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Results 651 - 700 of 1019
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Li H G - - 1994
OBJECTIVES: We examined the effect of shock timing within the QRS complex on cardioversion efficacy in a randomized crossover test of shocks delivered at two timing intervals relative to QRS onset. BACKGROUND: The local ventricular electrogram is used in implantable cardioverter-defibrillators to synchronize cardioversion shocks to terminate ventricular tachycardia. However, ...
Maulik N - - 1994
Heat shock has been shown to increase the cellular tolerances to ischemic injury. In this study, we examined the effects of heat shock induced by amphetamine on postischemic myocardial functional recovery in a setting of coronary revascularization for acute myocardial infarction. Intramuscular injection of amphetamine (3 mg/kg, i.m.) to pigs ...
Lessmeier T J - - 1994
To determine outcomes of implantable cardioverter-defibrillator (ICD) therapy in a uniform population of survivors of sudden cardiac death, we used epicardial defibrillation lead systems to study 300 patients with coronary artery disease (CAD) presenting exclusively with ventricular fibrillation (VF) unassociated with acute myocardial infarction. Operative (30-day) mortality, 2.7% overall, was ...
Phillips S J - - 1994
Between 1975 and 1993, 73 patients in cardiogenic shock were supported by a variety of venoarterial pumping (VAP) systems. There were 64 adults and 9 children. Shock was caused by myocardial infarction (MI) (26), failed percutaneous transluminal coronary angioplasty (PTCA) (25), post open heart surgery (9), viral cardiomyopathy (5), idiopathic ...
Grambow D W - - 1994
Percutaneous cardiopulmonary bypass (PCB) was instituted in 30 initially stable patients who developed either cardiac arrest refractory to resuscitation (n = 7) or cardiogenic shock (mean arterial blood pressure < 50 mm Hg unresponsive to fluid resuscitation or vasopressors) (n = 23) after a catheterization laboratory complication. Events leading to ...
López-Sendón J - - 1994
For many years ischemic heart disease involving the right ventricle had received little attention. During the last 15 years, the initial works of Cohn, Isner, and others spawned a number of clinical and experimental studies that extended the understanding of the pathophysiology of ischemia in the right ventricle. Most of ...
Kinch J W - - 1994
Right ventricular infarction complicates up to half of inferior left ventricular infarctions. The term represents a spectrum of disease from mild, asymptomatic right ventricular dysfunction to cardiogenic shock, and it includes transient ischemic myocardial dysfunction as well as myocardial necrosis. Right ventricular infarction is associated with considerable morbidity and mortality, ...
Pilz G - - 1994
To evaluate the clinical relevance of the experimental findings of a more severe cardiac depression in Pseudomonas (P.) than in non-P. sepsis, we retrospectively compared the hemodynamic data in 26 patients with P. sepsis (20 cases, single pathogen; six cases, more positive cultures with P. than with non-P. species), and ...
Smalling R W - - 1994
OBJECTIVES: The purpose of this study was to test the hypothesis that transvalvular left ventricular assistance would support the circulation in patients with cardiogenic shock secondary to acute myocardial infarction and allow recovery of function in patients with a reversibly damaged (stunned) left ventricle. BACKGROUND: Cardiogenic shock occurs in 7.5% ...
Ferguson K L - - 1994
The dramatic presentation of pheochromocytoma in crisis is uncommon and is classically associated with a state of hemodynamic and sympathetic hyperactivity. The case of a 35-year-old man with an occult pheochromocytoma presenting with hypotension and cardiogenic shock shortly after beginning imipramine therapy is presented. Retrospectively, there was a history of ...
Silance P G - - 1994
We collected all complete sets of measurements of cardiac index and oxygen-derived variables available in the recent literature (1975-1991; computerised Medline search) on critically ill patients with sepsis (n=21 studies), septic shock (n=20 studies) or severe heart failure (n=13 studies). For each study, the mean value for cardiac index, oxygen ...
Amrani M - - 1994
The aim of this study was to investigate the role of heat-shock proteins after heat-shock stress on the post-ischemic recovery of cardiac mechanical and endothelial function following a prolonged cardiac arrest. Isolated working rat hearts were subjected to a cardioplegic arrest for 4 hours at 4 degrees C. Three groups ...
