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https://www.readbyqxmd.com/read/28526597/slow-ventricular-tachycardia-in-a-91-year-old-man-with-implantable-cardioverter-defibrillator-and-acute-respiratory-failure
#1
Nicola Vargas, Loredana Tibullo, Cesare A E Landi, Giovanni Carifi, Emanuela Landi, Elisa Salsano, Francesco Di Grezia, Fiore Candelmo
Slow ventricular tachycardia (VT) in patients with devices such as an implantable cardioverter - defibrillator (ICD) is more common than in the rest of the population. The incidence in elderly patients with an ICD remains largely unknown. In younger patients, slow VT is generally asymptomatic or associated with limited clinical relevance. It may be efficiently and safely terminated by anti-tachycardia pacing. We present a case of slow VT in a 91-year-old man with ICD with type 1 acute respiratory failure and drowsiness...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28525624/early-and-asymptomatic-cardiac-dysfunction-in-chronic-kidney-disease
#2
Shanmugakumar Chinnappa, Edward White, Nigel Lewis, Omer Baldo, Yu-Kang Tu, Griet Glorieux, Raymond Vanholder, Meguid El Nahas, Andrew Mooney
Background: . Heart failure (HF) is highly prevalent and associated with high mortality in chronic kidney disease (CKD). However, the pathophysiology of cardiac dysfunction in CKD, especially in the early asymptomatic stage, is not well understood. We studied subclinical cardiac dysfunction in asymptomatic CKD patients without comorbid cardiac disease or diabetes mellitus by evaluating peak cardiac performance. Methods.: In a cross-sectional study ( n  = 130) we investigated 70 male non-diabetic CKD patients (21 CKD stage 2-3a, 27 CKD stage 3b-4 and 22 CKD stage 5) employing specialized cardiopulmonary exercise testing to measure peak cardiac output and cardiac power output non-invasively...
May 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28525548/computational-fluid-dynamics-characterization-of-pulsatile-flow-in-central-and-sano-shunts-connected-to-the-pulmonary-arteries-importance-of-graft-angulation-on-shear-stress-induced-platelet-mediated-thrombosis
#3
Robert Ascuitto, Nancy Ross-Ascuitto, Martin Guillot, Carey Celestin
OBJECTIVES: Central (aorta) and Sano (right ventricle)-to-pulmonary artery (PA) shunts, palliative operations for infants with complex heart defects, can develop life-threatening thrombosis. We employed computational fluid dynamics (CFD) to study pulsatile flow in these shunts, with the goal to identify haemodynamic characteristics conducive to thrombus formation. METHODS: CFD, using the finite volume method with cardiac catheterization data, and computer simulations, based on angiography, were employed to determine flow-velocity field, wall shear stress (WSS) profile and oscillatory shear index (OSI)...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28522658/effect-of-fontan-geometry-on-exercise-haemodynamics-and-its-potential-implications
#4
Elaine Tang, Zhenglun Alan Wei, Kevin K Whitehead, Reza H Khiabani, Maria Restrepo, Lucia Mirabella, James Bethel, Stephen M Paridon, Bradley S Marino, Mark A Fogel, Ajit P Yoganathan
OBJECTIVE: Exercise intolerance afflicts Fontan patients with total cavopulmonary connections (TCPCs) causing a reduction in quality of life. Optimising TCPC design is hypothesised to have a beneficial effect on exercise capacity. This study investigates relationships between TCPC geometries and exercise haemodynamics and performance. METHODS: This study included 47 patients who completed metabolic exercise stress test with cardiac magnetic resonance (CMR). Phase-contrast CMR images were acquired immediately following supine lower limb exercise...
May 18, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28522275/impact-of-continuous-positive-airway-pressure-on-left-ventricular-systolic-loading-and-coronary-flow-reserve-in-healthy-young-men
#5
Volker Schulze, Christian Meyer, Christian Eickholt, Roberto Sansone, Stefanie Keymel, Christian Heiss, Tienush Rassaf, Malte Kelm, Stephan Steiner
BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve. METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28522095/the-reduction-of-central-sleep-apnoea-severity-in-the-left-lateral-position-is-not-due-to-an-improvement-in-cardiac-haemodynamics-in%C3%A2-patients-with-chronic-heart-failure
#6
Egidio Traversi, Davide Rossi, Roberto Maestri, Francesca Olmetti, Maria Teresa La Rovere, Gian Domenico Pinna
OBJECTIVE: The severity of central sleep apnoea (CSA), a common comorbidity in patients with chronic heart failure (CHF) and reduced ejection fraction, markedly decreases from the supine to the lateral sleeping position, with no difference between the left and right positions. The mechanisms responsible for this beneficial effect have not yet been elucidated. METHODS: We tested the hypothesis that CSA attenuation in the left lateral position is due, at least in part, to an improvement in cardiac haemodynamics...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#7
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28519903/functional-neuroimaging-offers-insights-into-delirium-pathophysiology-a-systematic-review
#8
REVIEW
Lucy Haggstrom, Robert Welschinger, Gideon A Caplan
OBJECTIVE: This systematic review describes the current functional neuroimaging literature in delirium, discusses pathophysiological implications of these results and highlights areas for further study. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an extensive search of medical databases was undertaken, identifying eighteen studies of variable quality and design suitable for inclusion. RESULTS: Functional neuroimaging has highlighted significant abnormalities during delirium, with disturbances in cerebral haemodynamics and functional connectivity potentially playing a key role in delirium pathophysiology...
