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Procedure: Perfusion

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Total 26728 results found since Jan 2013.

Postoperative Acute Kidney Injury in Williams Syndrome Compared With Matched Controls
CONCLUSIONS: The OR of CS-AKI is increased in pediatric patients with WS compared with controls. CS-AKI was associated with VIS at the sixth postoperative hour. Increases in RPP and mean arterial pressure were associated with decreased odds of CS-AKI.
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

A Clinical and Physiological Prospective Observational Study on the Management of Pediatric Shock in the Post-Fluid Expansion as Supportive Therapy Trial Era*
CONCLUSIONS: Maintenance-only fluid therapy normalized clinical and myocardial perturbations in shock without compromising cardiac or hemodynamic function whereas fluid-bolus management of WHO shock resulted in high fatality. Troponin and lactate biomarkers of cardiac dysfunction could be promising outcome predictors in pediatric septic shock in resource-limited settings.
Source: Pediatric Critical Care Medicine - July 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Hypothermia for Traumatic Brain Injury in Children—A Phase II Randomized Controlled Trial*
Conclusions: Early therapeutic hypothermia in children with severe traumatic brain injury does not improve outcome and should not be used outside a clinical trial. Recruitment rates were lower and outcomes were better than expected. Conventional randomized controlled trials in children with severe traumatic brain injury are unlikely to be feasible. A large international trials group and alternative approaches to trial design will be required to further inform practice.
Source: Critical Care Medicine - June 17, 2015 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Determination of Lung Volume and Hemodynamic Changes During High-Frequency Ventilation Recruitment in Preterm Neonates With Respiratory Distress Syndrome
Objectives: To evaluate the changes in end-expiratory lung volume during an oxygenation-guided stepwise recruitment procedure in elective high-frequency ventilation. We hypothesized that high continuous distending pressure impedes pulmonary blood flow as evidenced by reduced lung volume measurements using respiratory inductive plethysmography. Changes in oxygenation, ventilation, and peripheral perfusion were evaluated as secondary outcomes. Design: A prospective, single center, observational, nonrandomized study. Setting: The study was conducted in a neonatal ICU in Italy. Patients: High-frequency ventilated preterm infan...
Source: Critical Care Medicine - July 17, 2015 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Acute Kidney Injury in Patients Undergoing the Extracardiac Fontan Operation With and Without the Use of Cardiopulmonary Bypass
Objectives: To describe the prevalence and risk factors for acute kidney injury in patients undergoing the extracardiac Fontan operation with and without cardiopulmonary bypass, and to determine whether acute kidney injury is associated with duration of mechanical ventilation, cardiovascular ICU and hospital postoperative length of stay, and early mortality. Design: Single-center retrospective cohort study. Setting: Pediatric cardiovascular ICU, university-affiliated children’s hospital. Patients: Patients with a preoperative creatinine before undergoing first-time extracardiac Fontan between January 1, 2004, and Apri...
Source: Pediatric Critical Care Medicine - January 1, 2017 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Endothelial-Dependent Vasomotor Dysfunction in Infants After Cardiopulmonary Bypass
Conclusions: Cutaneous endothelial dysfunction is present in infants immediately following cardiopulmonary bypass and recovers significantly in some patients within 24 hours postoperatively. Confirmation of an association between persistent endothelial-dependent vasomotor dysfunction and decreased urine output could have important clinical implications. Ongoing research will explore the pattern of endothelial-dependent vasomotor dysfunction after cardiopulmonary bypass and its relationship with biochemical markers of inflammation and clinical outcomes.
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Shock Index, Coronary Perfusion Pressure, and Rate Pressure Product As Predictors of Adverse Outcome After Pediatric Cardiac Surgery
Conclusions: Both shock index and coronary perfusion pressure may offer predictive value for adverse outcomes following cardiac surgery in children, although they are not superior to the primary hemodynamic variables.
Source: Pediatric Critical Care Medicine - January 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Postoperative Cerebral Oxygen Saturation in Children After Congenital Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective Observational Study
OBJECTIVES: During the early postoperative period, children with congenital heart disease can suffer from inadequate cerebral perfusion, with possible long-term neurocognitive consequences. Cerebral tissue oxygen saturation can be monitored noninvasively with near-infrared spectroscopy. In this prospective study, we hypothesized that reduced cerebral tissue oxygen saturation and increased intensity and duration of desaturation (defined as cerebral tissue oxygen saturation
Source: Critical Care Medicine - May 30, 2021 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Effectiveness of Pharmacological Therapies for Intracranial Hypertension in Children With Severe Traumatic Brain Injury—Results From an Automated Data Collection System Time-Synched to Drug Administration
Conclusions: Intracranial pressure decreased after multiple drug administrations, but hypertonic saline may warrant consideration as the first-line drug for treating intracranial hypertension, as it was associated with the most favorable cerebral hemodynamics and fastest resolution of intracranial hypertension.
Source: Pediatric Critical Care Medicine - March 1, 2016 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Extubation Failure Is Associated With Increased Mortality Following First Stage Single Ventricle Reconstruction Operation
Objectives: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. Design: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. Setting: The Royal Children’s Hospital, Melbourne. Patients: Data were collected for all infants who underwent a Norwood or Damus-Kaye-Stansel procedure between 2005 and 2014 at our institution. Interventions: None....
Source: Pediatric Critical Care Medicine - December 1, 2017 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Cerebral vascular effects of loading dose of dexmedetomidine: A Transcranial Color Doppler study
Conclusion: Increase in PI, CVRi, and ZFP suggests that there is a possibility of an increase in distal cerebral vascular resistance (CVR) with loading dose of dexmedetomidine. Decrease in mFV and eCPP along with an increase in CVR may lead to a decrease in cerebral perfusion. This effect can be exaggerated in patients with preexisting neurological illness. Further studies are needed to evaluate the effect of dexmedetomidine on various other pathological conditions involving brain like traumatic brain injury and vascular malformations.
Source: Indian Journal of Critical Care Medicine - January 11, 2016 Category: Intensive Care Authors: Appavoo ArulvelanSethuraman ManikandanHari Venkat EaswerKesavapisharady Krishnakumar Source Type: research