Mueller H S - - 1994
IACP has played an important role in the evolution of the therapy of cardiogenic shock. Although IACP has not developed to an independent treatment modality, it is an essential adjunct to facilitate early catheterization and reperfusion strategies. With this combined approach, hospital and long-term survival rates have reached encouraging results. ...
Ayers G M - - 1994
BACKGROUND: Synchronized cardioversion is generally accepted as safe for the treatment of ventricular tachycardia and atrial fibrillation when shocks are synchronized to the R wave and delivered transthoracically. However, others have shown that during attempted transvenous cardioversion of rapid ventricular tachycardia, ventricular fibrillation (VF) may be induced. It was our ...
Scholz K H - - 1994
The efficacy of the transfemoral left-ventricular assist device Hemopump (HP; 21 Fr outer diameter) was examined in experiments with adult sheep in two different models of cardiogenic shock (tachycardia shock; ischemia shock), and during ventricular fibrillation. During tachycardia (high frequency pacing-induced; n = 14), HP assist led to a significant ...
Delius M - - 1994
During lithotripsy by electrohydraulic or electromagnetic lithotripters, the application of extracorporeal shock waves has to be synchronized with the electrocardiogram to reduce the induction of arrhythmias. The relation between the refractory period of the cardiac cycle and arrhythmia induction by shock waves, and the underlying mechanism have so far not ...
Wall S R - - 1993
It was recently reported that in rats exposure to heat shock leads to appearance of a myocardial heat shock protein (HSP 70) and to an increase in myocardial catalase activity. This correlated with an improvement in post-ischemic function either in Langendorff-perfused hearts after low-flow ischemia or in working hearts after ...
Shoemaker W C - - 1993
OBJECTIVES: Gradual, almost imperceptible transitions occur between localized infection, generalized infection, systemic manifestations of the sepsis syndrome, septic shock, and death. The aim of this study was to describe the sequential pattern of hemodynamic and oxygen transport patterns of survivors and nonsurvivors of septic shock, so as to differentiate primary ...
Carroll B J - - 1993
From August 1989 to January 1993, the authors performed laparoscopic biliary operations in 900 patients, 13 of whom had severe cardiac dysfunction. Nine patients were Goldman Class IV, and four patients were Goldman Class III. Three patients had recent myocardial infarction, five patients were known to have low left ventricular ...
Lipski A - - 1993
Myocardial infarction is one of the rarer events causing acute graft failure during the postoperative period after transplantation and is usually caused by preexisting coronary artery disease of the donor heart. We discuss the case of a 56-year-old man in whom cardiogenic shock developed after heart transplantation, which was refractory ...
Walley V M - - 1993
This study reviews the clinical outcome of the 132 orthotopic heart transplantations performed at our institute from 1984 through 1991 and focuses on the pathology of those patients who died. The study comprised 124 adults (mean age, 45.6 +/- 0.9 years) and eight children. Twenty-six adult and one pediatric deaths ...
Trouton T G - - 1993
Although problems such as hypotension and pulmonary edema complicate the use of transthoracic DC countershocks, the mechanisms are not clear. In anesthetized dogs at 1 minute after only two defibrillator shocks there was a brief rise in coronary sinus lactate, exceeding arterial concentrations. Larger rises in lactate were seen after ...
Fitzpatrick A P - - 1993
A previously fit marathon-running 54 year old man was admitted as an emergency having collapsed with chest pain caused by an acute transmural anterior myocardial infarction. He was initially resuscitated by his general practitioner then had recurrent episodes of ventricular flutter and fibrillation requiring continuing cardiopulmonary resuscitation and repeated defibrillation. ...
Pollak H - - 1993
Of 2608 consecutive patients with acute myocardial infarction, 24 developed subacute free wall rupture (= 0.92%; 95% C.I. = 0.6-1.4). Clinical manifestations varied widely (shock on admission; 25% of cases; severe arrhythmias followed by shock: 17%; shock during hospital stay: 42%; symptoms suggestive of infarct extension without shock: 17%). The ...
Alpert J S - - 1993
Cardiogenic shock remains the most dreaded complication of acute myocardial infarction. Mortality rates remain high despite modern interventional therapy. Patients with a variety of other cardiovascular entities may also develop cardiogenic shock. Management consists of rapid stabilization of systemic arterial blood pressure, expeditious diagnostic evaluation, and definitive therapy when possible. ...