May 18, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28515531/anaesthetic-management-of-a-pregnant-woman-with-preeclampsia-and-eisenmenger-s-syndrome-role-of-advanced-haemodynamic-monitoring
#9
Muthapillai Senthilnathan, Savitri Velayudhan, Anusha Cherian, Pankaj Kundra
No abstract text is available yet for this article.
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515523/comparison-of-endotracheal-intubation-time-in-neutral-position-between-c-mac-%C3%A2-and-airtraq-%C3%A2-laryngoscopes-a-prospective-randomised-study
#10
Syed Moied Ahmed, Kashmiri Doley, Manazir Athar, Nadeem Raza, Obaid Ahmad Siddiqi, Shahna Ali
BACKGROUND AND AIMS: In the recent past, many novel devices such as AirTraq(®) and C-MAC(®) video laryngoscope (VL) have been introduced in an attempt to reduce anaesthetic morbidity and mortality associated with difficult intubation. In this study, we aimed to evaluate and compare C-MAC(®) VL with a standard Macintosh blade and the AirTraq(®) optical laryngoscope as a intubating devices with the patient's head in neutral position. METHODS: Sixty American Society of Anesthesiologist Physical Status I-II patients were randomly assigned to be intubated with C-MAC(®) VL (Group CM; n = 30) or AirTraq(®) (Group AT; n = 30) in the neutral position, with or without the application of optimization manoeuvres...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515522/comparison-of-airtraq%C3%A2-mccoy%C3%A2-and-macintosh-laryngoscopes-for-endotracheal-intubation-in-patients-with-cervical-spine-immobilisation-a-randomised-clinical-trial
#11
Vinod Hosalli, B K Arjun, Uday Ambi, Shivanand Hulakund
BACKGROUND AND AIMS: The study aimed at comparing the performance of the novel optical Airtraq™ laryngoscope with the McCoy™ and conventional Macintosh laryngoscopes for ease of endotracheal intubation in patients with neck immobilisation using manual inline axial cervical spine stabilisation (MIAS) technique. METHODS: Ninety consenting American Society of Anaesthesiologist's physical status I-II patients, aged 18-60 years, scheduled for various surgeries requiring tracheal intubation were randomly assigned into three groups of thirty each to undergo intubation with Macintosh, Airtraq™, or McCoy™ laryngoscope with neck immobilisation by MIAS technique...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515521/comparative-evaluation-of-airtraq%C3%A2-optical-laryngoscope-and-miller-s-blade-in-paediatric-patients-undergoing-elective-surgery-requiring-tracheal-intubation-a-randomized-controlled-trial
#12
Bikramjit Das, Arijit Samanta, Subhro Mitra, Shahin Nikhat Jamil
BACKGROUND AND AIMS: The Airtraq™ optical laryngoscope is the only marketed videolaryngoscope for paediatric patients besides the fibre-optic bronchoscope. We hypothesized that intubation would be easier with Airtraq™ compared to Miller blade. Hence, we compared Airtraq™ with the Miller laryngoscope as intubation devices in paediatric patients. METHODS: This prospective, randomized study was conducted in a tertiary care teaching hospital. Sixty children belonging to American Society of Anesthesiologists' Grade I-II, aged 2-10 years, posted for routine surgery requiring tracheal intubation were randomly allocated to undergo intubation using a Miller (n = 30) or Airtraq™ (n = 30) laryngoscope...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515520/a-comparative-evaluation-of-video-stylet-and-flexible-fibre-optic-bronchoscope-in-the-performance-of-intubation-in-adult-patients
#13
Syed Hussain Amir, Qazi Ehsan Ali, Sonali Bansal
BACKGROUND AND AIMS: Video Stylet (VS) is a new intubating modality that provides real-time video of endotracheal intubation (ETI). This device does not need alignment of the oral, pharyngeal and tracheal axes to view glottis and can be used in patients with limited mouth opening. The aim of this study was to compare flexible fibre-optic (FO) bronchoscope with VS in elective surgical patients in apparently normal airway patients requiring oral ETI. METHODS: Sixty patients undergoing elective surgery under general anaesthesia of age group 20-60 years, weight 40-70 kg, American Society of Anesthesiologist 1 and 2 and modified Mallampatti I and II were included in the study...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515518/is-segmental-epidural-anaesthesia-an-optimal-technique-for-patients-undergoing-percutaneous-nephrolithotomy
#14
Devangi A Parikh, Geeta A Patkar, Mayur S Ganvir, Ajit Sawant, Bharati A Tendolkar
