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[PMID]:29267497
[Au] Autor:Caires A; Fernandes GS; Leme AM; Castino B; Pessoa EA; Fernandes SM; Fonseca CD; Vattimo MF; Schor N; Borges FT
[Ad] Endereço:Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
[Ti] Título:Endothelin-1 receptor antagonists protect the kidney against the nephrotoxicity induced by cyclosporine-A in normotensive and hypertensive rats.
[So] Source:Braz J Med Biol Res;51(2):e6373, 2017 Dec 11.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Cyclosporin-A (CsA) is an immunosuppressant associated with acute kidney injury and chronic kidney disease. Nephrotoxicity associated with CsA involves the increase in afferent and efferent arteriole resistance, decreased renal blood flow (RBF) and glomerular filtration. The aim of this study was to evaluate the effect of Endothelin-1 (ET-1) receptor blockade with bosentan (BOS) and macitentan (MAC) antagonists on altered renal function induced by CsA in normotensive and hypertensive animals. Wistar and genetically hypertensive rats (SHR) were separated into control group, CsA group that received intraperitoneal injections of CsA (40 mg/kg) for 15 days, CsA+BOS and CsA+MAC that received CsA and BOS (5 mg/kg) or MAC (25 mg/kg) by gavage for 15 days. Plasma creatinine and urea, mean arterial pressure (MAP), RBF and renal vascular resistance (RVR), and immunohistochemistry for ET-1 in the kidney cortex were measured. CsA decreased renal function, as shown by increased creatinine and urea. There was a decrease in RBF and an increase in MAP and RVR in normotensive and hypertensive animals. These effects were partially reversed by ET-1 antagonists, especially in SHR where increased ET-1 production was observed in the kidney. Most MAC effects were similar to BOS, but BOS seemed to be better at reversing cyclosporine-induced changes in renal function in hypertensive animals. The results of this work suggested the direct participation of ET-1 in renal hemodynamics changes induced by cyclosporin in normotensive and hypertensive rats. The antagonists of ET-1 MAC and BOS reversed part of these effects.
[Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente
Lesão Renal Aguda/prevenção & controle
Ciclosporina/toxicidade
Antagonistas do Receptor de Endotelina A/farmacologia
Imunossupressores/toxicidade
Pirimidinas/farmacologia
Sulfonamidas/farmacologia
[Mh] Termos MeSH secundário: Lesão Renal Aguda/fisiopatologia
Animais
Creatinina/sangue
Antagonistas do Receptor de Endotelina A/uso terapêutico
Hemodinâmica
Immunoblotting
Imuno-Histoquímica
Rim/efeitos dos fármacos
Rim/fisiopatologia
Masculino
Estresse Oxidativo/fisiologia
Substâncias Protetoras/farmacologia
Substâncias Protetoras/uso terapêutico
Pirimidinas/uso terapêutico
Ratos Endogâmicos SHR
Ratos Wistar
Reprodutibilidade dos Testes
Sulfonamidas/uso terapêutico
Resultado do Tratamento
Ureia/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Endothelin A Receptor Antagonists); 0 (Immunosuppressive Agents); 0 (Protective Agents); 0 (Pyrimidines); 0 (Sulfonamides); 83HN0GTJ6D (Cyclosporine); 8W8T17847W (Urea); AYI8EX34EU (Creatinine); Q326023R30 (bosentan); Z9K9Y9WMVL (macitentan)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:27776979
[Au] Autor:Salman IM; Hildreth CM; Phillips JK
[Ad] Endereço:Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia. Electronic address: ibraheem_muhammed@yahoo.com.
[Ti] Título:Chronic kidney disease impairs renal nerve and haemodynamic reflex responses to vagal afferent input through a central mechanism.
[So] Source:Auton Neurosci;204:65-73, 2017 05.
