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"Haemodynamic Monitoring" OR "Hemodynamic Monitoring"

Ying Xu, Qin Gu
BACKGROUND: The Swan-Ganz catheter is a reliable method used to monitor hemodynamics in intensive care units. Pump-controlled retrograde trial off is a new weaning test for veno-arterial extracorporeal membrane oxygenation in recent years. The objective of this report is to describe a case in which pulmonary artery flotation catheter hemodynamic monitoring in combination with pump-controlled retrograde trial off was sufficient for veno-arterial extracorporeal membrane oxygenation weaning...
February 8, 2019: Perfusion
Antonio Messina, Davide Colombo, Federico Lorenzo Barra, Gianmaria Cammarota, Giacomo De Mattei, Federico Longhini, Stefano Romagnoli, Francesco DellaCorte, Daniel De Backer, Maurizio Cecconi, Paolo Navalesi
BACKGROUND: Assessment of fluid responsiveness is problematic in intensive care unit (ICU) patients, in particular for those undergoing modes of partial support, such as pressure support ventilation (PSV). We propose a new test, based on application of a ventilator-generated sigh, to predict fluid responsiveness in ICU patients undergoing PSV. METHODS: This was a prospective bi-centric interventional study conducted in two general ICUs. In 40 critically ill patients with a stable ventilatory PSV pattern and requiring volume expansion (VE), we assessed the variations in arterial systolic pressure (SAP), pulse pressure (PP) and stroke volume index (SVI) consequent to random application of 4-s sighs at three different inspiratory pressures...
January 28, 2019: Critical Care: the Official Journal of the Critical Care Forum
Mahalakshmi Ansari, Gino A Kurian
Evidence suggests that hydrogen sulfide precondition (HIPC) is an effective protocol in the management of ischemia reperfusion (I/R) by attenuating free radical and calcium overload in mitochondria. However the efficacy of HIPC is largely unknown in diabetic cardiomyopathy (DCM) hearts subjected to I/R procedure. Male Wistar rats were randomly divided into three groups: i) normal, ii) diabetes mellitus (DM), and iii) diabetic cardiomyopathy (DCM). DM and DCM animals were prepared by using streptozotocin injection at the age of 4 week (35mg/kg, i...
January 22, 2019: Biochimie
Wolfgang Huber, Hana Algül, Tobias Lahmer, Ulrich Mayr, Miriam Lehmann, Roland M Schmid, Andreas Faltlhauser
BACKGROUND: Acute pancreatitis (AP) usually has a mild course with a mortality rate below 1%. However, around 10% of patients develop severe AP (SAP) involving extra-pancreatic tissues and other organ systems. The mortality of SAP is around 42%. The outcome of SAP is closely related to the development of systemic inflammation and consecutive organ failures. Most current therapies including fluid resuscitation, antimicrobial therapy, drainage procedures, and endoscopic management of complications are symptomatic rather than causative approaches, except sphincterotomy for gallstone pancreatitis...
January 2019: Medicine (Baltimore)
Gijs Fortrie, Hilde R H de Geus, Michiel G H Betjes
Acute kidney injury (AKI) is a frequent complication of hospitalization and is associated with an increased risk of chronic kidney disease (CKD), end-stage renal disease (ESRD), and mortality. While AKI is a known risk factor for short-term adverse outcomes, more recent data suggest that the risk of mortality and renal dysfunction extends far beyond hospital discharge. However, determining whether this risk applies to all patients who experience an episode of AKI is difficult. The magnitude of this risk seems highly dependent on the presence of comorbid conditions, including cardiovascular disease, hypertension, diabetes mellitus, preexisting CKD, and renal recovery...
January 24, 2019: Critical Care: the Official Journal of the Critical Care Forum
Justin J Skowno
Every day, hundreds of children around the world undergo some form of heart surgery. Safely seeing a patient through the complexities of paediatric cardiac surgery requires a range of skills, many of which are based on use and interpretation of standard clinical monitoring. However, these monitors are unable to tell us about absolute cardiac output, or whether the current cardiovascular state is adequate to the patient's needs. This article is protected by copyright. All rights reserved.
January 22, 2019: Paediatric Anaesthesia
Mathieu Jozwiak, Sandrine Millasseau, Christian Richard, Xavier Monnet, Pablo Mercado, François Dépret, Jean-Emmanuel Alphonsine, Jean-Louis Teboul, Denis Chemla
OBJECTIVES: First, to validate bedside estimates of effective arterial elastance = end-systolic pressure/stroke volume in critically ill patients. Second, to document the added value of effective arterial elastance, which is increasingly used as an index of left ventricular afterload. DESIGN: Prospective study. SETTING: Medical ICU. PATIENTS: Fifty hemodynamically stable and spontaneously breathing patients equipped with a femoral (n = 21) or radial (n = 29) catheter were entered in a "comparison" study...
