assist-device-therapy
#19
REVIEW
Teruhiko Imamura, Ben Chung, Ann Nguyen, Gabriel Sayer, Nir Uriel
Left ventricular assist devices (LVADs) significantly improve outcomes of advanced heart failure patients. However, patients continue to have high readmission rates due to complications ranging from bleeding, thrombosis, heart failure, and infection. Considering that the hallmark benefit of LVAD therapy is improvement in hemodynamics (cardiac unloading and increased cardiac output), hemodynamic assessment on LVAD support is key to better understand these difficult complications and may serve as a tool to resolving them...
December 26, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29284341/cerebral-perfusion-monitoring-in-adult-patients-following-cardiac-surgery-an-observational-study
#20
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
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