American heart journal
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American heart journal · Oct 1993
Comparative StudyPulsed Doppler transesophageal echocardiographic determination of cardiac output in human beings: comparison with thermodilution technique.
Measurement of cardiac output is a clinically valuable and widely used index of cardiac function. Although transesophageal echocardiography has been used to assess left ventricular function, little data exist on the accuracy of this technique in the measurement of cardiac output. Therefore cardiac output derived by pulsed Doppler transesophageal echocardiography and thermodilution methods were compared in adult patients being mechanically ventilated. ⋯ Cardiac output derived by transesophageal echocardiography from the transverse plane (n = 26) and longitudinal plane (n = 22) were correlated with simultaneous thermodilution measurements. Thermodilution-derived cardiac output demonstrated excellent correlation with cardiac output measured by using transesophageal echocardiography from the transverse plane (r = 0.97, SEE = 0.84 L/min; p < 0.0001) and longitudinal plane (r = 0.95, SEE = 0.97 L/min; p < 0.0001). Transesophageal echocardiography is a promising technique in the measurement of cardiac output and expands the clinical use of this modality in the assessment of cardiac function.
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American heart journal · Oct 1993
ReviewThe role of the coronary collateral circulation in limiting myocardial ischemia and infarct size.
The role of coronary collateral circulation in limiting ischemia and infarction has been studied prospectively. Transient occlusion of a coronary artery angioplasty has provided evidence that collateral circulation decreases wall motion abnormalities, ST segment changes, and lactate production. ⋯ Although collateral flow may decrease coronary artery bypass graft patency in certain subgroups of patients, the perioperative infarct rate and mortality is decreased. Growth factors have been identified that increase the development collateral circulation and may improve ventricular function in the setting of myocardial infarction.
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American heart journal · Oct 1993
ReviewInnovative emergency defibrillation methods for refractory ventricular fibrillation in a variety of hospital settings.
This article reviews the ability of innovative rescue defibrillation techniques for the treatment of refractory ventricular fibrillation. These data were obtained in a variety of hospital settings at the University of California, San Francisco, from 1986 to 1992. Innovative rescue defibrillation techniques were applied to 15 patients with refractory ventricular fibrillation having failed > or = 2 high-energy transthoracic shocks in a variety of hospital settings. ⋯ Transesophageal defibrillation performed after 50 minutes of cardiac arrest successfully terminated ventricular fibrillation in each patient. Thus alternative methods now exist that permit rescue defibrillation in a variety of hospital emergency settings. These techniques are performed with simple-to-use equipment that is compatible with standard defibrillators.