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Hemodynamic support

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https://www.readbyqxmd.com/read/29161704/long-term-renal-and-cardiac-outcomes-after-stenting-in-patients-with-resistant-hypertension-and-atherosclerotic-renal-artery-stenosis
#1
Cristiana Catena, GianLuca Colussi, Gabriele Brosolo, Nicolas Verheyen, Marileda Novello, Nicole Bertin, Alessandro Cavarape, Leonardo A Sechi
BACKGROUND/AIMS: Atherosclerotic renal artery stenosis (ARAS) is frequently detected in patients with resistant hypertension (RHTN), but the evidence supporting the utility of renal revascularization in these patients is limited. This prospective, observational study investigates the outcomes of renal stenting in patients with RHTN and hemodynamically significant ARAS. METHODS: Fifty-four patients with RHTN were selected because of angiographic evidence of ARAS >70% and were followed for 4 years after renal stenting...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#2
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29158076/microcirculation-and-red-cell-transfusion-in-patients-with-sepsis
#3
REVIEW
Øystein Wendelbo, Tor Hervig, Oddbjørn Haugen, Jerard Seghatchian, Håkon Reikvam
Early identification of sepsis followed by diagnostic blood cultures and prompt administration of appropriate intravenous antibiotics covering all likely pathogen remains the corner stone in the initial management of sepsis. Source control, obtained by harvesting microbiological cultures and removal or drainage of the infected foci, is mandatory. However, optimization of hemodynamically unstable patients including volume support supplemented with vasopressor, inotropic and transfusion of red blood cells (RBCs) in case of persistent hypoperfusion have the potential to reduce morbidity and mortality...
November 10, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29153929/accuracy-of-a-simulation-algorithm-for-modelling-lv-contractility-diastolic-capacitance-and-energetics-using-data-available-from-common-hemodynamic-monitors-and-echocardiography
#4
Paul M Heerdt, Scott Korfhagen, Hesham Ezz, Clara Oromendia
OBJECTIVE: To test the hypothesis that a simulation algorithm populated with data readily available from hemodynamic monitors and echocardiography can accurately model cardiac contractility, diastolic capacitance, and energetics. DESIGN: Bland-Altman analysis of paired data sets. SETTING: University laboratory. PARTICIPANTS: Archived data previously recorded from 7 anesthetized swine. MEASUREMENTS AND MAIN RESULTS: Left ventricular pressure and volume (LVV) data that had been continuously recorded over a range of inotropic conditions were used as reference data...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29152829/procedural-trends-outcomes-and-readmission-rates-pre-and-post-fda-approval-for-mitraclip-from-the-national-readmission-database-2013-14
#5
Sidakpal S Panaich, Shilpkumar Arora, Apurva Badheka, Varun Kumar, Elad Maor, Claire Raphael, Abhishek Deshmukh, Guy Reeder, Mackram Eleid, Charanjit S Rihal
BACKGROUND: There are sparse clinical data on the procedural trends, outcomes and readmission rates following FDA approval and expansion of Transcatheter mitral valve repair/MitraClip(®) . Whether a complex new technology can be disseminated safely and quickly is controversial. METHODS: The study cohort was derived from the National Readmission Data (NRD) 2013-14. MitraClip(®) was identified using appropriate International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes...
