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Hemodynamic support

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https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#1
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29350305/percutaneous-mechanical-circulatory-support-devices-for-high-risk-percutaneous-coronary-intervention
#2
REVIEW
Subrata Kar
PURPOSE OF REVIEW: Percutaneous mechanical circulatory support devices (PMCSD) consist of the intra-aortic balloon pump (IABP), Impella (Abiomed Inc., Danvers, Massachusetts), Tandem Heart (Cardiac Assist, Inc., Pittsburgh, Pennsylvania), or extracorporeal membranous oxygenation (ECMO). They augment cardiac output, cardiac index, and cardiac power which allow the operator to mitigate hemodynamic perturbations during high-risk percutaneous coronary intervention (HR-PCI). This review discusses PMCSD and their contemporary literature...
January 19, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29348010/early-outcomes-with-the-evolut-pro-repositionable-self-expanding-transcatheter-aortic-valve-with-pericardial-wrap
#3
John K Forrest, Abeel A Mangi, Jeffrey J Popma, Kamal Khabbaz, Michael J Reardon, Neal S Kleiman, Steven J Yakubov, Daniel Watson, Susheel Kodali, Isaac George, Peter Tadros, George L Zorn, John Brown, Robert Kipperman, Sara Saul, Hongyan Qiao, Jae K Oh, Mathew R Williams
OBJECTIVES: This study sought to evaluate the Medtronic Evolut PRO Transcatheter Aortic Valve System in patients with severe symptomatic aortic stenosis. BACKGROUND: A next-generation self-expanding transcatheter aortic valve was designed with an external pericardial wrap with the intent to reduce paravalvular leak while maintaining the benefits of a low-profile, self-expanding, and repositionable supra-annular valve. METHODS: The Medtronic Evolut PRO Clinical Study included 60 patients undergoing transcatheter aortic valve replacement with the Evolut PRO valve at 8 investigational sites in the United States...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29346126/complete-revascularization-for-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#4
Gani Bajraktari, Haki Jashari, Pranvera Ibrahimi, Fernando Alfonso, Fisnik Jashari, Gjin Ndrepepa, Shpend Elezi, Michael Y Henein
INTRODUCTION: Despite the recent findings in randomized clinical trials (RCTs) with limited sample sizes and the updates in clinical guidelines, the current available data for the complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) at the time of primary percutaneous coronary intervention (PCI) are still contradictory. AIM: The aim of this meta-analysis of the existing RCTs was to assess the efficacy of the CR versus revascularization of infarct-related artery (IRA) only during primary PCI in patients with STEMI and multivessel disease (MVD)...
January 17, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29340539/the-spectrum-of-cardiovascular-effects-of-dobutamine-from-healthy-subjects-to-septic-shock-patients
#5
Arnaldo Dubin, Bernardo Lattanzio, Luis Gatti
Dobutamine is the inotrope most commonly used in septic shock patients to increase cardiac output and correct hypoperfusion. Although some experimental and clinical studies have shown that dobutamine can improve systemic and regional hemodynamics, other research has found that its effects are heterogenous and unpredictable. In this review, we analyze the pharmacodynamic properties of dobutamine and its physiologic effects. Our goal is to show that the effects of dobutamine might differ between healthy subjects, in experimental and clinical cardiac failure, in animal models and in patients with septic shock...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29340275/timing-of-transjugular-intrahepatic-portosystemic-shunt-for-budd-chiari-syndrome-an-italian-hepatologist-s-perspective
#6
Andrea Mancuso
