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hemodynamic optimization

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https://www.readbyqxmd.com/read/29778862/hemodynamic-optimization-following-biventricular-device-implant-do-we-still-need-an-echocardiogram
#1
EDITORIAL
Karoly Kaszala, Kenneth A Ellenbogen
No abstract text is available yet for this article.
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29778861/multicenter-randomized-controlled-crossover-trial-comparing-hemodynamic-optimization-against-echocardiographic-optimization-of-av-and-vv-delay-of-cardiac-resynchronization-therapy-the-bravo-trial
#2
Zachary I Whinnett, S M Afzal Sohaib, Mark Mason, Edward Duncan, Mark Tanner, David Lefroy, Mohamed Al-Obaidi, Sue Ellery, Francisco Leyva-Leon, Tim Betts, Mark Dayer, Paul Foley, Jon Swinburn, Martin Thomas, Raj Khiani, Tom Wong, Zaheer Yousef, Dominic Rogers, Paul R Kalra, Vignesh Dhileepan, Katherine March, James Howard, Andreas Kyriacou, Jamil Mayet, Prapa Kanagaratnam, Michael Frenneaux, Alun D Hughes, Darrel P Francis
OBJECTIVES: BRAVO (British Randomized Controlled Trial of AV and VV Optimization) is a multicenter, randomized, crossover, noninferiority trial comparing echocardiographic optimization of atrioventricular (AV) and interventricular delay with a noninvasive blood pressure method. BACKGROUND: Cardiac resynchronization therapy including AV delay optimization confers clinical benefit, but the optimization requires time and expertise to perform. METHODS: This study randomized patients to echocardiographic optimization or hemodynamic optimization using multiple-replicate beat-by-beat noninvasive blood pressure at baseline; after 6 months, participants were crossed over to the other optimization arm of the trial...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#3
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29772321/use-of-polidocanol-endovenous-microfoam-to-improve-hemodynamics-and-symptomology-in-patients-with-challenging-clinical-presentations-a-case-series
#4
Paul E Davis, John Phillips, Raghu Kolluri
BACKGROUND: We performed a retrospective review of treatment effects with FDA-approved Polidocanol endovenous microfoam (PEM, Varithena® 1%) on venous symptomology in ten (N=10) C3-C6 patients with chronic venous insufficiency (CVI) and concomitant complex disease/pathology that limited the use of endothermal ablation (ETA). METHODS: Pathology included: risk of bruising or bleeding, severe lipodermatosclerosis (LDS), Hydradenitis Suppurativa, chronic fibrosis of the vein from prior superficial thrombosis, risk for nerve injury and failed prior ETA...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770770/adjustable-diameter-tips-in-the-pediatric-patient-the-constrained-technique
#5
Brandon C Perry, Eric J Monroe, Giridhar Shivaram
Placement of transjugular intrahepatic portosystemic shunt (TIPS) is necessary in children with portal hypertension complicated by variceal bleeding or ascites. However, placement of adult-sized endografts may be problematic due to the smaller anatomy of pediatric patients. On the other hand, placement of fixed diameter smaller stents have the corresponding problem of not accommodating future growth of the child. We describe a novel method to create an adjustable diameter TIPS as a technical solution to these problems...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29762460/a-new-life-motherhood-after-heart-transplantation-a-single-center-experience-and-review-of-literature
#6
Francesca Macera, Lucia Occhi, Gabriella Masciocco, Marisa Varrenti, Maria Frigerio
BACKGROUND: Pregnancy after heart transplantation (HTx) may expose the recipient to hemodynamic and immunologic risks, and the newborn to toxic effects of immunosuppressive therapy. Adequate preconception counseling is crucial to identify optimal timing and to modify immunosuppressive therapy in order to minimize risks for both the mother and the fetus. METHOD: We describe our experience with 12 pregnancies occurred in 11 women who had undergone HTx at our center...