January 17, 2019: Critical Care Medicine
Pralay Shankar Ghosh, Afzal Azim, Sai Saran, Arvind Kumar Baronia, Banani Poddar, Ratender Kumar Singh, Mohan Gurjar, Prabhaker Mishra
Introduction: Lung-protective ventilation strategy and prone positioning are the strategies practiced to manage patients suffering from acute respiratory distress syndrome (ARDS). Inferior Vena Cava Distensibility (dIVC) Index has been used for predicting fluid responsiveness (FR) in supine position. We conducted this study to observe the utility of dIVC in prone position in ARDS patients and compare it with esophageal Doppler (ED) parameters. Materials and Methods: After ethical clearance, a prospective observational pilot study was conducted in a 12-bedded tertiary care hospital...
December 2018: Indian Journal of Critical Care Medicine
Teatske M Altenburg, Joost Rotteveel, Erik H Serné, Mai J M Chinapaw
OBJECTIVES: Standing desks and stability balls are increasingly popular to increase muscle activity and thereby prevent potential adverse cardiometabolic effects of prolonged sitting. The present study examined the effects of (1) sitting on a stability ball ('active sitting') and (2) hourly 10-min standing interruptions during prolonged sitting on postprandial cardiometabolic biomarkers. DESIGN: Experimental crossover study. METHODS: Twenty healthy-weight males (19...
January 4, 2019: Journal of Science and Medicine in Sport
Gábor Bari, Dániel Érces, Gabriella Varga, Szilárd Szucs, Zoltán Varga, Gábor Bogáts, Mihály Boros
OBJECTIVES: Extracorporeal circulation induces cellular and humoral inflammatory reactions, thus possibly leading to detrimental secondary inflammatory responses. Previous data have demonstrated the bioactive potential of methane and confirmed its anti-inflammatory effects in model experiments. Our goal was to investigate the in vivo consequences of exogenous methane administration on extracorporeal circulation-induced inflammation. METHODS: Two groups of anaesthetized Vietnamese minipigs (non-treated and methane treated, n = 5 each) were included...
January 12, 2019: European Journal of Cardio-thoracic Surgery
Sedef Tavukcu Ozkan, Harun Arbatli
Close hemodynamic monitoring is crucial for the patients to guide cardiovascular therapy for the optimal management. Transpulmonary thermodilution offers a less invasive hemodynamic monitoring with Pulse Index Continuous Cardiac Output system analysis. Intracardiac shunts have been associated with well-defined alterations in transpulmonary thermodilution-related hemodynamic parameters leading to inaccurate measurements and therefore are among the contraindications for transpulmonary thermodilution. However, data on the effects of arteriovenous fistulas as well as extracorporeal circuits on the thermodilution curves remain limited and inconclusive...
January 4, 2019: Journal of Vascular Access
Alexandre Joosten, Alexandra Jacobs, Olivier Desebbe, Jean-Louis Vincent, Saxena Sarah, Joseph Rinehart, Luc Van Obbergh, Alexander Hapfelmeier, Bernd Saugel
Pulse pressure variation (PPV) and stroke volume variation (SVV) can be used to assess fluid status in the operating room but usually require dedicated advanced hemodynamic monitors. Recently, a smartphone application (Capstesia™), which automatically calculates PPV from a picture of the invasive arterial pressure waveform from any monitor screen (PPVCAP ), has been developed. The purpose of this study was to compare PPVCAP with SVV from an uncalibrated pulse wave analysis monitor (SVVPC ). In 40 patients undergoing major abdominal surgery, we compared PPVCAP with SVVPC at post-induction, pre-incision, post-incision, end of surgery, and during every hypotensive episode (mean arterial pressure < 65 mmHg)...
January 3, 2019: Journal of Clinical Monitoring and Computing
George Gellert, Peter Bramlage
During interventional and structural cardiology procedures, such as mitral valve (MitraClip, BMV), aortic valve (TAVR, BAV), tricuspid valve (MitraClip), left atrial appendage (Watchman, Lariat), atrial septum (ASD/PFO closure), and coronary artery intervention (high-risk PCI), among others, patients are at a high risk of hemodynamic instability and require continuous monitoring. This is conventionally achieved through arterial catheterization and transpulmonary thermodilution. However, such invasive techniques are time-consuming and have been associated with steep learning curves, vascular complications, and increased risk of infection...
