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https://www.readbyqxmd.com/read/28925895/cardiovascular-drug-therapy-for-human-newborn-review-of-pharmacodynamic-data
#1
Ebru Ergenekon, Héctor Rojas-Anaya, María Carmen Bravo, Charalampos Kotidis, Liam Mahoney, Heike Rabe
BACKGROUND: Circulatory failure in preterm and term newborn infants is commonly treated with inotropes or vasoactive medications. In this structured literature review, the available data on pharmacodynamic effects of the inotropes adrenaline, dobutamine, dopamine, levosimendan, milrinone, noradrenaline, and the vasoactive drugs vasopressin and hydrocortisone are presented. METHODS: Structured searches were conducted to identify relevant articles according to pre-defined inclusion criteria which were human clinical trials published after 2000...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925890/the-use-of-hemodynamic-and-cerebral-monitoring-to-study-pharmacodynamics-in-neonates
#2
A Smits, L Thewissen, A Dereymaeker, E Dempsey, A Caicedo, Gunnar Naulaers
BACKGROUND: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. METHODS: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925053/extracorporeal-membrane-oxygenation-can-save-lives-in-children-with-heart-or-lung-failure-after-liver-transplantation
#3
Sandrine Jean, Christophe Chardot, Mehdi Oualha, Carmen Capito, Olivier Bustarret, Philippe Pouard, Sylvain Renolleau, Florence Lacaille, Laurent Dupic
The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported...
September 2017: Artificial Organs
https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#4
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28923351/functionally-redundant-control-of-cardiac-hypertrophic-signaling-by-inositol-1-4-5-trisphosphate-receptors
#5
M Iveth Garcia, Anja Karlstaedt, Jessica J Chen, Javier Amione-Guerra, Keith A Youker, Heinrich Taegtmeyer, Darren Boehning
Calcium plays an integral role to many cellular processes including contraction, energy metabolism, gene expression, and cell death. The inositol 1, 4, 5-trisphosphate receptor (IP3R) is a calcium channel expressed in cardiac tissue. There are three IP3R isoforms encoded by separate genes. In the heart, the IP3R-2 isoform is reported to being most predominant with regards to expression levels and functional significance. The functional roles of IP3R-1 and IP3R-3 in the heart are essentially unexplored despite measureable expression levels...
September 15, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28917508/insulin-dependent-metabolic-and-inotropic-responses-in-the-heart-are-modulated-by-hydrogen-peroxide-from-nadph-oxidase-isoforms-nox2-and-nox4
#6
Benjamin Steinhorn, Juliano L Sartoretto, Andrea Sorrentino, Natalia Romero, Hermann Kalwa, E Dale Abel, Thomas Michel
RATIONALE: Hydrogen peroxide (H2O2) is a stable reactive oxygen species (ROS) that has long been implicated in insulin signal transduction in adipocytes. However, H2O2's role in mediating insulin's effects on the heart are unknown. OBJECTIVE: We investigated the role of H2O2 in activating insulin-dependent changes in cardiac myocyte metabolic and inotropic pathways. The sources of insulin-dependent H2O2 generation were also studied. METHODS AND RESULTS: In addition to the canonical role of insulin in modulating cardiac metabolic pathways, we found that insulin also inhibited beta adrenergic-induced increases in cardiac contractility...
September 13, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28916638/pharmacological-and-physiological-assessment-of-serotonin-formation-and-degradation-in-isolated-preparations-from-mouse-and-human-heart
#7
Ulrich Gergs, Franziska Jung, Igor B Buchwalow, Britt Hofmann, Andreas Simm, Hendrik Treede, Joachim Neumann
Using transgenic mice (TG) that overexpress the human 5-HT4a-receptor specifically in cardiomyocytes, we wanted to know whether 5-HT can be formed and degraded in the mammalian heart and whether this can likewise lead to inotropic and chronotropic effects in this TG model. We noted that the 5-HT precursor, 5-hydroxy-tryptophan (5-HTP), can exert inotropic and chronotropic effects in cardiac preparations from TG but not from wild type (WT): similar results were found in human atrial preparations, as well as in intact TG animals using echocardiography...
