Oxygenation Effects of Antihypertensive Agents in Intensive Care: A Prospective Comparative Study of Nicardipine and Urapidil.

Acute arterial hypertension within the critical care context may necessitate the administration of intravenous antihypertensive agents. Nicardipine and urapidil are notable for their application in intensive care units. Nonetheless, dihydropyridine calcium channel inhibitors (DCCIs) such as nicardipine are implicated in the impairment of hypoxic pulmonary vasoconstriction, potentially disrupting oxygenation.

Safety of perioperative intravenous lidocaine in liver surgery - A pilot study.

Background And Aims: Perioperative lidocaine infusion has many interesting properties such as analgesic effects in the context of enhanced recovery after surgery. However, its use is limited in liver surgery due to its hepatic metabolism.

Material And Methods: This prospective, monocentric study was conducted from 2020 to 2021.

Determinants of postoperative complications in high-risk noncardiac surgery patients optimized with hemodynamic treatment strategies: A post-hoc analysis of a randomized multicenter clinical trial.

Study Objective: This post-hoc analysis of a randomized controlled trial was undertaken to establish the determinants of postoperative complications and acute kidney injury in high-risk noncardiac surgery patients supported with hemodynamic treatment strategies.

Design: We conducted a post-hoc analysis of patients enrolled in the OPtimization Hemodynamic Individualized by the respiratory QUotiEnt (OPHIQUE) trial.

Setting: Operating rooms in four university medical centers and one non-university hospital from December 26, 2018, to September 9, 2021.

Hypoxia Associated With Dihydropyridine Calcium Channel Inhibitors: A Pharmacovigilance Study in VigiBase.

Due to their negative effects on hypoxic pulmonary vasoconstriction, dihydropyridine calcium channel inhibitors (DCCIs) can lead to hypoxia in patients with a pulmonary shunt. To date, only preclinical studies and case reports have focused on this potential adverse drug reaction. We aimed to assess the reporting association between DCCIs and hypoxia using the World Health Organization pharmacovigilance database (VigiBase).

Respiratory Exchange Ratio guided management in high-risk noncardiac surgery: The OPHIQUE multicentre randomised controlled trial.

Background: There is a need to develop non-invasive markers to identify the occurrence of anaerobic metabolism in high-risk surgery. Our objective was to demonstrate that a goal-directed therapy algorithm incorporating the respiratory exchange ratio (ratio between CO production and O consumption) can reduce postoperative complications.

Methods: We conducted a randomized, multicenter, controlled clinical trial in four university medical centers and one non-university hospital from December 26, 2018, to September 9, 2021.

Perioperative individualized hemodynamic optimization according to baseline mean arterial pressure in cardiac surgery patients: Rationale and design of the OPTIPAM randomized trial.

Background: Postoperative morbidity and mortality after cardiac surgery with cardiopulmonary bypass (CPB) remain high despite recent advances in both anesthesia and perioperative management. Among modifiable risk factors for postoperative complications, optimal arterial pressure during and after surgery has been under debate for years. Recent data suggest that optimizing arterial pressure to the baseline of the patient may improve outcomes.

Anti-Xa activity and hemorrhagic events under extracorporeal membrane oxygenation (ECMO): a multicenter cohort study.

Background: Hemorrhagic events remain a major concern in patients under extracorporeal membrane oxygenation (ECMO) support. We tested the association between anticoagulation levels and hemorrhagic events under ECMO using anti-Xa activity monitoring.

Methods: We performed a retrospective multicenter cohort study in three ECMO centers.

Individualized hemodynamic optimization guided by indirect measurement of the respiratory exchange ratio in major surgery: study protocol for a randomized controlled trial (the OPHIQUE study).

Background: Observational studies have suggested that a high respiratory exchange ratio (RER) is associated with the occurrence of postoperative complications. The study's primary objective is to demonstrate that the incidence of postoperative complications is lower in an interventional group (patients monitored using a hemodynamic algorithm that incorporates the RER) than in a control group (treated according to standard practice).

Methods: We shall perform a prospective, multicenter, randomized, open-label, superiority trial of consecutive patients undergoing major noncardiac surgery (i.

Cesarean section under general anesthesia for antepartum reversible cerebral vasoconstriction syndrome: A case report.

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute and usually severe headache related to multifocal vasoconstriction of cerebral arteries, reversible within 3 months. About 10% of RCVS are pregnancy-related, but only three cases of antepartum RCVS have been described. We report the case of a 26-year-old pregnant woman who presented at 36 weeks gestation with antepartum RCVS.

Electrocardiographic changes after long-term treatment with sotalol in hypertensive patients.

The long-term electrocardiographic effects of sotalol, a beta blocker tha prolongs the cardiac repolarization time in animals, were investigated in ten hypertensive patients and compared to ten matched hypertensive patients treated with diuretics. An electrocardiogram was recorded before and during an exercise test on a bicycle. Heart rate was lower at rest and throughout exercise in the sotalol-treated patients.

Comparison of once and twice daily sotalol in exercise-induced angina pectoris.

The efficacy of chronic oral treatment with a total daily dose of 320 mg sotalol, given as a single or as two divided doses, was compared with placebo in a double-blind cross-over study of 12 patients with angina pectoris. Sotalol given once or twice daily significantly reduced heart rate and systolic and diastolic blood pressures at rest. The exercise heart rates were significantly decreased in both treatment groups.

Sotalol and metoprolol comparison of their anti-hypertensive effect.

28 patients, aged 35-62 years, with uncomplicated hypertension, entered a double-blind, crossover study, in which the effects of single daily doses of sotalol and metoprolol were compared. Both drugs exerted a clinically useful anti-hypertensive effect as monotherapy, or in combination with a thiazide diuretic. No significant difference in hypotensive effects was noted between the two beta-blocking agents, when the dose was titrated to an optimal clinical effect.

Pharmacokinetics of sotalol after chronic administration to patients with renal insufficiency.

Ten hypertensive patients with modern to severe impairment of renal function were treated with sotalol for 5 to 10 weeks (average 6.4 weeks). Dosage was individually titrated (range 80 to 480 mg daily).