Journal of cardiovascular and thoracic research
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J Cardiovasc Thorac Res · Jan 2021
Echocardiographic parameters in patients with and without hypotension during dialysis.
Introduction: Hypotension during dialysis is a common complication of hemodialysis and is associated with increased patient mortality and morbidity. Intradialytic hypotension is a decrease in systolic BP ≥20 mm Hg or a reduction in mean arterial pressure by 10 mm Hg along with clinical events and the need for correction. This study compares cardiac function, using transthoracic echocardiography with strain modality in patients with intradialytic hypotension with those without hypotension during dialysis. ⋯ Global Longitudinal Strain (GLS) was significantly lower in the intradialytic hypotension group (-14.17 ± 2.79 versus -18.99 ± 2.25, P value < 0.001). The receiver operator characteristics (ROC) curve point-coordinates that GLS of -16.85 and lower (more positive) has 83% sensitivity and 87% specificity for intradialytic hypotension. Conclusion: The echocardiographic assessment could be used as a tool for the prediction of hypotension during dialysis.
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J Cardiovasc Thorac Res · Jan 2017
The effect of intraoperative lung protective ventilation vs conventional ventilation, on postoperative pulmonary complications after cardiopulmonary bypass.
Introduction: This study aimed to evaluate the effects of high positive-end expiratory pressure (PEEP) and low tidal volume (TV) and recruitment maneuver, on postoperative pulmonary complications (PPCs) after coronary artery bypass grafting (CABG) surgery. Methods: This study is a randomized double blind clinical trial on 64 patients who were undergoing CABG surgery, and were randomly divided into two groups of conventional ventilation (C-Vent) with TV of 9 mL/kg and PEEP=0 cm H2O, and lung protective ventilation (P-Vent), with 6 mL/kg TV and PEEP=10 cm H2O with recruitment maneuver every 30 minutes. Measures of PPCs and modified clinical pulmonary infection score (mCPIS), were assessed for the first 24 hours of postoperative time in order to evaluate the pulmonary complications. ⋯ Pathologic changes in the chest X-ray (CXR) of 24 hours after surgery, were lower in P-Vent group, but the difference was not significant (P = 0.22). The PPC criteria was less positive in P-Vent (2 patients) vs 9 patients in C-Vent group (P = 0.02) and mCPIS score was significantly lower in P-Vent group (1.2 ± 1.4) than C-Vent group (2 ± 1.6) (P = 0.048). Conclusion: Lung protective strategy during and after cardiac surgery, reduces the postoperative mCPIS in patients undergoing open heart surgery for CABG.
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J Cardiovasc Thorac Res · Jan 2016
Comparison of four techniques on facility of two-hand Bag-valve-mask (BVM) ventilation: E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (non-dominant hand) and Thenar Eminence (non-dominant hand) - E-C (dominant hand).
Introduction: Bag-valve-mask (BVM) ventilation is the first and important part of the airway management. The aim of present study was to evaluate the quality of four different BVM ventilation techniques - E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (Non dominant hand), and Thenar Eminence (Non dominant hand)-E-C (Dominant hand) - among two novice and experienced groups. Methods: In a case-control and mannequin based study that was conducted in Tabriz University of medical sciences, 120 volunteers were recruited and divided into two groups. 60 participants in experienced and other 60 as novice group who observed BVM ventilation but hadn't practical experience about BVM ventilation. Every participant in both groups performed 4 BVM ventilation techniques under the supervision of an experienced assessor. ⋯ The data were analyzed with SPSS 17.0. Results: In novice group, when evaluating each technique performance, they did Thenar Eminence (non-dominant hand) - E-C (dominant hand) technique much better than the others (P<0.0001). But in the experienced group, there was no meaningful difference between the all four techniques (P= 0.102). Conclusion: Novice participants did Thenar Eminence (non-dominant hand) - E-C (dominant hand) technique better than the others. Therefore, it is recommended that training of this technique was placed in educational program of medical students.
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J Cardiovasc Thorac Res · Jan 2015
Haemodynamic Responses to Tracheal Intubation Using Propofol, Etomidate and Etomidate-Propofol Combination in Anaesthesia Induction.
The aim of this study was to measure the haemodynamic responses to a etomidate-propofol combination used for anaesthesia induction and to compare the haemodynamic responses with the separate use of each drug. ⋯ Etomidate-propofol combination may be a valuable alternative when extremes of hypotensive and hypertensive responses due to propofol and etomidate are best to be avoided.
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J Cardiovasc Thorac Res · Jan 2015
ReviewThe Impact of High Versus Low Sedation Dosing Strategy on Cognitive Dysfunction in Survivors of Intensive Care Units: A Systematic Review and Meta-Analysis.
The practice of low vs. high sedation dosing strategy may impact the cognitive and mental health function in the intensive care unit (ICU). We aim to demonstrate that high sedation strategy will result in change of mental health function in ICU patients. ⋯ High sedation dosing strategy will negatively affect cognitive function in critically ill patients. Large randomized trials are needed to address cognitive dysfunction in subgroup of patients with delirium.