[Is] ISSN:1872-7484
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:We investigated age- and sex-related changes in reflex renal sympathetic nerve activity (RSNA) and haemodynamic responses to vagal afferent stimulation in a rodent model of chronic kidney disease (CKD). Using anaesthetised juvenile (7-8weeks) and adult (12-13weeks) Lewis Polycystic Kidney (LPK) and Lewis control rats of either sex (n=63 total), reflex changes in RSNA, heart rate (HR) and mean arterial pressure (MAP) to vagal afferent stimulation (5-s train, 4.0V, 2.0-ms pulses, 1-16Hz) were measured. In all groups, stimulation of the vagal afferents below 16Hz produced frequency-dependent reductions in RSNA, HR and MAP, while a 16Hz stimulus produced an initial sympathoinhibition followed by sympathoexcitation. In juvenile LPK versus age-matched Lewis, sympathoinhibition was reduced when responses were expressed as % baseline (P<0.05), but not as microvolts, while bradycardic responses were greater. Reflex depressor responses were greater (P=0.015) only in juvenile female LPK. In adult LPK, reflex sympathoinhibition (%) was blunted (P<0.05), and an age-related decline apparent (when expressed as microvolts). Reflex reductions in HR and MAP were only diminished (P<0.05) in adult female LPK versus age-matched Lewis. Peak reflex sympathoexcitation at 16Hz did not differ between groups; however, area under the curve values were greater in the LPK versus Lewis (overall, 9±1 versus 19±3µVs, P<0.05) irrespective of age, suggestive of enhanced sympathoexcitatory drive in the LPK. Our data demonstrates a progressive deficit in the central processing of vagal afferent input and a differential sex influence on reflex regulation of autonomic function and blood pressure homeostasis in CKD.
[Mh] Termos MeSH primário: Hemodinâmica/fisiologia
Rim/inervação
Rim/fisiopatologia
Reflexo/fisiologia
Insuficiência Renal Crônica/fisiopatologia
Nervo Vago/fisiopatologia
[Mh] Termos MeSH secundário: Vias Aferentes/fisiopatologia
Animais
Área Sob a Curva
Pressão Sanguínea/fisiologia
Estudos de Coortes
Modelos Animais de Doenças
Feminino
Frequência Cardíaca/fisiologia
Masculino
Ratos Endogâmicos Lew
Especificidade da Espécie
Sistema Nervoso Simpático/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28453799
[Au] Autor:Metras A; Fouilloux V; Al-Yamani M; Roques X; Macé L; Thambo JB; Metras D; Kreitmann B; Roubertie F
[Ad] Endereço:Department of Cardiovascular Surgery, Bordeaux Heart University Hospital, University of Bordeaux II, France.
[Ti] Título:Early to mid-term results after total cavopulmonary connection performed in the second decade of life.
[So] Source:Interact Cardiovasc Thorac Surg;24(5):762-767, 2017 05 01.
[Is] ISSN:1569-9285
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Total cavopulmonary connection (TCPC) performed in the second decade of life has rarely been studied. Thus, we investigated (bicentric study) early and late morbidity and mortality following completion of TCPC in these patients. METHODS: From January 1999 to June 2014, 63 patients (14.5 ± 2.9 years) underwent TCPC (extracardiac conduit). Palliation before completion was an isolated bidirectional cavopulmonary shunt (BCPS) in 3 patients or BCPS associated with additional pulmonary blood flow (APBF) that was either antegrade (Group 1) in 38 (63%) or retrograde (Group 2) in 22 (37%). Preoperative and perioperative data were reviewed retrospectively. RESULTS: Mean pulmonary arterial and ventricular end-diastolic pressures were 12.2 and 9.2 mmHg, respectively. Mean Nakata index was 279 ± 123 and 228 ± 87 mm 2 /m 2 in Groups 1 and 2, respectively ( P = 0.01). Aortic cross-clamping was performed in 22 from Group 1 and 8 from Group 2 ( P = 0.04). Mean follow-up was 4.57 years [0.8-15]. Nine patients had prolonged stays in the intensive care unit (>6 days). There were 1 early and 2 late deaths (non-cardiac related). Actuarial survival was 96% at 4 years. At last follow-up, single-ventricle function remained normal or improved in all patients (Group 1) compared to 82% in Group 2 ( P = 0.02). New York Heart Association (NYHA) class had improved in both groups: 47 patients were NYHA class II and 16 class III preoperatively vs 50 class I and 10 class II postoperatively ( P < 0.001). CONCLUSIONS: Single-ventricle palliation with BCPS and APBF allowed completion of TCPC in the second decade of life, with encouraging mid-term results. However, BCPS with retrograde APBF was associated with single-ventricle dysfunction: thus, this technique needs to be used cautiously as long-lasting palliation.
