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Total 2417 results found since Jan 2013.

Goal-directed fluid therapy using stroke volume variation does not result in pulmonary fluid overload in thoracic surgery requiring one-lung ventilation.
Conclusions. SVV-guided fluid management in thoracic surgery requiring lateral thoracotomy and one-lung ventilation does not result in pulmonary fluid overload. Although oxygenation was reduced, pulmonary function remained within a clinically acceptable range. PMID: 22778929 [PubMed]
Source: Critical Care Research and Practice - December 1, 2014 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Agreement between stroke volume measured by oesophageal Doppler and uncalibrated pulse contour analysis during fluid loads in severe aortic stenosis
Abstract The purpose of this analysis was to study agreement and trending of stroke volume measured by oesophageal Doppler and 3rd generation Vigileo during fluid loads in patients with severe aortic stenosis. Observational study in 32 patients (30 analyzed) scheduled for aortic valve replacement due to severe aortic stenosis. After induction of anesthesia and before start of surgery, hemodynamic registrations for 1 min were obtained before and after a fluid load. Agreement between stroke volume measured by oesophageal Doppler (SVOD) and Vigileo (SVVig) was evaluated in Bland–Altman plot and trending in four-qu...
Source: Journal of Clinical Monitoring and Computing - January 31, 2015 Category: Information Technology Source Type: research

Carotid artery stenting in nonagenarians: are there benefits in surgically treating this high risk population?
Conclusions CAS in nonagenarian patients carried increased risk of perioperative ischemic events, compared with contemporary trial results in symptomatic and asymptomatic patients. Further, mean survival time postprocedure fell short of guidelines for receiving procedural benefit. Although larger scale multicenter research is needed, we recommend careful consideration of overall health status when contemplating stenting in nonagenarians.
Source: Journal of NeuroInterventional Surgery - February 12, 2015 Category: Neurosurgery Authors: Wach, M. M., Dumont, T. M., Shakir, H. J., Snyder, K. V., Hopkins, L. N., Levy, E. I., Siddiqui, A. H. Tags: Editor''s choice, Ischemic stroke Source Type: research

Non-invasive measurements of pulse pressure variation and stroke volume variation in anesthetized patients using the Nexfin blood pressure monitor
In this study we investigated whether Nexfin adequately reflects alterations in these hemodynamic parameters during a provoked fluid shift in anesthetized and mechanically ventilated patients. The study included 54 patients undergoing non-thoracic surgery with positive pressure mechanical ventilation. The provoked fluid shift comprised 15° Trendelenburg positioning, and fluid responsiveness was defined as a concomitant increase in stroke volume (SV) >10 %. Nexfin blood pressure measurements were performed during supine steady state, Trendelenburg and supine repositioning. Hemodynamic parameters included arterial blood...
Source: Journal of Clinical Monitoring and Computing - August 29, 2015 Category: Information Technology Source Type: research

Noninvasive pulse pressure variation and stroke volume variation to predict fluid responsiveness at multiple thresholds: a prospective observational study
Conclusion Noninvasive PPV and SVV measurements allow an acceptable FR prediction, although the reliability of both variables is dependent on the intended increase in SVI, which improves substantially with concomitant smaller grey zones at higher ↑SVI thresholds.
Source: Canadian Journal of Anesthesia - September 3, 2015 Category: Anesthesiology Source Type: research

ELR-CXC chemokine antagonism is neuroprotective in a rat model of ischemic stroke
Publication date: 8 October 2015 Source:Neuroscience Letters, Volume 606 Author(s): Barry J. Connell, John R. Gordon, Tarek M. Saleh Inflammation-related cerebral damage mediated by infiltrating neutrophils following reperfusion plays a role in reperfusion-induced brain damage subsequent to a stroke event. The ELR-CXC family of chemokines are CXCR1 and CXCR2 agonists that are known to drive neutrophil migration and activation. The present study demonstrated the benefit of anti-inflammatory therapy in the treatment of ischemic stroke with the administration of the competitive ELR-CXC chemokine antagonist, CXCL8(3–72)...
Source: Neuroscience Letters - September 4, 2015 Category: Neuroscience Source Type: research

Influence of tidal volume on pulse pressure variation and stroke volume variation during experimental intra-abdominal hypertension
Conclusion: IAH induction in non-hypovolemic subjects significantly increased SVV and PPV with the three tested V T , but the magnitude of that change was higher with larger V T . This observation reveals the dependence of functional hemodynamic markers on intrathoracic as well intra-abdominal pressures, in addition to volemic status. Also, PPV and SVV were unable to predict fluid responsiveness after IAH induction. Future studies should take into consideration these findings when exploring relationships between dynamic preload indicators and fluid responsiveness during IAH.
Source: BMC Anesthesiology - September 22, 2015 Category: Anesthesiology Authors: F. DíazB. ErranzA. DonosoT. SalomonPablo Cruces Source Type: research