May 14, 2018: Transplantation
https://www.readbyqxmd.com/read/29761422/computational-pre-surgical-planning-of-arterial-patch-reconstruction-parametric-limits-and-in-vitro-validation
#7
S Samaneh Lashkarinia, Senol Piskin, Tijen A Bozkaya, Ece Salihoglu, Can Yerebakan, Kerem Pekkan
Surgical treatment of congenital heart disease (CHD) involves complex vascular reconstructions utilizing artificial and native surgical materials. A successful surgical reconstruction achieves an optimal hemodynamic profile through the graft in spite of the complex post-operative vessel growth pattern and the altered pressure loading. This paper proposes a new in silico patient-specific pre-surgical planning framework for patch reconstruction and investigates its computational feasibility. The proposed protocol is applied to the patch repair of main pulmonary artery (MPA) stenosis in the Tetralogy of Fallot CHD template...
May 14, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#8
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29759779/16-years-of-cardiac-resynchronization-pacing-among-congenital-heart-disease-patients-direct-contractility-dp-dt-max-screening-when-the-guidelines-do-not-apply
#9
Peter P Karpawich, Neha Bansal, Sharmeen Samuel, Yamuna Sanil, Kathleen Zelin
OBJECTIVES: The purpose of this study was to use direct cardiac resynchronization therapy (CRT)-paced contractility (dP/dt-max) response as a pre-implantation evaluation among patients with congenital heart disease (CHD) and follow clinical parameters and contractility indexes after CRT implantation. BACKGROUND: Patients with CHD often develop early heart failure with few therapeutic options, leading to heart transplantation (HT). Unfortunately, guidelines for CRT do not apply, and function evaluations by cardiac ultrasound are often inaccurate among CHD anatomies...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#10
Pavel Szturz, Pavel Folwarczny, Roman Kula, Jan Neiser, Pavel Ševčík, Jan Benes
BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopresors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi- parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29753455/effect-of-severe-bioprosthetic-valve-tissue-ingrowth-and-inflow-calcification-on-valve-in-valve-performance
#11
Hoda Hatoum, Jennifer Dollery, Scott M Lilly, Juan A Crestanello, Lakshmi Prasad Dasi
While in vivo studies clearly demonstrate that supra-annular Valve-in-Valve (ViV) implantation provides the highest probability for optimal post-ViV pressure gradients (PG), there is still no physical insight into explaining anomalies where some supra-annular ViV implantations yield high pressure gradients while some sub-annular implantations yield low pressure gradients. The aim of this study is to explain how severe tissue ingrowth and calcification (TIC) in a surgical aortic valve (SAV) can be one physical mechanism leading to anomalous ViV performance characteristic...
May 4, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29749935/improvement-of-reverse-remodeling-using-electrocardiogram-fusion-optimized-intervals-in-cardiac-resynchronization-therapy-a-randomized-study
#12
Emilce Trucco, José María Tolosana, Elena Arbelo, Ada Doltra, María Ángeles Castel, Eva Benito, Roger Borràs, Eduard Guasch, Silvia Vidorreta, Barbara Vidal, Silvia Montserrat, Marta Sitges, Antonio Berruezo, Josep Brugada, Lluís Mont
OBJECTIVES: The aim of this study was to compare patient response to cardiac resynchronization therapy (CRT) using fusion-optimized atrioventricular (AV) and interventricular (VV) intervals versus nominal settings. BACKGROUND: The additional benefit obtained by AV- and VV-interval optimization in patients undergoing CRT remains controversial. Previous studies show short-term benefit in hemodynamic parameters; however, midterm randomized comparison between electrocardiogram optimization and nominal parameters is lacking...