September 15, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28916123/reverse-takotsubo-cardiomyopathy-and-cardiogenic-shock-associated-with-methamphetamine-consumption
#8
Omar Chehab, Adam Ioannou, Akshat Sawhney, Alexandra Rice, Simon Dubrey
BACKGROUND: Reverse Takotsubo cardiomyopathy is characterized by transient myocardial hypokinesia affecting predominantly the basal myocardial wall. It is a rare variant of Takotsubo cardiomyopathy affecting younger patients. CASE REPORT: We report a case of a young man who having consumed methamphetamines presented with cardiogenic shock and severe left ventricular systolic dysfunction, affecting predominantly the basal segments with sparing of the apex. After inotropic support, the left ventricular ejection fraction improved...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28915395/effects-of-polymyxin-b-hemoperfusion-on-hemodynamics-and-prognosis-in-septic-shock-patients
#9
Chen-Tse Lee, Yu-Kang Tu, Yi-Chun Yeh, Tzu Chang, Po-Yuan Shih, Anne Chao, Hsing-Hao Huang, Ya-Jung Cheng, Yu-Chang Yeh
PURPOSE: We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. MATERIAL AND METHODS: We retrospectively examined the effects of PMX-HP in septic shock patients with intra-abdominal or gram-negative bacterial infection during October 2013-May 2016. A one-to-one matching between the PMX-HP and conventional groups was performed, and 28-day mortality, and change in inotropic score, Sequential Organ Failure Assessment (SOFA) score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24h in the two groups were compared...
April 25, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28915308/mutilating-purpura-fulminans-in-an-adult-with-meningococcal-sepsis
#10
María Elena Arnáiz-García, Ana María Arnáiz-García, Francisco Gutierrez-Diez, Juan Francisco Nistal, Jose María González-Santos, Ivana Pulitani, Carlos Amado-Diago, Javier Arnáiz
We report a dramatic case of meningococcal sepsis manifesting as purpura fulminans in an elderly diabetic woman. Hemodynamic instability and severe bilateral cutaneous lesions involving her hands and feet developed rapidly. Specific antibiotic therapy and the administration of inotropic and vasopressor drugs were initiated. The severity and extension of the cutaneous lesions (attributed to purpura fulminans) worsened because of the need for vasoconstrictors for the treatment of septic shock. Bilateral transmetatarsal and metacarpal amputations were required to stabilize the patient...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28913813/pharmacotherapy-pearls-for-emergency-neurological-life-support
#11
Gretchen M Brophy, Theresa Human
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913740/temporary-mechanical-circulatory-support-for-cardiogenic-shock
#12
REVIEW
Jean Touchan, Maya Guglin
Cardiogenic shock is a life-threatening presentation of severe heart failure with high morbidity and mortality. Given the modest increased in cardiac output and neutral/negative survival benefits with today's available inotropes (namely, dobutamine and milrinone), the use of mechanical circulatory support (MCS) has increased dramatically over the past 2 decades. In this review article, we discuss the physiologic concept, clinical evidence of benefit, and current use and indications/potential complications of the four most commonly used devices for MCS: intra-aortic balloon pump, Impella percutaneous ventricular assist device, TandemHeart, and extracorporeal membrane oxygenation (ECMO)...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28910238/telemanagement-of-heart-failure-patients-across-the-post-acute-care-continuum
#13
Amy Dadosky, Heather Overbeck, Laura Barbetta, Ken Bertke, Maureen Corl, Kathleen Daly, Natasha Hiles, Nancy Rector, Eugene Chung, Santosh Menon
BACKGROUND: Heart failure (HF) is a chronic condition causing nearly 1 million hospital admissions annually in the United States with 25% of patients rehospitalized within 30 days. INTRODUCTION: The purpose of this study was to investigate whether telemanagement of HF patients throughout the post-acute continuum of care would reduce rehospitalization rates and improve patient self-care knowledge and satisfaction. MATERIALS AND METHODS: HF patients discharged to a skilled nursing facility (SNF) received telemanagement by HF clinicians with opportunity for continuation at home with assistance of home healthcare (HHC) nurses...
