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https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#1
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/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#2
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/29753912/biomimetic-soft-fibrous-hydrogels-for-contractile-and-pharmacologically-responsive-smooth-muscle
#3
Yonghui Ding, Xin Xu, Sadhana Sharma, Michael Floren, Kurt Stenmark, Stephanie J Bryant, Corey P Neu, Wei Tan
The ability to assess changes in smooth muscle contractility and pharmacological responsiveness in normal or pathological-relevant vascular tissue environments is critical to enable vascular drug discovery. However, major challenges remain in both capturing the complexity of in vivo vascular remodeling and evaluating cell contractility in complex, tissue-like environments. Herein, we developed a biomimetic fibrous hydrogel with tunable structure, stiffness, and composition to resemble the native vascular tissue environment...
May 10, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29750931/relative-adrenal-insufficiency-is-associated-with-prolonged-postoperative-hemodynamic-instability
#4
Amine Mazine, Ismail Bouhout, Nadim Saydy, Louis-Mathieu Stevens, Maude Gagné-Loranger, Frédéric Vanden Eynden, Daniel Parent, Yoan Lamarche, Denis Bouchard
BACKGROUND: We assessed the hypothesis that a significant proportion of patients undergoing cardiac surgery suffer from postoperative relative adrenal insufficiency (RAI), and that this puts them at higher risk of persistent hemodynamic instability. METHODS: A prospective study included 135 patients who underwent cardiac surgery using cardiopulmonary bypass between July 2006 and December 2007. Adrenal function was assessed 36 hours after surgery using a 1 μg cosyntropin (ACTH) stimulation test...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#5
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/29737254/pharmacological-treatment-of-hypertension-effects-in-endothelial-function
#6
Leonardo Cobos-Segarra, Patricio Lopez-Jaramillo, Carlos Ponte-Negretti Ci, Raul Villar, Ernesto Penaherrera
The vascular endothelium plays a crucial role to maintain the functional integrity of the cardiovascular system through the secretion of vasoactive substances such as prostacyclin and NO. Endothelial dysfunction participate in the genesis of HTA, but also hypertension produces endothelial damage. The mayor class of antihypertensive drugs have beneficial effects in the recuperation of the endothelial function, actions that are contributing to explain the impact of the adequate control of HTA in the reduction of CV events...
May 7, 2018: Current Hypertension Reviews
https://www.readbyqxmd.com/read/29735214/effect-of-vasoactive-therapy-used-for-brain-dead-donors-on-graft-survival-after-kidney-transplantation
#7
D Birtan, M K Arslantas, G T Altun, P C Dincer, S Gecegormez, A Demirel, H O Ayanoglu
Serum catecholamine levels and peripheral vascular resistance decrease after brain death. Vasoactive drugs are used to control these hemodynamic changes and to improve perfusion of the organs. These drugs might have a role in rejection or loss of the graft organ. We aimed to investigate the effects of vasoactive drugs used in the cadaveric donor care on post-transplant renal graft functions. In this retrospective study, medical records of 135 cadaveric donors (270 kidneys) and recipients of these kidneys were evaluated...
May 4, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29723456/-contrast-enhanced-ultrasonography-in-the-diagnosis-of-venous-erectile-dysfunction
#8
Qing-Qiang Gao, Zhi-Bin Jin, Liang Shi, Yun Chen, Hai Chen, Wen Yu, You-Feng Han, Jian-Huai Chen, Zheng Zhang, Yang Xu, Yu-Tian Dai, Zhi-Peng Xu
Objective: To investigate the effect and safety of contrast-enhanced ultrasonography (CEUS) in the diagnosis of venous erectile dysfunction (VED). METHODS: From June 2015 to March 2016, 43 ED patients underwent corpus cavernography, of whom 23 were diagnosed with and the other 20 without corpus cavernosal venous leakage (CCVL). All the patients received intracorporal injection of a vasoactive drug and CEUS. RESULTS: Of the 23 patients with CCVL, 21 were confirmed by CEUS, including 12 cases of double venous leakage, 2 cases of single venous leakage, 5 cases of crural venous leakage, and 2 cases of the mixed type, while the other 2 showed no CCVL on CEUS...