BACKGROUND AND AIMS: Neuraxial anaesthesia has recently become popular for percutaneous nephrolithotomy (PCNL). We conducted a study comparing general anaesthesia (GA) with segmental (T6-T12) epidural anaesthesia (SEA) for PCNL with respect to anaesthesia and surgical characteristics. METHODS: Ninety American Society of Anesthesiologists Physical Status-I and II patients undergoing PCNL randomly received either GA or SEA. Overall patient satisfaction was the primary end point...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515516/changes-in-cardiac-index-during-labour-analgesia-a-double-blind-randomised-controlled-trial-of-epidural-versus-combined-spinal-epidural-analgesia-a-preliminary-study
#15
Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or uterine hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. METHODS: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515420/vascular-remodelling-relates-to-an-elevated-oscillatory-shear-index-and-relative-residence-time-in-spontaneously-hypertensive-rats
#16
Zhiyan Chen, Haiyi Yu, Yue Shi, Minjia Zhu, Yueshen Wang, Xi Hu, Youyi Zhang, Yu Chang, Ming Xu, Wei Gao
Haemodynamic disorders are common clinical findings in hypertension and lead to adverse cardiovascular events. However, the haemodynamic conditions in hypertension models are poorly understood. This study aimed to observe the characteristics of haemodynamics in spontaneously hypertensive rats (SHRs) and antihypertensive-treated SHRs. Twenty-four adult male SHRs and Wistar-Kyoto rats (WKYs) were randomly divided into four groups and treated for 7 days as follows: WKY-CON (WKYs + saline), WKY-NIF (WKYs + nifedipine, 50 mg/kg/day), SHR-CON (SHRs + saline), and SHR-NIF (SHRs + nifedipine)...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28515328/mechanotransmission-in-endothelial-cells-subjected-to-oscillatory-and-multi-directional-shear-flow
#17
Mahsa Dabagh, Payman Jalali, Peter J Butler, Amanda Randles, John M Tarbell
Local haemodynamics are linked to the non-uniform distribution of atherosclerosic lesions in arteries. Low and oscillatory (reversing in the axial flow direction) wall shear stress (WSS) induce inflammatory responses in endothelial cells (ECs) mediating disease localization. The objective of this study is to investigate computationally how the flow direction (reflected in WSS variation on the EC surface over time) influences the forces experienced by structural components of ECs that are believed to play important roles in mechanotransduction...
May 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28514936/evaluation-of-an-indirect-oscillometric-blood-pressure-monitor-in-anaesthetised-dogs-at-three-different-anatomical-locations
#18
M Fujiyama, H Sano, J P Chambers, M Gieseg
AIMS: To evaluate the agreement between invasive and non-invasive measurements of blood pressure (BP) using an oscillometer (PetTrust) at three different anatomical locations in anaesthetised dogs under different haemodynamic conditions. METHODS: Eight adult Greyhounds weighing 23.5-36.5 kg were anaesthetised with isoflurane and positioned in dorsal recumbency. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were measured invasively via a dorsal pedal artery and non-invasively using the oscillometer with cuffs placed above the carpus, above the tarsus and around the tail base...
July 2017: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/28513192/the-haemodynamic-effect-of-an-adjustable-band-in-an-arteriovenous-fistula
#19
M Sturm, H Lee, S Thomas, T Barber
A number of treatment approaches exist for excessive flowrate arteriovenous fistulae. Banding has a number of advantages, yet there is concern over its use due to reported high post-surgery thrombosis rates. A computational study is conducted of a new technique, to elucidate the hemodynamics present in the process. The key improvement involves the use of an adjustable band which can be used to optimise the flowrate during the surgery. The pressure and flowrate changes are apparent from the computational results and the computational results also demonstrate that further optimization may be possible...
May 17, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28513057/systemic-inflammation-and-alterations-to-cerebral-blood-flow-in-obstructive-sleep-apnea
#20
Hsiu-Ling Chen, Hsin-Ching Lin, Cheng-Hsien Lu, Pei-Chin Chen, Chih-Cheng Huang, Kun-Hsien Chou, Mao-Chang Su, Michael Friedman, Yi-Wen Chen, Wei-Che Lin
Systemic inflammation and alterations to regional cerebral blood flow (CBF) have been reported previously in obstructive sleep apnea (OSA). This study utilized arterial spin labelling (ASL) perfusion magnetic resonance imaging (MRI) to evaluate CBF in OSA patients and determine its relationship with systemic inflammation. Twenty male patients with moderate and severe OSA [apnea-hypopnea index (AHI) >15] and 16 healthy male volunteers (AHI <5) were recruited. Early- or late-phase changes in leucocyte apoptosis and its subsets were determined by flow cytometry...
May 17, 2017: Journal of Sleep Research
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