Effect of isoflurane post-treatment on tPA-exaggerated brain injury in a rat ischemic stroke model.
CONCLUSIONS: Isoflurane post-treatment may mitigate infarction volume and intracranial hemorrhage in tPA-exaggerated brain injury. Our findings provide an encouraging novel approach for enhancing clinical outcomes in tPA-exaggerated brain injury. PMID: 26045932 [PubMed]
Source: Korean Journal of Anesthesiology - November 18, 2015 Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research

Electrical velocimetry for noninvasive cardiac output and stroke volume variation measurements in dogs undergoing cardiovascular surgery
Conclusions and clinical relevanceIn dogs undergoing cardiovascular surgery, EV provided accurate CO measurements compared with CIPAC, although its trending ability was poor. Further, SVV by EV, but not CVP, reliably predicted fluid responsiveness during mechanical ventilation in dogs.
Source: Veterinary Anaesthesia and Analgesia - April 30, 2016 Category: Veterinary Research Authors: Kazumasu Sasaki, Tatsushi Mutoh, Tomoko Mutoh, Ryuta Kawashima, Hirokazu Tsubone Tags: Research Paper Source Type: research

Anesthesia for Endovascular Approaches to Acute Ischemic Stroke
Publication date: September 2016 Source:Anesthesiology Clinics, Volume 34, Issue 3 Author(s): Rafi Avitsian, Sandra B. MachadoTeaser Involvement of the Anesthesiologist in the early stages of care for acute ischemic stroke patient undergoing endovascular treatment is essential. Anesthetic management includes the anesthetic technique (general anesthesia vs sedation), a matter of much debate and an area in need of well-designed prospective studies. The large numbers of confounding factors make the design of such studies a difficult process. A universally agreed point in the endovascular management of acute ischemic stroke i...
Source: Anesthesiology Clinics - August 9, 2016 Category: Anesthesiology Source Type: research

Anesthesia as Safe as Conscious Sedation in Stroke Thrombectomy Anesthesia as Safe as Conscious Sedation in Stroke Thrombectomy
Two new randomized studies have provided reassurance on the safety of general anesthesia for patients undergoing endovascular therapy for acute stroke.Medscape Medical News
Source: Medscape Medical News Headlines - May 24, 2017 Category: Consumer Health News Tags: Neurology & Neurosurgery News Source Type: news

Conscious Sedation versus General Anesthesia for Patients with Acute Ischemic Stroke Undergoing Endovascular Therapy: A Systematic Review and Meta-Analysis.
Abstract The aim of this study is to compare the effect of conscious sedation (CS) with general anesthesia (GA) on clinical outcomes in patients with acute ischemic stroke (AIS) undergoing endovascular therapy (EVT). MEDLINE, EMBASE, and Cochrane Central Registers of Controlled Trials (from inception to July 2017) were searched for reports on CS and GA of AIS undergoing EVT. Two reviewers assessed the eligibility of the identified studies and extracted data. Data were analyzed using the fixed-effects model, and the sources of heterogeneity were explored by sensitive analysis. Trial sequential analysis was conducte...
Source: Biomed Res - May 24, 2018 Category: Research Authors: Jing R, Dai HJ, Lin F, Ge WY, Pan LH Tags: Biomed Res Int Source Type: research

Additional Factors Regarding Clinical Outcomes of General Anesthesia and Conscious Sedation for Acute Ischemic Stroke
To the Editor We applaud Simonsen et al for performing a randomized clinical trial about the effect of general anesthesia (GA) and conscious sedation (CS) during endovascular therapy on infarct growth and clinical outcomes in acute ischemic stroke. Despite its equipoise, this study is important in the field because it reinforces the results of recent randomized clinical trials concerning GA safety in thrombectomy for acute ischemic stroke.
Source: JAMA Neurology - July 16, 2018 Category: Neurology Source Type: research

Anesthetic management of endovascular treatment for acute ischemic stroke: Influences on outcome and complications
ConclusionsGeneral anesthesia and conscious sedation are both safe alternatives for anesthetic management of patients submitted to endovascular thrombectomy. No anesthetic management is universally recommended and hopefully the ongoing randomized clinical trials will shed some light on the best approach; meanwhile, the choice of anesthesia should be based on the patient's individual characteristics. Regarding neuroprotection, hemodynamic stability is currently the most important strategy, as no pharmacological method has been proven effective in humans.ResumoJustificativa e objetivosO uso emergente de terapias endovascular...
Source: Brazilian Journal of Anesthesiology - July 25, 2018 Category: Anesthesiology Source Type: research

Endovascular thrombectomy in acute ischemic stroke: new treatment guide
Purpose of review Recent randomized clinical trials (RCTs) have demonstrated strong efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions (LVO). SIESTA, AnSTROKE, GOLIATH showed no deleterious effects of general anesthesia on patient outcome after EVT compared with conscious sedation. DAWN and DEFUSE 3 are extending the time window for EVT up to 24 h in carefully selected patients. This review discusses the current literature on the rapidly expanding subject of endovascular stroke therapy and optimal anesthetic management. Recent findings Recent retrospective studie...
Source: Current Opinion in Anaesthesiology - August 1, 2018 Category: Anesthesiology Tags: NON-OPERATING ROOM ANESTHESIA: Edited by Mark S. Weiss Source Type: research