July 2017: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/29720045/protocol-for-a-prospective-collaborative-systematic-review-and-meta-analysis-of-individual-patient-data-from-randomized-controlled-trials-of-vasoactive-drugs-in-acute-stroke-the-blood-pressure-in-acute-stroke-collaboration-stage-3
#9
Else Charlotte Sandset, Nerses Sanossian, Lisa J Woodhouse, Craig Anderson, Eivind Berge, Kennedy R Lees, John F Potter, Thompson G Robinson, Nikola Sprigg, Joanna M Wardlaw, Philip M Bath
Rationale Despite several large clinical trials assessing blood pressure lowering in acute stroke, equipoise remains particularly for ischemic stroke. The "Blood pressure in Acute Stroke Collaboration" commenced in the mid-1990s focussing on systematic reviews and meta-analysis of blood pressure lowering in acute stroke. From the start, Blood pressure in Acute Stroke Collaboration planned to assess safety and efficacy of blood pressure lowering in acute stroke using individual patient data. Aims To determine the optimal management of blood pressure in patients with acute stroke, including both intracerebral hemorrhage and ischemic stroke...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29703636/mobilisation-is-feasible-in-intensive-care-patients-receiving-vasoactive-therapy-an-observational-study
#10
Anneke Rebel, Vince Marzano, Margot Green, Karlee Johnston, Jiali Wang, Teresa Neeman, Imogen Mitchell, Bernie Bissett
BACKGROUND: Mobilisation of intensive care unit (ICU) patients reduces ICU-acquired weakness and is associated with better functional outcomes. However, the prevalence of mobilisation of ICU patients remains low. A known barrier to mobilisation is haemodynamic instability, frequently with patients requiring vasoactive therapy. There is a lack of published data to guide clinicians about the safety and feasibility of mobilising patients receiving vasoactive therapy. OBJECTIVES: To describe our mobilisation practice in ICU patients receiving vasoactive therapy and identify factors associated with mobilisation and adverse events...
April 24, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29702500/future-pharmacological-therapy-in-hypertension
#11
Merrill H Stewart, Carl J Lavie, Hector O Ventura
PURPOSE OF REVIEW: Hypertension (HTN) is a widespread and growing disease, with medication intolerance and side-effect present among many. To address these obstacles novel pharmacotherapy is an active area of drug development. This review seeks to explore future drug therapy for HTN in the preclinical and clinical arenas. RECENT FINDINGS: The future of pharmacological therapy in HTN consists of revisiting old pathways to find new targets and exploring wholly new approaches to provide additional avenues of treatment...
April 26, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29680327/clinical-characteristics-of-patients-with-newly-developed-acute-cholecystitis-after-admission-to-the-intensive-care-unit
#12
Soo Jung Kim, Seok Jeong Lee, Su Hwan Lee, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
INTRODUCTION: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients. OBJECTIVES: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). METHODS: We performed a retrospective cohort study from January 2006 to August 2016 at a tertiary care university hospital...
April 18, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29671764/evaluation-of-factors-associated-with-hypermetabolism-and-hypometabolism-in-critically-ill-aki-patients
#13
Cassiana R de Góes, André Luis Balbi, Daniela Ponce
Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris⁻Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1...