Budd-Chiari syndrome (BCS) management flow-chart is derived from experts' opinion and is not evidence-based. Guidelines suggest BCS management should follow a stepwise strategy: medical therapy as first-line treatment, revascularization or transjugular intrahepatic portosystemic shunt (TIPS) if no response to medical therapy, and liver transplant as rescue therapy. Recent evidence suggests that only medical therapy results in a bad long-term outcome. The biggest criticism of guidelines is the indication that BCS should receive further treatment only when hemodynamic consequences of portal hypertension become clinically evident...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29338996/incidence-and-predictors-of-postoperative-need-for-high-dose-inotropic-support-in-patients-undergoing-cardiac-surgery-for-infective-endocarditis
#7
Alessandro Belletti, Stephan Jacobs, Giovanni Affronti, Alexander Mladenow, Giovanni Landoni, Volkmar Falk, Felix Schoenrath
OBJECTIVE: Patients with infective endocarditis undergoing cardiac surgery are a high-risk population. Few data on incidence and predictors of need for high-dose inotropic support in this setting are currently available. DESIGN: Retrospective study. SETTING: Tertiary-care hospital. PARTICIPANTS: Ninety consecutive patients undergoing cardiac surgery for infective endocarditis. INTERVENTIONS: None...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29335615/marinobufagenin-is-related-to-elevated-central-and-24-h-systolic-blood-pressures-in-young-black-women-the-african-predict-study
#8
Michél Strauss, Wayne Smith, Wen Wei, Olga V Fedorova, Aletta E Schutte
Marinobufagenin (MBG) is an endogenous steroidal α1-Na+K+-ATPase inhibitor. Because of its role in sodium handling, MBG has been associated with both antihypertensive and prohypertensive effects in normal physiology and pathology. MBG is positively associated with blood pressure in Dahl salt-sensitive rats exhibiting a similar hypertensive phenotype to black populations, characterized by impaired urinary Na+ excretion. However, clinical studies exploring blood pressure (BP)-related effects of MBG in black populations are scant...
January 15, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/29335287/identifying-candidates-for-advanced-hemodynamic-support-after-cardiac-arrest
#9
EDITORIAL
Jason A Bartos, Aaron L Doonan, Demetris Yannopoulos
No abstract text is available yet for this article.
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29334615/hemodynamic-and-metabolic-responses-to-self-paced-and-ramp-graded-exercise-testing-protocols
#10
Nicholas M Beltz, Fabiano Amorim, Ann L Gibson, Jeffrey M Janot, Len Kravitz, Christine M Mermier, Nathan Cole, Terence A Moriarty, Tony P Nunez, Sam Trigg, Lance Dalleck
PURPOSE: Recent examinations have shown lower maximal oxygen uptake (VO2max) during traditional ramp (RAMP) compared to self-paced (SPV) graded exercise testing (GXT) attributed to differences in cardiac ouput. The current study examined the differences in hemodyamic and metabolic responses between RAMP and SPV during treadmill exercise. METHODS: Sixteen recreationally trained men (23.7±3.0 yrs) completed two separate treadmill GXT protocols. SPV consisted of five 2-min stages (10 min total) of increasing speed clamped by the Borg RPE6-20 scale...
January 15, 2018: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/29331874/thyroid-hormone-resuscitation-after-brain-death-in-potential-organ-donors-a-primer-for-neurocritical-care-providers-and-narrative-review-of-the-literature
#11
REVIEW
Ian A Buchanan, Vivek A Mehta
Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS)...
January 8, 2018: Clinical Neurology and Neurosurgery
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
#12
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/29330133/the-evaluation-of-drug-induced-changes-in-left-ventricular-function-in-pentobarbital-anesthetized-dogs
#13
Yevgeniya E Koshman, Brett R Herzberg, Terese R Seifert, James S Polakowski, Scott W Mittelstadt
INTRODUCTION: The goal of this study was to determine whether assessment of myocardial contractility and hemodynamics in an anesthetized dog model, could consistently detect drug-induced changes in the inotropic state of the heart using drugs known to have clinically relevant positive and negative effects on myocardial contractility. METHODS: Derived parameters included: diastolic, systolic and mean arterial BP, peak systolic LVP, HR, end-diastolic LVP, and LVdP/dtmax as the primary contractility index...
