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Procedure: Perfusion

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Total 26728 results found since Jan 2013.

Traumatic brain injury: pathophysiology for neurocritical care
Abstract Severe cases of traumatic brain injury (TBI) require neurocritical care, the goal being to stabilize hemodynamics and systemic oxygenation to prevent secondary brain injury. It is reported that approximately 45 % of dysoxygenation episodes during critical care have both extracranial and intracranial causes, such as intracranial hypertension and brain edema. For this reason, neurocritical care is incomplete if it only focuses on prevention of increased intracranial pressure (ICP) or decreased cerebral perfusion pressure (CPP). Arterial hypotension is a major risk factor for secondary brain injury, but hy...
Source: Journal of Intensive Care - April 26, 2016 Category: Intensive Care Source Type: research

Pulmonary Hypertension in the Intensive Care Unit
Pulmonary hypertension occurs as the result of disease processes increasing pressure within the pulmonary circulation, eventually leading to right ventricular failure. Patients may become critically ill from complications of pulmonary hypertension and right ventricular failure or may develop pulmonary hypertension as the result of critical illness. Diagnostic testing should evaluate for common causes such as left heart failure, hypoxemic lung disease and pulmonary embolism. Relatively few patients with pulmonary hypertension encountered in clinical practice require specific pharmacologic treatment of pulmonary hypertension...
Source: Journal of Intensive Care Medicine - May 26, 2016 Category: Intensive Care Authors: Jentzer, J. C., Mathier, M. A. Tags: Analytic Reviews Source Type: research

Individualizing Thresholds of Cerebral Perfusion Pressure Using Estimated Limits of Autoregulation
Objectives: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying “one” autoregulation-guided cerebral perfusion pressure target—called “cerebral perfusion pressure optimal”. We investigated whether a cerebral perfusion pressure autoregulation range—which uses a continuous estimation of the “lower” and “upper” cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed wi...
Source: Critical Care Medicine - August 17, 2017 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Chronic Thromboembolic Pulmonary Hypertension: Advances in Therapy
Semin Respir Crit Care Med 2017; 38: 677-685 DOI: 10.1055/s-0037-1606224Chronic thromboembolic pulmonary hypertension is a progressive disease characterized by obstruction of the pulmonary vascular bed by insufficient resolution of thromboemboli leading to increased pulmonary vascular resistance with resultant right heart dysfunction and poor long-term survival. Estimates of cumulative incidence after an acute pulmonary embolism range from 1 to 4% within 2 years of an initial event. Current recommendations focus on screening patients being evaluated for pulmonary hypertension with ventilation/perfusion scans and then consi...
Source: Seminars in Respiratory and Critical Care Medicine - October 15, 2017 Category: Respiratory Medicine Authors: Fisher, Micah R. Kim, Nick H. Tags: Review Article Source Type: research

Safety and Feasibility of Early Physical Therapy for Patients on Extracorporeal Membrane Oxygenator: University of Maryland Medical Center Experience*
Objectives: To examine the feasibility and safety of mobilizing patients while on extracorporeal membranous oxygenation support. Design: Retrospective cohort study. Setting: Medical and Surgical ICUs in a large tertiary care hospital in the United States. Patients: Adults supported on extracorporeal membranous oxygenation from January 2014 to December 2015. Measurements and Main Results: We reviewed the medical records from physical therapy, perfusion, and intensivists to obtain the number and type of physical therapy interventions and discharge status; extracorporeal membranous oxygenation type and descripti...
Source: Critical Care Medicine - December 19, 2017 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Primary Graft Dysfunction (PGD) Following Lung Transplantation
Semin Respir Crit Care Med 2018; 39: 148-154 DOI: 10.1055/s-0037-1615797Primary graft dysfunction (PGD) is a form of acute lung injury that results from ischemia reperfusion injury (IRI) and is the major cause of early posttransplant morbidity and mortality. Patients who survive PGD have decreased quality of life, an increased risk of chronic lung allograft dysfunction, specifically bronchiolitis obliterans syndrome, and a significantly increased risk of death. In 2017, the International Society for Heart and Lung Transplantation released updated consensus statements on the PGD definition, most up-to-date PGD risk factors,...
Source: Seminars in Respiratory and Critical Care Medicine - March 28, 2018 Category: Respiratory Medicine Authors: Shah, Rupal J. Diamond, Joshua M. Tags: Review Article Source Type: research