Critical care management of adult traumatic brain injury
Publication date: Available online 29 March 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Michael Puntis, Martin Smith Severe traumatic brain injury (TBI) is associated with significant morbidity and mortality. The critical care management of TBI requires a coordinated and comprehensive approach to treatment, including strategies to prevent secondary brain injury by avoidance of systemic physiological disturbances, such as hypotension, hypoxaemia, hypo- and hyperglycaemia and hyperthermia, and maintenance of adequate cerebral perfusion and oxygenation. Management protocols have evolved with internat...
Source: Anaesthesia and intensive care medicine - March 30, 2017 Category: Anesthesiology Source Type: research

Hemodynamic Monitoring for the Evaluation and Treatment of Shock: What Is the Current State of the Art?
Semin Respir Crit Care Med 2015; 36: 890-898DOI: 10.1055/s-0035-1564874Hemodynamic monitoring has become a fundamental and ubiquitous, if not defining, aspect of critical care medicine practice. Modern monitoring techniques have changed significantly over the past few years and are now able to rapidly identify shock states earlier, define the etiology, and monitor the response to therapies. Many of these techniques are now minimally invasive or noninvasive. Basic hemodynamic monitoring and evaluation usually includes a focused physical examination and static hemodynamic vital signs: temperature, heart rate, respiratory rat...
Source: Seminars in Respiratory and Critical Care Medicine - November 23, 2015 Category: Respiratory Medicine Authors: Suess, Eric M.Pinsky, Michael R. Source Type: research

Lung ultrasound and blood gas-based classification of critically ill patients with dyspnea: A pathophysiologic approach
Conclusion: This classification gives an organized approach in managing patients with dyspnea. It predicts that patients with alveolar defect-consolidation are most sick of all the groups and need immediate intervention.
Source: Indian Journal of Critical Care Medicine - November 19, 2018 Category: Intensive Care Authors: Saurabh Saigal Rajnish Joshi Jai Prakash Sharma Vandana Pandey Abhijit Pakhare Source Type: research

Toward a Better Mechanistic Understanding of Critical Illness: Endothelial, Microvascular and Coagulation Dysfunction
Few physiologic processes are closer to the “heart and soul” of critical care practice as tissue perfusion. Matching oxygen delivery to metabolic demand is arguably the quintessential physiologic essence of the practice of critical care medicine and one of the central daily struggles of every intensivist. It is no surprise that a deep und erstanding of how the cardiovascular system functions and how its components articulate to achieve efficient perfusion and oxygen delivery is central to the craft of the practicing clinician caring for the critically ill.
Source: Critical Care Clinics - March 13, 2020 Category: Intensive Care Authors: Hernando Gomez Danies, Joseph A. Carcillo Tags: Preface Source Type: research