[Mh] Termos MeSH primário: Técnica de Fontan/métodos
Cardiopatias Congênitas/cirurgia
Hemodinâmica/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seguimentos
França/epidemiologia
Cardiopatias Congênitas/mortalidade
Cardiopatias Congênitas/fisiopatologia
Seres Humanos
Masculino
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/icvts/ivw427


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[PMID]:29374922
[Au] Autor:Wang DY; Xie WG; Xi MM; Li Z; Wang B
[Ad] Endereço:Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China.
[Ti] Título:[Effects of application of pulse contour cardiac output monitoring technology in early treatment of patients with large area burns].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):14-20, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample test and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis. (1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 ( =7.428, <0.01). The PCCI values of patients at PIH 4, 8, 12, 16, 20, and 24 were (2.4±0.9), (2.6±1.2), (2.2±0.6), (2.6±0.7), (2.8±0.6), and (2.7±0.7) L·min(-1)·m(-2,) respectively, and they were significantly lower than the normal value 4 L·min(-1)·m(-2)( =-3.143, -3.251, -11.511, -8.889, -6.735, -6.976, <0.05 or <0.01). At PIH 76, 80, 84, 88, 92, and 96, the PCCI values of patients were (4.9±1.5), (5.7±2.0), (5.9±1.7), (5.5±1.3), (5.3±1.1), and (4.9±1.4) L·min(-1)·m(-2,) respectively, and they were significantly higher than the normal value ( =2.277, 3.142, 4.050, 4.111, 4.128, 2.423, <0.05 or <0.01). The PCCI values of patients at other time points were close to normal value ( >0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 ( =7.863, <0.01). The SVRI values of patients at PIH 12, 16, 20, 24, and 28 were (2 298±747), (2 581±498), (2 705±780), (2 773±669), and (3 109±1 215) dyn·s·cm(-5)·m(2,) respectively, and they were significantly higher than the normal value 2 050 dyn·s·cm(-5)·m(2)( =0.878, 3.370, 2.519, 3.747, 3.144, <0.05 or <0.01). At PIH 4, 8, 72, 76, 80, 84, 88, 92, and 96, the SVRI values of patients were (1 632±129), (2 012±896), (1 381±503), (1 180±378), (1 259±400), (1 376±483), (1 329±385), (1 410±370), and (1 346±346) dyn·s·cm(-5)·m(2,) respectively, and they were significantly lower than the normal value ( =-4.593, -0.112, -5.157, -8.905, -7.914, -5.226, -6.756, -6.233, -7.038, <0.01). The SVRI values of patients at other time points were close to normal value ( >0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 ( =0.704, >0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value ( =-3.112, -3.554, -2.969, -2.450, -2.476, <0.05). The GEDVI values of patients at other time points were close to normal value ( >0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 ( =1.859, <0.01). The EVLWI values of patients at PIH 16, 20, 24, 28, 32, 36, and 40 were significantly higher than normal value ( =4.386, 3.335, 6.363, 4.391, 7.513, 5.392, 5.642, <0.01). The EVLWI values of patients at other time points were close to normal value ( >0.05). (5) The fluid infusion coefficients of patients at the first and second 24 hours post injury were 1.90 and 1.39, respectively. The blood lactic acid values of patients from PID 1 to 7 were 7.99, 5.21, 4.57, 4.26, 2.54, 3.13, and 3.20 mmol/L, respectively, showing a declined tendency. (6) There was obvious negative correlation between PCCI and SVRI ( =-0.528, <0.01). There was obvious positive correlation between GEDVI and PCCI ( =0.577, <0.01). There was no obvious correlation between GEDVI and SVRI ( =0.081, >0.05). There was obvious positive correlation between blood lactic acid and SVRI ( =0.878, <0.01). (7) All patients were cured except the one who abandoned treatment. PiCCO monitoring technology can monitor the changes of early hemodynamic indexes and volume of burn patients dynamically, continuously, and conveniently, and provide valuable reference for early-stage comprehensive treatment like anti-shock of patients with large area burns.
[Mh] Termos MeSH primário: Queimaduras/terapia
Débito Cardíaco
Monitorização Fisiológica/métodos
Ressuscitação
[Mh] Termos MeSH secundário: Água Extravascular Pulmonar
Hidratação
Hemodinâmica
Seres Humanos
Choque/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.004


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[PMID]:29480841
[Au] Autor:Chen LJ; Zhang YQ; Tong ZR; Sun AM
[Ad] Endereço:Department of Pediatric Cardiology.