November 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29149387/analgosedation-in-paediatric-severe-traumatic-brain-injury-tbi-practice-pitfalls-and-possibilities
#6
N Ketharanathan, Y Yamamoto, U Rohlwink, E D Wildschut, M Hunfeld, E C M de Lange, D Tibboel
Analgosedation is a fundamental part of traumatic brain injury (TBI) treatment guidelines, encompassing both first and second tier supportive strategies. Worldwide analgosedation practices continue to be heterogeneous due to the low level of evidence in treatment guidelines (level III) and the choice of analgosedative drugs is made by the treating clinician. Current practice is thus empirical and may result in unfavourable (often hemodynamic) side effects. This article presents an overview of current analgosedation practices in the paediatric intensive care unit (PICU) and addresses pitfalls both in the short and long term...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29149012/the-author-replies
#7
Joseph A Carcillo
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29149010/the-author-replies
#8
Joseph A Carcillo
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29146517/nanomedicine-safety-in-preclinical-and-clinical-development-focus-on-idiosyncratic-injection-infusion-reactions
#9
REVIEW
S M Moghimi
Injection/infusion reactions to nanopharmaceuticals (and particulate drug carriers) are idiosyncratic and well documented. The molecular basis of nanoparticle-mediated injection reactions is debatable, with two hypotheses as front-runners. The first is complement-activation-related 'pseudoallergy', where a causal role for nanoparticle-mediated complement activation in injection/infusion reactions is considered. However, the second hypothesis (the rapid phagocytic response hypothesis) states a transitional link from robust clearance of nanoparticles (NPs) from the blood by strategically placed responsive macrophages to adverse hemodynamic and cardiopulmonary reactions, regardless of complement activation...
November 13, 2017: Drug Discovery Today
https://www.readbyqxmd.com/read/29146417/association-between-percutaneous-hemodynamic-support-device-and-survival-from-cardiac-arrest-in-the-state-of-michigan
#10
Andrew Pressman, Kelly N Sawyer, William Devlin, Robert Swor
INTRODUCTION: The role of circulatory support in the post-cardiac arrest period remains controversial. Our objective was to investigate the association between treatment with a percutaneous hemodynamic support device and outcome after admission for cardiac arrest. METHODS: We performed a retrospective study of adult patients with admission diagnosis of cardiac arrest or ventricular fibrillation (VF) from the Michigan Inpatient Database, treated between July 1, 2010, and June 30, 2013...
October 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#11
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29135479/use-of-remote-pulmonary-artery-pressure-monitoring-cardiomems-system-in-total-artificial-heart-to-assess-pulmonary-hemodynamics-for-heart-transplantation
#12
Salman Gohar, Ziad Taimeh, Jeff Morgan, O H Frazier, Francisco Arabia, Andrew Civitello, Ajith Nair
The temporary total artificial heart (TAH-t) has been valuable as a bridge to transplantation in patients with biventricular failure. However, the challenges of accurately assessing pulmonary vascular resistance after TAH-t implantation can preclude these patients from heart transplantation, especially those with pre-existing pulmonary hypertension. The CardioMEMS Heart Failure System (St. Jude's Medical, Little Canada, MN) comprises a wireless pressure sensor that is implanted percutaneously in the pulmonary artery and transmits real-time measurements of pulmonary artery pressures...
November 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#13
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29132698/risk-factor-analysis-for-intraoperative-extracorporeal-membrane-oxygenation-weaning-failure-after-lung-transplantation
#14
Kyoung Shik Narm, Seokkee Lee, Jee Won Suh, Anes Kim, Jin Gu Lee, Moo Suk Park, Song Yee Kim, Joo Han Song, Su Jin Jeong, Hyo Chae Paik
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used for hemodynamic support during lung transplantation (LTx). We evaluated the risk factors associated with failure of weaning from ECMO in the operating room during LTx. METHODS: We retrospectively reviewed 74 consecutive patients who had undergone LTx from March 2013 to February 2016. Patients who underwent single LTx, multiorgan transplantation, and LTx for pulmonary hypertension were excluded...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#15
REVIEW
Robert A Maxwell, Christopher Michael Bell
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29130616/emergency-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-two-center-experience-of-incidence-outcome-and-temporal-trends-from-2010-to-2015
#16
Teresa Trenkwalder, Costanza Pellegrini, Andreas Holzamer, Alois Philipp, Tobias Rheude, Jonathan Michel, Wibke Reinhard, Michael Joner, Albert M Kasel, Adnan Kastrati, Heribert Schunkert, Dierk Endemann, Kurt Debl, N Patrick Mayr, Michael Hilker, Christian Hengstenberg, Oliver Husser
BACKGROUND: Although the incidence of periprocedural complications has decreased in transcatheter aortic valve implantation (TAVI), life-threatening complications occur and emergency veno-arterial extracorporeal membrane oxygenation (vaECMO) can provide immediate circulatory stabilization. We report our two-center experience of vaECMO during life-threatening complications in TAVI. METHODS: From January 2010 to December 2015, 1,810 consecutive patients underwent TAVI at two centers...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29127009/nicorandil-alleviates-myocardial-injury-and-post-infarction-cardiac-remodeling-by-inhibiting-mst1
#17
Shanjie Wang, Yanhong Fan, Xinyu Feng, Chuang Sun, Zhaofeng Shi, Tian Li, Jianjun Lv, Zhi Yang, Zhijing Zhao, Dongdong Sun
BACKGROUND: Cardiomyocyte autophagy and apoptosis are crucial events underlying the development of cardiac abnormalities and dysfunction after myocardial infarction (MI). A better understanding of the cell signaling pathways involved in cardiac remodeling may support the development of new therapeutic strategies for the treatment of heart failure (HF) after MI. METHODS: A cardiac MI injury model was constructed by ligating the left anterior descending (LAD) coronary artery...