April 19, 2018: Nutrients
https://www.readbyqxmd.com/read/29661433/better-selection-criteria-with-prognostic-factors-for-liver-transplantation
#14
L S Nacif, R S Pinheiro, V Rocha-Santos, V M Barbosa, A P de Moura Dias, R B Martino, R A Macedo, L Ducatti, L Haddad, F Galvão, W Andraus, L Carneiro D' Albuquerque
BACKGROUND: Liver transplantation has evolved significantly in recent years, with each advancement part of the effort toward increasing patient and graft survival as well as quality of life. The objective of this study was to evaluate the prognostic factors and selection criteria for liver transplantation. METHODS: Our study was a statistical analysis, logistic regression, and survival evaluation of a total of 80 liver transplants that were performed between June 1, 2016 and September 24, 2016...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29657198/scoring-systems-and-outcome-of-chronic-kidney-disease-patients-admitted-in-intensive-care-units
#15
Jitendra Goswami, Manish R Balwani, Vivek Kute, Manoj Gumber, Mohan Patel, Umesh Godhani
The outcome of chronic kidney disease (CKD) patients admitted to the Intensive Care Unit (ICU) is difficult to predict. This study assessed the outcome of CKD patients admitted to the ICU and evaluated prediction of 30-day mortality using the Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), and Sequential Organ Failure Assessment (SOFA) score. One hundred consecutive CKD patients admitted to the ICU at a tertiary care hospital, Ahmedabad between 2011 and 2013 were included prospectively...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29644444/-s3-guidelines-on-intensive-medical-care-of-cardiac-surgery-patients-hemodynamic-monitoring-and-cardiovascular-system-an-update
#16
REVIEW
M Habicher, T Zajonz, M Heringlake, A Böning, S Treskatsch, U Schirmer, A Markewitz, M Sander
An update of the S3- guidelines for treatment of cardiac surgery patients in the intensive care unit, hemodynamic monitoring and cardiovascular system was published by the Association of Scientific Medical Societies in Germany (AWMF) in January 2018. This publication updates the guidelines from 2006 and 2011. The guidelines include nine sections that in addition to different methods of hemodynamic monitoring also reviews the topic of volume therapy as well as vasoactive and inotropic drugs. Furthermore, the guidelines also define the goals for cardiovascular treatment...
April 11, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#17
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29617700/vasoactive-intestinal-peptide-protects-salivary-glands-against-structural-injury-and-secretory-dysfunction-via-il-17a-and-aqp5-regulation-in-a-model-of-sj%C3%A3-gren-syndrome
#18
Chengyin Li, Fenglin Zhu, Bin Wu, Yue Wang
OBJECTIVE: Sjögren syndrome (SS) is an autoimmune disease involving exocrine glands. Currently, drugs that can improve both abnormal immunity and exocrine gland function are needed. The study aimed to investigate the effect and mechanism of vasoactive intestinal peptide (VIP) on the immune response and exocrine gland function in SS. METHODS: We investigated the effects of VIP on the immune response and secretory function of submandibular glands using NOD mice, and analyzed the expression of IL-17A and AQP5 (aquaporin 5)...
April 4, 2018: Neuroimmunomodulation
https://www.readbyqxmd.com/read/29616230/anesthesia-associated-relative-hypovolemia-mechanisms-monitoring-and-treatment-considerations
#19
Jessica Noel-Morgan, William W Muir
Although the utility and benefits of anesthesia and analgesia are irrefutable, their practice is not void of risks. Almost all drugs that produce anesthesia endanger cardiovascular stability by producing dose-dependent impairment of cardiac function, vascular reactivity, and compensatory autoregulatory responses. Whereas anesthesia-related depression of cardiac performance and arterial vasodilation are well recognized adverse effects contributing to anesthetic risk, far less emphasis has been placed on effects impacting venous physiology and venous return...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29605208/characteristics-and-mortality-risk-of-children-with-life-threatening-influenza-infection-admitted-to-paediatric-intensive-care-in-england-2003-2015
#20
Pia Hardelid, Melpo Kapetanstrataki, Lee Norman, Sarah J Fleming, Paula Lister, Ruth Gilbert, Roger C Parslow
BACKGROUND: Information is lacking about the severity of complications in children with influenza admitted to paediatric intensive care units (PICU) in the UK. In this study, we report risk factors for mortality, invasive ventilation and use of vasoactive drugs for children admitted to PICU with influenza. METHODS: We evaluated all admissions to PICUs in England for resident children with a recorded influenza diagnosis between September 2003 and March 2015. We used the Paediatric Intensive Care Audit Network (PICANet) database linked to hospital admission records to identify influenza cases, and high-risk comorbidities among admitted children...
April 2018: Respiratory Medicine
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