[Ti] Título:Evaluation of the anatomic and hemodynamic abnormalities in tricuspid atresia before and after surgery using computational fluid dynamics.
[So] Source:Medicine (Baltimore);97(2):e9510, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Analysis of hemodynamics inside tricuspid atresia (TA) chamber is essential to the understanding of TA for optimal treatment. In this study, we introduced a combined computational fluid dynamics (CFD) to simulate blood flow in the left ventricle (LV) to study the diastolic flow changes in TA.Real-time 3-dimentional echocardiography loops (ECHO) were acquired in normal control group, in TA patients before surgery (pre-op group) and after surgery (post-op group). ECHO loops were reconstructed and simulated by CFD, the geometric, volumetric changes, and vortices in the LV were studies and compare among 3 groups.Compared with the control group, pre-op TA patients demonstrated significant LV remodeling, manifesting with smaller LV length, larger diameter, width and spherical index, as well as lager volumes; post-op TA group showed revisions in values of both geometric and volumetric measurements. CDF also demonstrated the abnormality of vortices in the pre-op TA patients and the alteration of existence and measurements of vortex in postoperation group.Echo-based CFD modeling can show the abnormality of TA in both LV geometric, volumetric measurements and intracardiac vortices; and CFD is capable to demonstrate the alterations of LV after Fontan and Glenn surgical procedure.
[Mh] Termos MeSH primário: Ventrículos do Coração/diagnóstico por imagem
Hemodinâmica
Fluxo Sanguíneo Regional
Atresia Tricúspide/diagnóstico por imagem
Atresia Tricúspide/cirurgia
[Mh] Termos MeSH secundário: Adulto
Simulação por Computador
Ecocardiografia Tridimensional
Feminino
Ventrículos do Coração/fisiopatologia
Seres Humanos
Hidrodinâmica
Masculino
Modelos Cardiovasculares
Tamanho do Órgão
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Atresia Tricúspide/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009510


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[PMID]:28470920
[Au] Autor:Rob D; Spunda R; Lindner J; Rohn V; Kunstýr J; Balík M; Rulísek J; Kopecký P; Lips M; Smíd O; Kovárník T; Mlejnský F; Linhart A; Belohlávek J
[Ad] Endereço:2nd Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
[Ti] Título:A rationale for early extracorporeal membrane oxygenation in patients with postinfarction ventricular septal rupture complicated by cardiogenic shock.
[So] Source:Eur J Heart Fail;19 Suppl 2:97-103, 2017 May.
[Is] ISSN:1879-0844
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR. METHODS AND RESULTS: We conducted a retrospective search of institutional database for patients presenting with postinfarction VSR from January 2007 to June 2016. Data from 31 consecutive patients (mean age 69.5 ± 9.1 years) who were admitted to hospital were analysed. Seven out of 31 patients with VSR who were in refractory CS received V-A ECMO support preoperatively. ECMO improved end-organ perfusion with decreased lactate levels 24 hours after implantation (7.9 mmol/L vs. 1.6 mmol/L, p = 0.01), normalized arterial pH (7.25 vs. 7.40, p < 0.04), improved mean arterial pressure (64 mmHg vs. 83 mmHg, p < 0.01) and lowered heart rate (115/min vs. 68/min, p < 0.01). Mean duration of ECMO support was 12 days, 5 out of 7 patients underwent surgical repair, 4 were weaned from ECMO, 3 survived 30 days and 2 survived more than 1 year. The most frequent complication (5 patients) and the cause of death (3 patients) was bleeding. CONCLUSIONS: Our experience suggests that early V-A ECMO in patients with VSR and refractory CS might prevent irreversible multiorgan failure by improved end-organ perfusion. Bleeding complications remain an important limitation of this approach.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos
Choque Cardiogênico/terapia
Ruptura do Septo Ventricular/complicações
[Mh] Termos MeSH secundário: Idoso
Angiografia
Feminino
Seguimentos
Hemodinâmica/fisiologia
Seres Humanos
Masculino
Estudos Retrospectivos
Fatores de Risco
Choque Cardiogênico/etiologia
Choque Cardiogênico/fisiopatologia
Resultado do Tratamento
Ruptura do Septo Ventricular/diagnóstico
Ruptura do Septo Ventricular/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/ejhf.852


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[PMID]:28470919
[Au] Autor:Ostadal P; Rokyta R; Kruger A; Vondrakova D; Janotka M; Smíd O; Smalcova J; Hromadka M; Linhart A; Belohlávek J
[Ad] Endereço:Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic.