Impact of Altered Airway Pressure on Intracranial Pressure, Perfusion, and Oxygenation: A Narrative Review
Conclusions: The effects of airway pressure and ventilation on cerebral perfusion and oxygenation are increasingly understood, especially in the setting of brain injury. In the face of competing mechanisms and priorities, multimodal monitoring and individualized titration will increasingly be required to optimize care.
Source: Critical Care Medicine - January 17, 2019 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Heterogeneity and Variability in Pressure Autoregulation of Organ Blood Flow: Lessons Learned Over 100+ Years
Conclusions: The organs with robust autoregulation are the brain, spinal cord, heart, and kidney. Skeletal muscle has moderate autoregulation. Nearly all splanchnic organs including the stomach, small intestine, colon, liver, and pancreas possess weak autoregulation. Autoregulation can be readily affected by a variety of clinically relevant factors. Organs with weak or weakened autoregulation are at a greater risk of suboptimal perfusion when blood pressure fluctuates. Cerebral autoregulation and outcomes are closely related. These lessons learned over 100+ years are instructive in clinical care.
Source: Critical Care Medicine - February 16, 2019 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Prone Positioning in Acute Respiratory Distress Syndrome
Semin Respir Crit Care Med 2019; 40: 094-100 DOI: 10.1055/s-0039-1685180Prone positioning is nowadays considered as one of the most effective strategies for patients with severe acute respiratory distress syndrome (ARDS). The evolution of the pathophysiological understanding surrounding the prone position closely follows the history of ARDS. At the beginning, the focus of the prone position was the improvement in oxygenation attributed to a perfusion redistribution. However, the mechanisms behind the prone position are more complex. Indeed, the positive effects on oxygenation and CO2 clearance of the prone position are to ...
Source: Seminars in Respiratory and Critical Care Medicine - May 5, 2019 Category: Respiratory Medicine Authors: Gattinoni, Luciano Busana, Mattia Giosa, Lorenzo Macr ì, Matteo Maria Quintel, Michael Tags: Review Article Source Type: research

Management of Peripheral Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock
Conclusions: Extracorporeal membrane oxygenation is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach based physiologic principles provides a basis for care.
Source: Critical Care Medicine - August 16, 2019 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Physiologic Basis of Symptoms in Pleural Disease
Semin Respir Crit Care Med 2019; 40: 305-313 DOI: 10.1055/s-0039-1693648Pleural effusions are commonly encountered and have a significant impact on the respiratory system. The reported effect of thoracentesis on physiologic parameters including oxygenation, lung volumes, and respiratory mechanics is variable likely owing to studies with a small, heterogeneous population of patients.Most patients who are short of breath from pleural effusion experience relief following drainage due to improvement in the length–tension relationship of the respiratory muscles. An observed increase in oxygenation following thoracentesis is l...
Source: Seminars in Respiratory and Critical Care Medicine - September 15, 2019 Category: Respiratory Medicine Authors: DeBiasi, Erin M. Feller-Kopman, David Tags: Review Article Source Type: research

CRITICAL CARE MANAGEMENT OF THE ACUTE POST-IMPLANT LVAD PATIENT: Management of Acute Post-Op LVAD Patients
Publication date: Available online 20 December 2019Source: Canadian Journal of CardiologyAuthor(s): Roman G. Nepomuceno, Livia A. Goldraich, Sabe De, Ahmed F. Hegazy, Dan Bainbridge, Muhanad Algadheeb, A. Dave NagpalAbstractLeft ventricular assist devices (LVADs) improve survival and quality of life in refractory end-stage heart failure. However, the therapy itself is associated with some degree of morbidity and mortality, at highest risk during the first 30 days post-implantation. Management of the freshly implanted LVAD patient requires an in-depth understanding of the acute post-implant period and common critical care i...
Source: Canadian Journal of Cardiology - December 21, 2019 Category: Cardiology Source Type: research

Critical Care Management of the Acute Postimplant LVAD Patient
Publication date: February 2020Source: Canadian Journal of Cardiology, Volume 36, Issue 2Author(s): Roman G. Nepomuceno, Livia A. Goldraich, Sabe De, Ahmed F. Hegazy, Dan Bainbridge, Muhanad Algadheeb, A. Dave NagpalAbstractLeft ventricular assist devices (LVADs) improve survival and quality of life in refractory end-stage heart failure. However, the therapy itself is associated with some degree of morbidity and mortality at highest risk during the first 30 days postimplantation. Management of the patient with a freshly implanted LVAD requires an in-depth understanding of the acute postimplant period and common critical ca...
Source: Canadian Journal of Cardiology - February 7, 2020 Category: Cardiology Source Type: research

Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019*
Conclusions: In patients with acute respiratory distress syndrome from coronavirus disease 2019, potential for lung recruitment presents large variability, while elevated dead space fraction may be a specific pathophysiological trait. These findings may guide selection of personalized mechanical ventilation settings.
Source: Critical Care Medicine - July 30, 2020 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Extracorporeal Membrane Oxygenation to Support Life-Threatening Drug-Refractory Electrical Storm
Conclusions: Among venoarterial extracorporeal membrane oxygenation-supported drug-refractory electrical storm patients, 42% survived 6 months post-ICU admission. Ventricular tachycardia and/or ventricular fibrillation episodes alternating with short periods of sinus rhythm and age less than 50 years were independently associated with better survival.
Source: Critical Care Medicine - September 12, 2020 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research