November 14, 2018: Heart Surgery Forum
Konrad Leszek Mendrala, Dariusz Gajniak, Tomasz Cyzowski, Tomasz Czober, Danuta Gierek, Ewa Kucewicz-Czech
INTRODUCTION: Monitoring lung function during pneumonia is essential for the evaluation of the effectiveness of therapy in ICU patients. Among various bedside techniques, two particularly interesting are the lung ultrasound and the transpulmonary thermodilution technique. In this observational single center study we want to assess the correlation between the lung ultrasound examination (LUS) and transpulmonary thermodilution volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI)...
December 30, 2018: Advances in Respiratory Medicine
Leah M Raj, Leslie A Saxon
ICDs and resynchronisation devices are routinely implanted in patients with heart failure for primary prevention of sudden cardiac death or to treat the condition. The addition of device features and algorithms that directly or indirectly monitor cardiac haemodynamics to assess heart failure status can provide additional benefit by treating heart failure more continuously. Established and emerging devices and sensors aimed at treating or measuring cardiac haemodynamics represent the next era of heart failure disease management...
December 2018: Arrhythmia & Electrophysiology Review
William Toppen, Elizabeth Aquije Montoya, Stephanie Ong, Daniela Markovic, Yuhan Kao, Xueqing Xu, Alan Chiem, Maxime Cannesson, David Berlin, Igor Barjaktarevic
PURPOSE: Passive leg raise (PLR), in combination with technologies capable of capturing stroke volume changes, has been widely adopted in the management of shock. However, dedicated evaluation of safety, feasibility, and receptiveness of patients and nursing staff to PLR maneuver is missing. METHODS: A noninterventional, prospective trial recruited adult patients with onset of undifferentiated shock within 24 hours with persistent vasopressor requirements despite fluid resuscitation...
December 20, 2018: Journal of Intensive Care Medicine
Jan Biegus, Robert Zymliński, Mateusz Sokolski, Piotr Gajewski, Waldemar Banasiak, Piotr Ponikowski
BACKGROUND: Lactate is an end-product of anaerobic cell metabolism. Although lactate is believed to have prognostic significance in heart failure (HF), the data on the pathomechanisms that lead to lactate accumulation is scarce. AIM: We aim to determine the clinical, respiratory, biochemical and haemodynamic correlates of lactate in HF. METHODS: Patients hospitalised at one cardiac centre with a diagnosis of HF, who underwent haemodynamic monitoring, were included in the analysis...
December 19, 2018: Kardiologia Polska
Anca Daniela Farcas, Florin Petru Anton, Mihaela Mocan, Luminita Animarie Vida-Simiti
Hypertension is a major issue of public health because of its increasing prevalence and multiple complications caused by failing to achieve an efficient blood pressure control. Considering hypertension as a hemodynamic disorder allows to prescribe a tailored therapy guided by individual hemodynamic parameters, therefore leading to an increased rate of control. We present the case of a 59 years old diabetic, dyslipidemic and obese male who, although treated with 5 classes of antihypertensive drugs had uncontrolled hypertension that caused left ventricular failure...
October 2018: Clujul Medical (1957)
Veli-Pekka Harjola, George Giannakoulas, Dirk von Lewinski, Simon Matskeplishvili, Alexandre Mebazaa, Zoltan Papp, Robert H G Schwinger, Piero Pollesello, John T Parissis
As a calcium sensitizer and inodilator that augments cardiac contractility without increasing myocardial oxygen demand or exacerbating ischaemia, levosimendan may be well configured to deliver inotropic support in cases of acute heart failure (AHF). Other factors favouring levosimendan in this setting include its extended duration of action due to the formation of an active metabolite and the lack of any attenuation of effect in patients treated with beta-blockers. Effects of levosimendan on systemic haemodynamics include its significant, dose-dependent increases in cardiac output, stroke volume and heart rate, and decreases in right and left ventricular filling and total peripheral resistance...
December 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
Helen Perry, Oliver Stirrup, Juande Gutierrez, Dimuthu Vinayagam, Basky Thilaganathan, Asma Khalil
BACKGROUND: There is increasing evidence for the importance of haemodynamic monitoring in pregnancy. Device-specific reference ranges are required in order to correctly intepret hemodynamic indices in healthy and pathological pregnancies. METHODS: This was a prospective cohort study of healthy singleton pregnancies. Haemodynamic measurements of stroke volume, cardiac output and systemic vascular resistance throughout pregnancy were obtained using NICOM® , a non-invasive device based on bio-reactance technology...
November 22, 2018: Ultrasound in Obstetrics & Gynecology
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