January 9, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29328496/hypotension-risk-based-on-vasoactive-agent-discontinuation-order-in-patients-in-the-recovery-phase-of-septic-shock
#14
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/29325843/preoperative-intra-aortic-counterpulsation-in-cardiac-surgery-insights-from-a-retrospective-series-of-588-consecutive-high-risk-patients
#15
Giuseppe Gatti, Laura Morra, Gianluca Castaldi, Luca Maschietto, Florida Gripshi, Enrico Fabris, Andrea Perkan, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: To support a rational use of preoperative intra-aortic balloon pump (IABP) in cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single university hospital. PARTICIPANTS: The study included 588 (mean age 68.5 ± 9.6 yr) consecutive patients who received IABP before cardiac surgery from 1999 to 2016. INTERVENTIONS: Coronary surgery was performed in 573 (97.4%) cases...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324626/vascular-effects-of-adrenomedullin-and-the-anti-adrenomedullin-antibody-adrecizumab-in-sepsis
#16
Christopher Geven, Andreas Bergmann, Matthijs Kox, Peter Pickkers
Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular integrity are compromised, and contribute to the development of shock. The free circulating peptide adrenomedullin (ADM) is involved in regulation of the endothelial barrier function and tone of blood vessels. Several animal studies have shown that ADM administration improves outcome of sepsis...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29320485/non-invasive-ventilation-and-surfactant-treatment-as-primary-mode-of-respiratory-support-in-surfactant-deficient-newborn-piglets
#17
Carmen Rey-Santano, Victoria E Mielgo, Miguel Angel Gomez-Solaetxe, Francesca Ricci, Federico Bianco, Fabrizio Salomone, Begoña Loureiro, Jon López de Heredia Y Goya
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV), forms of non-invasive ventilation (NIV) for respiratory support, are increasingly being chosen as the initial treatment for neonates with surfactant (SF) deficiency. Our objective was to compare NCPAP with NIPPV with or without SF administration as a primary mode of ventilation. METHODS: Twenty-four newborn piglets with SF-deficient lung injury produced by repetitive bronchoalveolar lavages were randomly assigned to NCPAP or NIPPV, with or without SF administration (InSurE method)...
January 10, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29317401/acute-and-chronic-increases-of-circulating-fstl1-normalize-energy-substrate-metabolism-in-pacing-induced-heart-failure
#18
Mitsuru Seki, Jeffery C Powers, Sonomi Maruyama, Maria A Zuriaga, Chia-Ling Wu, Clara Kurishima, Lydia Kim, Jesse Johnson, Anthony Poidomani, Tao Wang, Eric Muñoz, Sudarsan Rajan, Joon Y Park, Kenneth Walsh, Fabio A Recchia
BACKGROUND: FSTL1 (follistatin-like protein 1) is an emerging cardiokine/myokine that is upregulated in heart failure (HF) and is found to be cardioprotective in animal models of cardiac injury. We tested the hypothesis that circulating FSTL1 can affect cardiac function and metabolism under baseline physiological conditions and in HF. METHODS AND RESULTS: FSTL1 was acutely (10 minutes) or chronically (2 weeks) infused to attain clinically relevant blood levels in conscious dogs with cardiac tachypacing-induced HF...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29313269/patient-specific-modeling-of-hemodynamics-supporting-surgical-planning-in-a-fontan-circulation-correction
#19
Theodorus M J van Bakel, Kevin D Lau, Jennifer Hirsch-Romano, Santi Trimarchi, Adam L Dorfman, C Alberto Figueroa
Computational fluid dynamics (CFD) is a modeling technique that enables calculation of the behavior of fluid flows in complex geometries. In cardiovascular medicine, CFD methods are being used to calculate patient-specific hemodynamics for a variety of applications, such as disease research, noninvasive diagnostics, medical device evaluation, and surgical planning. This paper provides a concise overview of the methods to perform patient-specific computational analyses using clinical data, followed by a case study where CFD-supported surgical planning is presented in a patient with Fontan circulation complicated by unilateral pulmonary arteriovenous malformations...
January 8, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29310555/mechanical-circulatory-support-for-the-failing-fontan-conversion-to-assisted-single-ventricle-circulation-preliminary-observations
#20
Syed M Peer, Kristopher B Deatrick, Thomas J Johnson, Jonathan W Haft, Francis D Pagani, Richard G Ohye, Edward L Bove, Alvaro Rojas-Peña, Ming-Sing Si
BACKGROUND: Mechanical circulatory support (MCS) of a failing Fontan circulation remains challenging. We hypothesized that MCS can be provided by converting the Fontan circulation into a mechanically assisted single ventricle parallel circulation (MASVC). METHODS: A porcine model of functionally univentricular circulation was created under cardiopulmonary bypass (CPB) by performing an atrial septectomy, tricuspid valvectomy, and interrupting antegrade pulmonary blood flow...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
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