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Whether sublingual microcirculation reflects systemic preload remains unknown WHAT THIS ARTICLE TELLS US THAT IS NEW: Thirty-two preload dependent episodes were identified in 17 patientsEpisodes were accompanied by reduced arterial pressure and stroke volume, along with reduced sublingual microcirculationFluid administration improved microcirculation and stroke volume, but not blood pressureSublingual microcirculation might be an indicator of vascular volume BACKGROUND:: Dynamic indices, such as pulse press...
Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortalityIntraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured only every 4 to 6 h WHAT THIS ARTICLE TELLS US THAT IS NEW: In adults recovering from abdominal surgery, continuous blood pressure recording with a noninvasive monitor revealed that both hypotension and hypertension were common, prolonged, and profoundMany of these events were not detec...
Extracorporeal membrane oxygenation is used in severe acute respiratory distress syndrome; whereas the long-term complications among survivors of acute respiratory distress syndrome treated without extracorporeal membrane oxygenation are well described, the status of extracorporeal membrane oxygenation survivors is poorly understood WHAT THIS ARTICLE TELLS US THAT IS NEW: In a single-center cohort of acute respiratory distress syndrome survivors, management with (vs. without) extracorporeal membrane oxygena...
Factors and Their Influence on Regional Cerebral Blood Flow during Nonpulsatile Cardiopulmonary Bypass. By Govier AV, Reves JG, McKay RD, Karp RB, Zorn GL, Morawetz RB, Smith LR, Adams M, and Freeman AM. Ann Thorac Surg. 1984; 38:609-13. Reprinted with permission.In this study, we examined the relationship of regional cerebral blood flow (CBF) to mean arterial pressure, systemic blood flow, partial pressure of arterial carbon dioxide (PaCO2), nasopharyngeal temperature, and hemoglobin during hypothermic non...
Mesenchymal stromal cells are multipotent adult stem cells with the capacity to differentiate into multiple cell types and have immunomodulatory properties that have been shown to have substantial therapeutic promise in preclinical acute lung injury modelsMesenchymal stromal cells release extracellular vesicles, which are small, spherical membrane fragments comprising distinct populations including both exosomes and microvesicles, which have therapeutic effects in several disease modelsMesenchymal stromal c...
Preclinical and clinical studies suggest that lidocaine might be neuroprotective, which could benefit surgical patients at risk of neurologic compromise WHAT THIS ARTICLE TELLS US THAT IS NEW: This multicenter trial of intravenous lidocaine administered during and after cardiac surgery did not show an effect on cognition at 6 weeks postoperatively BACKGROUND:: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials ...
High tidal volumes and pressures may worsen acute lung injury, sometimes resulting in a trade-off between inflicted damage versus inadequate ventilation WHAT THIS ARTICLE TELLS US THAT IS NEW: In a rat model of experimental lung injury, gradually increasing tidal volume to a known injurious level may result in less (or in some circumstances, more) damage BACKGROUND:: This study hypothesized that, in experimental mild acute respiratory distress syndrome, lung damage caused by high tidal volume (VT) could be ...
Dental procedures under sedation can cause hypoxic events and even death. However, the mechanism of such hypoxic events is not well understood.
Children with obstructive sleep apnea are at greater risk for postoperative hypoxia and other respiratory events as compared with children without this disorderThere is some reason to believe that children with obstructive sleep apnea may be at greater risk for opioid-induced respiratory depression due to increased sensitivity to the drugs WHAT THIS ARTICLE TELLS US THAT IS NEW: The authors hypothesized that children with obstructive sleep apnea would be more sensitive to the effects of an opioid (remifenta...
Perioperative hypotension is associated with cardiovascular events in patients having noncardiac surgery, but it is unknown if the severity of preexisting coronary artery disease determines susceptibility to the cardiovascular risks of perioperative hypotension WHAT THIS ARTICLE TELLS US THAT IS NEW: In patients who had risk factors for, or known, coronary artery disease and were having noncardiac surgery, perioperative hypotension and degree of coronary artery disease on preoperative coronary computed tomo...