[Ti] Título:Extra corporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): rationale and design of the multicenter randomized trial.
[So] Source:Eur J Heart Fail;19 Suppl 2:124-127, 2017 May.
[Is] ISSN:1879-0844
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Extracorporeal membrane oxygenation (ECMO) in veno-arterial configuration represents an increasingly used method for circulatory support. ECMO in cardiogenic shock offers rapid improvement of circulatory status and significant increase in tissue perfusion. Current evidence on the use of ECMO in cardiogenic shock remains insufficient. The aim of the ECMO-CS trial is to compare two recognized therapeutic approaches in the management of severe cardiogenic shock: early conservative therapy and early implantation of veno-arterial ECMO on the background of standard care. METHODS: Eligible patients have either rapidly deteriorating or severe cardiogenic shock, defined using echocardiography, hemodynamic and metabolic criteria. Patients are randomized to the one of two arms: immediate veno-arterial ECMO therapy or early conservative therapy. All other diagnostic and therapeutic procedures are performed as per current standard of care, including other cardiovascular interventions (i.e. percutaneous coronary intervention or cardiac surgery). Follow-up includes visits at 30 days, 6 months and 12 months. Primary endpoint is a composite of death from any cause, resuscitated circulatory arrest, and implantation of another mechanical circulatory support device at 30 days. The sample size of 120 individuals (60 in each arm) provides 80% power to detect 50% reduction of primary endpoint, at alpha = 0.05. Patient recruitment started in October 2014. CONCLUSION: The results of the ECMO-CS trial may significantly influence current practice in the management of patients with severe and rapidly deteriorating cardiogenic shock. ECMO-CS trial registration number is NCT02301819.
[Mh] Termos MeSH primário: Oxigenação por Membrana Extracorpórea/métodos
Insuficiência Cardíaca/terapia
Hemodinâmica/fisiologia
Seleção de Pacientes
Choque Cardiogênico/terapia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Choque Cardiogênico/complicações
Choque Cardiogênico/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1002/ejhf.857


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[PMID]:27773456
[Au] Autor:Uriel N; Adatya S; Malý J; Kruse E; Rodgers D; Heatley G; Herman A; Sood P; Berliner D; Bauersachs J; Haverich A; Zelízko M; Schmitto JD; Netuka I
[Ad] Endereço:Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA. Electronic address: nuriel@medicine.bsd.uchicago.edu.
[Ti] Título:Clinical hemodynamic evaluation of patients implanted with a fully magnetically levitated left ventricular assist device (HeartMate 3).
[So] Source:J Heart Lung Transplant;36(1):28-35, 2017 Jan.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The HeartMate 3 (HM3) is a Conformiteé Européenne (CE) mark-approved left ventricular assist device (LVAD) with a fully magnetically levitated rotor with features consisting of a wide range of operational speeds, wide flow paths and an artificial pulse. We performed a hemodynamic and echocardiographic evaluation of patients implanted with the HM3 LVAD to assess the speed range for optimal hemodynamic support. METHODS: Sixteen HM3 patients underwent pump speed ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP] and blood pressure [BP]) and 3-dimensional echocardiography (3DE). Data were recorded at up to 13 speed settings. Speed changes were in steps of 100 revolutions per minute (rpm), starting at 4,600 rpm and ramping up to 6,200 rpm. RESULTS: Mean original speed was 5,306 ± 148 rpm, with a majority of patients (10 of 16, 62.5%) having normal CVPs and PCWPs at their original rpm settings. Going from lowest to highest speeds, cardiac output improved at the rate of 0.08 ± 0.08 liter/min per 100 rpm (total change 1.25 ± 1.20 liters/min) and PCWP decreased at the rate of -0.48 ± 0.27 mm Hg per 100 rpm (total change -6.13 ± 3.72 mm Hg). CVP and systolic BP did not change significantly with changes in rpm. Left ventricular end-diastolic dimension (LVEDD) decreased at a rate of -0.15 ± 0.09 cm per 100 rpm. Number of rpm was adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in 13 (81.3%) patients. For the remaining 3 patients, medical management was pursued to optimize hemodynamic support. CONCLUSION: Hemodynamic normalization of pressures was achieved in the majority of patients implanted with the HM3 pump within a narrow speed range.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/cirurgia
Coração Auxiliar
Hemodinâmica/fisiologia
Magnetismo/instrumentação
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Idoso
Desenho de Equipamento
Feminino
Seguimentos
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Masculino
Estudos Prospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29390298
[Au] Autor:Han D; Liu YG; Pan S; Luo Y; Li J; Ou-Yang C
[Ad] Endereço:Anesthesia Department, Capital Institute of Pediatrics affiliated Children's Hospital.
