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Decision support guided fluid challenges and stroke volume response during high-risk surgery: a post hoc analysis of a randomized controlled trial.

J Clin Monit Comput

January 2025

Department of Anaesthesiology and Intensive Care, Bicetre hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin Bicetre, France.

Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery.

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Does Nocturnal Blood Pressure Matter in Retinal Small Vessels? A Systematic Review and Meta-Analysis of the Literature.

Curr Hypertens Rep

January 2025

Department of Internal Medicine, Aristotle University, Hypertension, Hypertension-24h ambulatory blood pressure monitoring center, Papageorgiou Hospital, Thessaloniki, Greece.

Purpose Of The Review: Τhe association between nocturnal blood pressure (BP) and alterations in the retinal microvasculature remains understudied, with few available studies to provide conflicting results. Therefore, we conducted a systematic review and meta-analysis to determine whether an association exists between retinal microvascular alterations and nocturnal BP patterns, determined by 24h ambulatory BP measurement.

Recent Findings: Our search concluded to 1002 patients (6 studies).

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Prediction of pre-eclampsia using maternal hemodynamic parameters at 12 + 0 to 15 + 6 weeks.

Ultrasound Obstet Gynecol

January 2025

Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.

Objectives: To compare the maternal hemodynamic profile at 12 + 0 to 15 + 6 weeks' gestation in women who subsequently developed pre-eclampsia (PE) and those who did not, and to assess the screening performance of maternal hemodynamic parameters for PE in combination with the Fetal Medicine Foundation (FMF) triple test, including maternal factors (MF), mean arterial pressure (MAP), uterine artery pulsatility index and placental growth factor.

Methods: This was a prospective case-control study involving Chinese women with a singleton pregnancy who underwent preterm PE screening at 11 + 0 to 13 + 6 weeks' gestation using the FMF triple test, between February 2020 and February 2023. Women identified as being at high risk (≥ 1:100) for preterm PE by the FMF triple test were matched 1:1 with women identified as low risk (< 1:100) for maternal age ± 3 years, maternal weight ± 5 kg and date of screening ± 14 days.

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Background: Low-volume hypertonic solutions, such as half-molar lactate (LAC), may be a potential treatment used for fluid resuscitation. This study aimed to evaluate the underlying cardiovascular effects and mechanisms of LAC infusion compared to sodium-matched hypertonic sodium chloride (SAL).

Methods: Eight healthy male participants were randomized in a controlled, single-blinded, crossover study.

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Background: Given the prevalence of cardiovascular disease, encountering difficult airways in this patient population is quite common. The challenge for anesthesiologists lies not only in establishing the airway but also in managing the hemodynamic instability caused by sympathetic activation during intubation. The purpose of this report is to describe the anesthetic experience of this patient with severe mitral and tricuspid regurgitation, atrial fibrillation with rapid ventricular response, and moderate pulmonary hypertension with an anticipated difficult airway.

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