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Proposal: Bold New Indications for Transcatheter Pulmonary Flow Restrictors.
Pediatr Cardiol
January 2025
Pediatric Heart Center, Johann-Wolfgang-Goethe University Clinic, Theodor-Storm-Kai 7, 60596, Frankfurt, Germany.
This proposal presents a proof of concept for the use of pulmonary flow restrictors (PFRs) based on MVP™-devices, drawing from clinical experience, and explores their potential role in the management of newborns with hypoplastic left heart syndrome (HLHS), other complex left heart lesions, and infants with end-stage dilated cardiomyopathy (DCM). At this early stage of age, manually adjusted PFRs can be tailored to patient's size and hemodynamic needs. Although currently used off-label, PFRs have substantial potential to improve outcomes in these vulnerable patient populations.
View Article and Find Full Text PDFNorepinephrine titration in patients with sepsis-induced encephalopathy: cerebral pulsatility index compared to mean arterial pressure guided protocol: randomized controlled trial.
BMC Anesthesiol
January 2025
Department of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University Hospitals, Tanta, Gharbya, Egypt.
Background: Although surviving sepsis campaign (SSC) guidelines are the standard for sepsis and septic shock management, outcomes are still unfavourable. Given that perfusion pressure in sepsis is heterogeneous among patients and within the same patient; we evaluated the impact of individualized hemodynamic management via the transcranial Doppler (TCD) pulsatility index (PI) on mortality and outcomes among sepsis-induced encephalopathy (SIE) patients.
Methods: In this prospective, single-center randomized controlled study, 112 patients with SIE were randomly assigned.
Quantitative Electroencephalography Alpha:Delta Ratio and Suppression Ratio Monitoring During Infant Aortic Arch Reconstruction.
Pediatr Neurol
December 2024
Department of Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address:
Background: During infant aortic arch reconstruction, traditional electroencephalography (EEG) provides only qualitative data limiting neuromonitoring efficacy. Interhemispheric differences in the alpha:delta ratio (ADR) and suppression ratio (SR) measured using quantitative EEG generate numerical trends that may suggest cerebral ischemia. We hypothesized that the ADR and SR during cardiopulmonary bypass (CPB) would correlate with hemodynamics, and that ADR and SR interhemispheric differences would precede neurological injury from infants requiring aortic arch reconstruction.
View Article and Find Full Text PDFCoronary Intervention Outcomes in Patients with Liver Cirrhosis.
Curr Cardiol Rep
January 2025
Division of Cardiology, NYU Grossman School of Medicine, New York, NY, USA.
Purpose Of Review: This review assesses the outcomes of coronary interventions in patients with liver cirrhosis and coronary artery disease (CAD), focusing on the clinical challenges posed by cirrhosis-related hemodynamic and coagulopathic changes. It highlights essential considerations for managing these patients, who have an increased risk of adverse events during coronary procedures.
Recent Findings: Recent studies have shown that patients with liver cirrhosis undergoing PCI experience significantly higher mortality rates compared to non-cirrhotic patients, particularly in the context of STEMI and NSTEMI.
Rhomboid Intercostal and Subserratus Plane Block for Acute Pain Management after Abdominal Surgeries: A Narrative Review.
Curr Pain Headache Rep
January 2025
Department of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Purpose Of Review: The rhomboid intercostal and subserratus plane (RISS) block is an effective, safer alternative for managing postoperative acute pain following abdominal surgeries. The RISS block offers several advantages over traditional approaches, including reduced incidence of puncture-related complications, lower rates of systemic opioid consumption, and more consistent analgesic coverage of lower thoracic dermatomes.
Recent Findings: Despite a favorable safety profile, the RISS block carries potential risks, such as pneumothorax and local anesthetic systemic toxicity, particularly when long-acting anesthetics such as bupivacaine or ropivacaine are used.
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