Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy. In this regard, the functional assessment of arterial load by dynamic arterial elastance could help to determine which patients will improve not only their cardiac output but also their mean arterial pressure.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1177/0885066617709434 | DOI Listing |
J Physiol
January 2025
Center for Developmental Health, Oregon Health & Science University, Portland, OR, USA.
Robust preclinical models of asymmetric ventricular loading in late gestation reflecting conditions such as hypoplastic left heart syndrome are lacking. We characterized the morphometry and microvascular function of the hypoplastic left ventricle (LV) and remaining right ventricle (RV) in a sham-controlled late gestation fetal lamb model of impaired left ventricular inflow (ILVI). Singleton fetuses were instrumented at ∼120 days gestational age (dGA; term is ∼147 days) with vascular catheters, an aortic flow probe and a deflated left atrial balloon.
View Article and Find Full Text PDFCrit Care
January 2025
División de Terapia Intensiva, Hospital Juan A. Fernández, Buenos Aires, Argentina.
The advancements in cardiovascular imaging over the past two decades have been significant. The miniaturization of ultrasound devices has greatly contributed to their widespread adoption in operating rooms and intensive care units. The integration of AI-enabled tools has further transformed the field by simplifying echocardiographic evaluations and enhancing the reproducibility of hemodynamic measurements, even for less experienced operators.
View Article and Find Full Text PDFJ Mol Cell Cardiol
December 2024
Kinesiology & Health, University of Wyoming, Laramie, WY, USA; Zoology & Physiology, University of Wyoming, Laramie, WY, USA. Electronic address:
The age of the U.S. population is increasing alongside a growing burden of age-related cardiovascular disease.
View Article and Find Full Text PDFAnn Intensive Care
January 2025
Intensive Care Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - Morumbi, São Paulo, CEP: 05651-901, SP, Brasil.
Sheldon Magder's article on applying Arthur Guyton's principles to clinical fluid management provides valuable insights into optimizing hemodynamics in critically ill patients. While emphasizing the role of right atrial pressure (RAP) in assessing cardiac output, challenges arise due to RAP's variable accuracy and the oversimplification of cardiovascular dynamics. Integrating RAP with dynamic assessments and bedside ultrasound can enhance fluid management strategies.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesia, Indiana University School of Medicine, Indianapolis, Indiana.
Interscalene blocks, commonly used for shoulder surgery analgesia, often cause transient phrenic nerve palsy, leading to hemi-diaphragmatic paresis. This complication is particularly problematic in patients with pulmonary comorbidities and has been extensively investigated. However, its impact on patients with Fontan physiology remains less understood with limited representation in the literature.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!