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Current Concepts in Fluid Resuscitation and Vasopressor Use in Cirrhosis.
Semin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
View Article and Find Full Text PDFBlood Flow Restricted Resistance Exercise in Well-Trained Men: Salivary Biomarker Responses and Oxygen Saturation Kinetics.
J Strength Cond Res
December 2024
Jayhawk Athletic Performance Laboratory, Wu Tsai Human Performance Alliance, University of Kansas, Lawrence, Kansas.
Eserhaut, DA, DeLeo, JM, and Fry, AC. Blood flow restricted resistance exercise in well-trained men: Salivary biomarker responses and oxygen saturation kinetics. J Strength Cond Res 38(12): e716-e726, 2024-Resistance exercise with continuous lower-limb blood flow restriction (BFR) may provide supplementary benefit to highly resistance-trained men.
View Article and Find Full Text PDFOutdoor Overground Gait Biomechanics and Energetics in Individuals With Transtibial Amputation Walking With a Prescribed Passive Prosthesis and a Bionic Myoelectric Prosthesis.
J Appl Biomech
January 2025
J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
The metabolic cost of walking for individuals with transtibial amputation is generally greater compared with able-bodied individuals. One aim of powered prostheses is to reduce metabolic deficits by replicating biological ankle function. Individuals with transtibial amputation can activate their residual limb muscles to volitionally control bionic ankle prostheses for walking; however, it is unknown how myoelectric control performs outside the laboratory.
View Article and Find Full Text PDFEchocardiography in the Ventilated Patient: What the Clinician Has to Know.
J Clin Med
December 2024
Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy.
Heart and lung sharing the same anatomical space are influenced by each other. Spontaneous breathing induces dynamic changes in intrathoracic pressure, impacting cardiac function, particularly the right ventricle. In intensive care units (ICU), mechanical ventilation (MV) and therefore positive end-expiratory pressure (PEEP) are often applied, and this inevitably influences cardiac function.
View Article and Find Full Text PDFThe Accuracy of the Passive Leg Raising Test Using the Perfusion Index to Identify Preload Responsiveness-A Single Center Study in a Resource-Limited Setting.
Diagnostics (Basel)
January 2025
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok 10400, Thailand.
We investigated the accuracy of predicting preload responsiveness by means of a passive leg raising test (PLR) using the perfusion index (PI) in critically ill patients showing signs of hypoperfusion in a resource-limited setting. We carried out a prospective observational single center study in patients admitted for sepsis or severe malaria with signs of hypoperfusion in Chattogram, Bangladesh. A PLR was performed at baseline, and at 6, 24, 48, and 72 h.
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