September 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28906389/risk-factor-analysis-for-nonocclusive-mesenteric-ischemia-following-cardiac-surgery-a-case-control-study
#14
Ju Yong Lim, Joon Bum Kim, Sung Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
Although rare, postcardiac surgery nonocclusive mesenteric ischemia (NOMI) is a life-threatening condition. Identifying the risk factors for NOMI during immediate postoperative period may help early detection and intervention, which leads to improved clinical outcomes. The objective of this study was to identify the clinical features and risk factors of NOMI for prognosis identification after cardiac surgery, focusing on immediate postoperative parameters.Among 9445 patients who underwent cardiac surgery over a span of 9 years, 40 NOMI cases (0...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28895696/b-type-natriuretic-peptide-usefulness-in-the-management-of-critically-ill-neonates
#15
Gisela L Salas, Mariela Jozefkowicz, Gustavo S Goldsmit, Gabriela Disa, Alejandra Rodiño, Susana Rodríguez, Diana Fariña
INTRODUCTION: B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. OBJETIVE: To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28894423/%C3%AE-adrenergic-inhibition-prevents-action-potential-and-calcium-handling-changes-during-regional-myocardial-ischemia
#16
Shannon R Murphy, Lianguo Wang, Zhen Wang, Philip Domondon, Di Lang, Beth A Habecker, Rachel C Myles, Crystal M Ripplinger
β-adrenergic receptor (β-AR) blockers may be administered during acute myocardial infarction (MI), as they reduce energy demand through negative chronotropic and inotropic effects and prevent ischemia-induced arrhythmogenesis. However, the direct effects of β-AR blockers on ventricular electrophysiology and intracellular Ca(2+) handling during ischemia remain unknown. Using optical mapping of transmembrane potential (with RH237) and sarcoplasmic reticulum (SR) Ca(2+) (with the low-affinity indicator Fluo-5N AM), the effects of 15 min of regional ischemia were assessed in isolated rabbit hearts (n = 19)...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28889210/ketamine-and-midazolam-differently-impact-post-intubation-hemodynamic-profile-when-used-as-induction-agents-during-emergency-airway-management-in-hemodynamically-stable-patients-with-st-elevation-myocardial-infarction
#17
Marco Zuin, Gianluca Rigatelli, Fabio Dell'Avvocata, Giuseppe Faggian, Luca Conte, Sara Giatti, Flavio Michielan, Loris Roncon
We investigated the incidence of post-intubation hypotension (PIH) in hemodynamically stable patients with STEMI requiring rapid sequences intubation (RSI) and medicated with ketamine or midazolam as induction agent. STEMI patients admitted between 1st January 2009 and 1st January 2017 who did not receive any type of inotropic support before the endotracheal intubation (ETI) was reviewed. PIH was defined as a reduction greater than 20% or a drop of systolic blood pressure (SBP) below 90 mmHg within 10 min from the administration of the induction agent [ketamine (1 mg/kg) or midazolam (0...
September 9, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28888956/oxysterol-5%C3%AE-cholestan-3-one-modulates-a-contractile-response-to-%C3%AE-2-adrenoceptor-stimulation-in-the-mouse-atria-involvement-of-no-signaling
#18
Vaycheslav I Sytchev, Yulia G Odnoshivkina, Roman V Ursan, Alexey M Petrov
AIM: Atrial β2-adrenoceptors provide an important mechanism for regulation of cardiac function and changes in their downstream signaling are involved in processes underlying heart disorders. We have investigated the mechanism by which the cholesterol metabolite 5α-cholestan-3-one (5ɑCh3) modulates inotropic effect of β2-adrenoceptor agonist fenoterol. MAIN METHODS: Atria from mice were electrically stimulated and changes in contraction amplitude in response to fenoterol were studied in 5ɑCh3-pretreated samples...
September 6, 2017: Life Sciences
https://www.readbyqxmd.com/read/28888521/impact-of-center-left-ventricular-assist%C3%A2-device-volume-on-outcomes%C3%A2-after%C3%A2-implantion-an-intermacs-analysis
#19
Jennifer A Cowger, John M Stulak, Palak Shah, Todd F Dardas, Francis D Pagani, Shannon M Dunlay, Simon Maltais, Keith D Aaronson, Ramesh Singh, Nahush A Mokadam, James K Kirklin, Christopher T Salerno
OBJECTIVES: This study examined patient outcomes after left ventricular assist device (LVAD) implantation across a range of center surgical volumes. BACKGROUND: In order for a center to qualify for reimbursement, Centers for Medicare and Medicaid Services (CMS) requires it to implant ≥10 LVADs or total artificial hearts over a 3-year period. The impact of center LVAD surgical volumes on patient outcomes has not been thoroughly scrutinized. METHODS: Center volumes were provided for 7,416 patients undergoing LVAD implantation who were enrolled in INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support)...
August 30, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#20
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
September 7, 2017: Pediatric Cardiology
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