Shears L L - - 1993
Myocardial contusion may present as a benign nonclinical event or a life-threatening emergency. Although cardiac output is recognized to be decreased with major contusion, the contribution of hypovolemic shock to myocardial dysfunction is unclear. This study was designed to evaluate the relationship between myocardial contusion and hypovolemic shock. After Sprague-Dawley ...
Orliaguet G - - 1993
We report the case of a 27-year-old patient with blunt thoracic trauma in whom transesophageal echocardiography enabled an early diagnosis of severe myocardial contusion. Conventional mechanical ventilation dramatically enhanced cardiogenic shock because of myocardial contusion, requiring increasing doses of catecholamine. High-frequency jet ventilation produced an immediate improvement in hemodynamic status, ...
Leor J - - 1993
PURPOSE: Patients with large myocardial infarction (MI) presenting with clinical signs of heart failure are at increased risk for subsequent development of cardiogenic shock and death. Little is known, however, about the development of cardiogenic shock among patients with acute MI presenting without clinical signs of heart failure. The aim ...
Alpert J S - - 1993
Cardiogenic shock usually is the result of marked depression in myocardial function. Rapid recognition and stabilization are essential if the patient is to survive. A variety of cardiovascular conditions can lead to cardiogenic shock; the most common of these is acute myocardial infarction. Once stabilization of the cardiogenic shock patient ...
Robben N C - - 1993
BACKGROUND: A case of reversible cardiogenic shock linked to 5-fluorouracil (5-FU) was observed. Recognizing the increasing use of 5-FU, the authors tried to map this syndrome. METHODS: They reviewed 134 additional case reports, retrieved information from literature searches, focused on clinical features, and discussed possible pathophysiologic findings and prevention of ...
Scott B D - - 1993
To determine whether dual-pathway sequential shocks and single-pathway biphasic shocks improved the efficacy of transthoracic defibrillation, we delivered single or sequential truncated waveform shocks of variable duration, voltage, and direction (polarity) to three groups of closed-chest dogs. Dual-pathway sequential shocks were assessed in group 1 (eight animals), biphasic shocks with ...
Walters G - - 1993
Several consultant cardiologists were invited to assess the accuracy of the Lifepak 200 automated external defibrillator (AED) (Fig. 1), from ECG records collected from pre-hospital cardiac arrest victims. They were asked to classify the ECG rhythms, and also give an opinion on whether or not a shock should have been ...
Park J K - - 1993
From December 1975 to September 1989, nine children, ages 0.6-15.8 years (mean = 8.1 years) and weighing 5-44 kg (mean = 24 kg), were identified as requiring intraaortic balloon pump support. Indications included ventricular failure refractory to maximal conventional therapy, inability to wean from cardiopulmonary bypass, and myocardial ischemia. Prior ...
Zeng Z R - - 1993
A prospective study of arrhythmia during extracorporeal shock wave lithotripsy (ESWL) was performed in 50 patients, using an EDAP LT01 piezoelectric lithotriptor. The 12-lead standard ECG was recorded continuously for 10 min before and during treatment. One or more atrial and/or ventricular ectopic beats occurred during ESWL in 15 cases ...
Moritz A - - 1993
Cardiogenic shock after acute myocardial infarction develops according to the amount of lost myocardium, function of remote myocardium, and the phenomenon of infarct expansion. Patients treated with mechanical support alone, without additional measures, have a mortality rate of 80%, the same as patients treated medically. Emergency angioplasty and emergency coronary ...
Bengtson J R - - 1992
OBJECTIVES: The purpose of this study is to describe the outcome in cardiogenic shock treated with aggressive reperfusion therapy and to identify factors predictive of in-hospital and long-term mortality. BACKGROUND: Cardiogenic shock is the most common cause of death in patients admitted to the coronary care unit. Although studies have ...
Lau K W - - 1992
Cardiogenic shock from severe left ventricular dysfunction remains the most common cause of death in patients with acute myocardial infarction despite the advent of inotropic agents and intra-aortic balloon support. Lytic agents have not convincingly reduced mortality when administered in a shock scenario. Recently, observational studies have demonstrated survival benefit ...
Quezado Z M - - 1992
Septic shock, a distributive form of shock, is a common and lethal disease characterized by tachycardia, hypotension, normal or elevated cardiac index, and decreased systemic vascular resistance (SVR). For 2 to 4 days after onset of shock, the left ventricular ejection fraction (LVEF) is depressed; with adequate volume replacement, the ...