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29747952/awake-thoracic-endovascular-aneurysm-repair-for-aortic-rupture-a-case-series
#13
Jessica Forcillo, Yazan M Duwayri, William D Jordan, Bradley G Leshnower
Thoracic endovascular aortic repair (TEVAR) has been proven to be the optimal therapy for patients with a ruptured descending thoracic aortic pathology. In these emergent settings, TEVAR provides a rapid delivery of treatment to an unstable patient with a lethal disease. Typically, the greatest challenge is maintaining hemodynamic stability until the time of graft deployment. In this report, we describe our technique of performing awake TEVAR for ruptured descending thoracic aortic disease.
April 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29745979/trends-etiologies-and-predictors-of-90-day-readmission-after-percutaneous-ventricular-assist-device-implantation-a-national-population-based-cohort-study
#14
Hafeez Ul Hassan Virk, Byomesh Tripathi, Shuchita Gupta, Akanksha Agrawal, Sandeep Dayanand, Faisal Inayat, Chayakrit Krittanawong, Ali Raza Ghani, Mohammad Nour Zabad, Parasuram Melarcode Krishnamoorthy, Aman Amanullah, Gregg Pressman, Christian Witzke, Sean Janzer, Jon George, Sanjog Kalra, Vincent Figueredo
Percutaneous ventricular assist devices (pVADs) are indicated to provide hemodynamic support in high-risk percutaneous interventions and cardiogenic shock. However, there is a paucity of published data regarding the etiologies and predictors of 90-day readmissions following pVAD use. We studied the data from the US Nationwide Readmissions Database (NRD) for the years 2013 and 2014. Patients with a primary discharge diagnosis of pVAD use were collected by searching the database for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural code 37...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#15
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#16
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29743101/individualized-perioperative-hemodynamic-goal-directed-therapy-in-major-abdominal-surgery-ipegasus-trial-study-protocol-for-a-randomized-controlled-trial
#17
Sandra Funcke, Bernd Saugel, Christian Koch, Dagmar Schulte, Thomas Zajonz, Michael Sander, Angelo Gratarola, Lorenzo Ball, Paolo Pelosi, Savino Spadaro, Riccardo Ragazzi, Carlo Alberto Volta, Thomas Mencke, Amelie Zitzmann, Benedikt Neukirch, Gonzalo Azparren, Marta Giné, Vicky Moral, Hans Otto Pinnschmidt, Oscar Díaz-Cambronero, Maria Jose Alberola Estelles, Marisol Echeverri Velez, Maria Vila Montañes, Javier Belda, Marina Soro, Jaume Puig, Daniel Arnulf Reuter, Sebastian Alois Haas
BACKGROUND: Postoperative morbidity and mortality in patients undergoing surgery is high, especially in patients who are at risk of complications and undergoing major surgery. We hypothesize that perioperative, algorithm-driven, hemodynamic therapy based on individualized fluid status and cardiac output optimization is able to reduce mortality and postoperative moderate and severe complications as a major determinant of the patients' postoperative quality of life, as well as health care costs...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#18
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29733922/lower-heart-rate-is-associated-with-good-one-year-outcome-in-post-resuscitation-patients
#19
Tuomas Oksanen, Marjaana Tiainen, Jukka Vaahersalo, Stepani Bendel, Tero Varpula, Markus Skrifvars, Ville Pettilä, Erika Wilkman
BACKGROUND: Optimal hemodynamic goals in post-resuscitation patients are not clear. Previous studies have reported an association between lower heart rate and good outcome in patients receiving targeted temperature management (TTM) after out-of-hospital cardiac arrest. METHODS: We analyzed heart rate (HR) and outcome data of 504 post-resuscitation patients from the prospectively collected database of the FINNRESUSCI study. One-year neurologic outcome was dichotomized by the Cerebral Performance Category (CPC) to good (1-2) or poor (3-5)...
May 4, 2018: Resuscitation
https://www.readbyqxmd.com/read/29732190/hybrid-extracorporeal-membrane-oxygenation
#20
REVIEW
Alexandre Brasseur, Sabino Scolletta, Roberto Lorusso, Fabio Silvio Taccone
Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency...
March 2018: Journal of Thoracic Disease
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