[Ti] Título:Comparison of hemodynamic effects of sevoflurane and ketamine as basal anesthesia by a new and direct monitoring during induction in children with ventricular septal defect: A prospective, randomized research.
[So] Source:Medicine (Baltimore);96(50):e9039, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. METHODS: Forty-four children with ventricular septal defect (2.2 ±â€Š1.2 years) were enrolled and randomized to receive sevoflurane (Group S) or intramuscular ketamine (Group K) for sedation, followed by intravenous midazolam-sufentanil induction and tracheal intubation. Recorded parameters included heart rate (HR), arterial pressures, stroke volume index (SVI), cardiac index (CI), systemic vascular resistance index (SVRI), the maximal slope of systolic upstroke (dp/dtmax) after sedation obtained with sevoflurane or ketamine, 1, 2, 5 minutes after midazolam-sufentanil, 1, 2, 5, and 10 minutes after tracheal intubation. Rate-pressure product (RPP) and cardiac power output (CPO) were calculated. RESULTS: As compared with Group S, Group K had faster decreases during intravenous anesthetic induction in arterial pressures (P < .01 for all), higher HR, arterial pressures, SVRI, dp/dtmax, RPP, lower SVI, CI, CPO (P < .05 for all) during the study period. CONCLUSION: As compared with sevoflurane, ketamine facilitated intravenous anesthetic induction exerts unfavorable effects on systemic hemodynamic and myocardial energetic in children with ventricular septal defect.
[Mh] Termos MeSH primário: Anestésicos Dissociativos/administração & dosagem
Anestésicos Inalatórios/administração & dosagem
Comunicação Interventricular/cirurgia
Hemodinâmica/efeitos dos fármacos
Ketamina/administração & dosagem
Éteres Metílicos/administração & dosagem
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Lactente
Intubação Intratraqueal
Masculino
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Dissociative); 0 (Anesthetics, Inhalation); 0 (Methyl Ethers); 38LVP0K73A (sevoflurane); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009039


  10 / 126769 MEDLINE  
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[PMID]:29237361
[Au] Autor:Rogers MP; Reskin SM; Ubert A; Black MC; Grubb KJ
[Ad] Endereço:1 Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
[Ti] Título:Hybrid Endovascular Aortic Arch Reconstruction for Acute Aortic Dissection: An Endovascular Bridge Technique for Complex Anatomy.
[So] Source:Vasc Endovascular Surg;52(2):143-147, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Acute type A aortic dissections starting at the arch pose a challenge for cardiac surgeons. Open surgical repair requires deep hypothermic circulatory arrest for arch reconstruction and is associated with significant morbidity and mortality. Hybrid aortic repair techniques, with open arch debranching and thoracic endovascular aortic repair, have been employed in high-risk cases and challenging aortic pathology. Herein, we present a case of a 33-year-old African American male with a history of open thoracoabdominal aortic reconstruction and femoral-femoral artery bypass for a type B dissection who subsequently presented with new-onset chest pain and was found to have a retrograde type A dissection of a bovine arch with multiple dissection flaps and possible contrast extravasation on chest computed tomography. Endovascular reconstruction of the aortic arch using a hybrid technique was utilized and proved to be feasible and further should be considered when complex anatomy limits traditional surgical options.
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Aorta Torácica/cirurgia
Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/métodos
Procedimentos Endovasculares/métodos
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Aneurisma Dissecante/diagnóstico por imagem
Aneurisma Dissecante/fisiopatologia
Aorta Torácica/anormalidades
Aorta Torácica/diagnóstico por imagem
Aorta Torácica/fisiopatologia
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aneurisma da Aorta Torácica/fisiopatologia
Aortografia/métodos
Implante de Prótese Vascular/instrumentação
Angiografia por Tomografia Computadorizada
Procedimentos Endovasculares/instrumentação
Hemodinâmica
Seres Humanos
Masculino
Resultado do Tratamento
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747037



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