Alvarez J M - - 1992
Postinfarction ventricular septal rupture (VSR) is a high-risk complication following myocardial infarction (MI). Surgical treatment has evolved to improve an otherwise poor prognosis. Certain subsets of patients remain a formidable challenge. The presence of cardiogenic shock has consistently been found to have the highest risk. Over a 10-year period, our ...
Rees M R - - 1992
Percutaneous cardiopulmonary support (CPS) was initiated in 9 patients to provide haemodynamic stability after failure of conventional resuscitation. 4 patients were in cardiogenic shock and 4 remained in asystole, with 1 in resistant ventricular fibrillation, after cardiac arrest. During CPS for those in cardiogenic shock, the mean intra-arterial pressures ranged ...
Saksena S - - 1992
Bidirectional shocks using 2 current pathways have been used in endocardial lead systems for implantable cardioverter-defibrillators, but the optimal shock waveform for endocardial defibrillation is unknown. The clinical efficacy and electrical characteristics of bidirectional monophasic and biphasic shocks for endocardial cardioversion-defibrillation of fast monomorphic or polymorphic ventricular tachycardia (VT), or ...
Feld H - - 1992
Aggressive treatment strategies that include early revascularization may significantly improve survival from acute MI complicated by cardiogenic shock. Symptoms of impending cardiogenic shock include tachycardia, cool extremities, pallor, cyanosis, and a normal or low blood pressure. When possible, the right and left sides of the heart are catheterized immediately. For ...
McClelland J H JH Division of Cardiology, Oregon Health Sciences University, - - 1992
Cardioversion shocks given during ventricular tachycardia may cause ventricular fibrillation or acceleration of ventricular tachycardia, or arrest the tachycardia. A recently proposed theory may explain why the former two phenomena may occur. Briefly, this theory states that potential gradient shock fields of a critical strength delivered to tissue with a ...
Lawrence M E - - 1992
We have presented an unusually swift progression of progressive systemic sclerosis (PSS), with death from cardiogenic shock in a 22-year-old woman who had severe hypertension and acute renal insufficiency. She arrived at our hospital with pericardial tamponade and shock. Despite initial improvement after pericardiocentesis, the patient's condition soon deteriorated and ...
Inoue T - - 1992
Hemofiltration was performed in 15 patients with refractory congestive heart failure. All of these patients had oliguria, although intensive treatment with diuretics, digitalis, vasodilators, and catecholamines was prescribed. Hemofiltration was performed under hemodynamic monitoring in 14 patients. The water removal by hemofiltration decreased pulmonary arterial pressure, pulmonary capillary wedge pressure ...
Xiwei D - - 1992
The prognostic risk factors in 4323 patients with rheumatic heart disease, admitted from 1970 to 1990, were analysed. The overall mortality was 31.75% in this group of patients. Single factor analysis indicated that cardiac functional classification, time of death, month of death, cardiothoracic ratio, valvular lesions, cardiogenic shock, digitalis-induced arrhythmias, ...
Johnson E E - - 1992
BACKGROUND: Two sequential biphasic shocks delivered over separate lead configurations markedly improve defibrillation efficacy compared with a single shock alone. We investigated the effect of varying the intershock interval between sequential biphasic shocks on defibrillation. METHODS AND RESULTS: Defibrillation thresholds (DFTs) were obtained in six dogs for shock separations ranging ...
Liebson P R - - 1992
In the ICU, both transthoracic and transesophageal echocardiography can assist in the acute management of a number of different disorders. In hypotensive patients, echocardiography helps distinguish between cardiogenic shock (resulting from acute myocardial infarction), septic shock, and circulatory shock (associated with a reduction in circulating blood volume); it can also ...
Dillon S M - - 1992
BACKGROUND: It is currently believed that defibrillation shocks act primarily by stimulating excitable myocardium to abolish wave fronts. Recent studies have shown that shocks applied during pacing not only stimulate excitable myocardium but also prolong the depolarization and refractoriness of myocardium already in a depolarized state. This study investigates the ...
Wharton J M - - 1992
BACKGROUND: Potential gradient field determination may be a helpful means of describing the effects of defibrillation shocks; however, potential gradient field requirements for defibrillation with different electrode configurations have not been established. METHODS AND RESULTS: To evaluate the field requirements for defibrillation, potential fields during defibrillation shocks and the following ...
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