November 7, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29125053/twenty-minutes-of-normothermic-cardiac-arrest-in-a-pig-model-the-role-of-short-term-hypothermia-for-neurological-outcome
#18
Katharina Foerster, Christoph Benk, Friedhelm Beyersdorf, Heidi Cristina Schmitz, Karin Wittmann, Itumeleng Taunyane, Claudia Heilmann, Georg Trummer
INTRODUCTION: Cardiopulmonary resuscitation restores circulation, but with inconsistent blood-flow and pressures. Our recent approach using an extracorporeal life support system, named "controlled integrated resuscitation device" (CIRD), may lead to improved survival and neurological recovery after cardiac arrest (CA). The basic idea is to provide a reperfusion tailored to the individual patient by control of the conditions of reperfusion and the composition of the reperfusate. Hypothermia is one aspect of this concept...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29125047/extra-corporeal-membrane-oxygenation-and-outcomes-in-massive-pulmonary-embolism-two-eras-at-an-urban-tertiary-care-hospital
#19
David L Ain, Mazen Albaghdadi, Jay Giri, Farhad Abtahian, Michael R Jaff, Kenneth Rosenfield, Nathalie Roy, Mauricio Villavicencio-Theoduloz, Thoralf Sundt, Ido Weinberg
Mortality associated with high-risk pulmonary embolism (PE) remains high. Extra-corporeal membrane oxygenation (ECMO) allows for acute hemodynamic stabilization and potentially for administration of other disease process altering therapies. We sought to compare two eras: pre-ECMO and post-ECMO in relation to high-risk PE treatment and mortality. A single-center retrospective chart review was conducted of high-risk PE patients. High-risk PE was defined as acute PE and cardiac arrest or shock. A total of 60 patients were identified, 31 in the pre-ECMO era and 29 in the post-ECMO era...
November 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/29123159/zinc-is-a-critical-regulator-of-placental-morphogenesis-and-maternal-hemodynamics-during-pregnancy-in-mice
#20
Rebecca L Wilson, Shalem Y Leemaqz, Zona Goh, Dale McAninch, Tanja Jankovic-Karasoulos, Gabriela E Leghi, Jessica A Phillips, Katrina Mirabito Colafella, Cuong Tran, Sean O'Leary, Sam Buckberry, Stephen Pederson, Sarah A Robertson, Tina Bianco-Miotto, Claire T Roberts
Zinc is an essential micronutrient in pregnancy and zinc deficiency impairs fetal growth. We used a mouse model of moderate zinc deficiency to investigate the physiological mechanisms by which zinc is important to placental morphogenesis and the maternal blood pressure changes during pregnancy. A 26% reduction in circulating zinc (P = 0.005) was exhibited in mice fed a moderately zinc-deficient diet. Zinc deficiency in pregnancy resulted in an 8% reduction in both near term fetal and placental weights (both P < 0...
November 9, 2017: Scientific Reports
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