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Abel F L - - 1989
Myocardial function in sepsis and endotoxin shock is reviewed. Clinical, whole animal, and isolated tissue studies are compared to answer the question whether sepsis and/or endotoxin directly damage the myocardium. Myocardial performance is considered relative to control of preload, afterload, and heart rate. Despite the fact that these vary widely ...
Trouton T G - - 1989
The mechanisms of myocardial injury and necrosis following transthoracic shocks from a direct current cardiac defibrillator were investigated in adult greyhounds. Myocardial lactate extraction became negative maximally at 1 minute, following two (mean -22% +/- SEM23) or five (-193% +/- 135) shocks and returned to baseline in 6-15 minutes. Myocardial ...
Czarnecki W - - 1989
Haemodynamic effects of inosine were studied in intact dogs and subsequently in patients suffering from prolonged otherwise intractable cardiogenic shock. The nucleoside significantly improve myocardial performance in patients with an extremely low cardiac index by 63 +/- 29% as well as animals with no signs of haemodynamic deterioration, increasing cardiac ...
Keon W J - - 1989
Spontaneous primary dissection of a coronary artery is extremely rare, and when it involves the left main trunk the outcome is catastrophic. A 41-year-old woman who survived such a dissection and resultant myocardial infarct with cardiogenic shock is reported here. The patient required a Jarvik 7-70 artificial heart to sustain ...
Daily E K - - 1989
Although extensive myocardial damage is the major cause of pump failure and cardiogenic shock, certain other mechanical defects associated with myocardial infarction may precipitate a severe shock state associated with a poor prognosis. Early recognition and differentiation of the underlying pathology is essential for prompt, appropriate treatment to correct the ...
Hands M E - - 1989
The incidence, outcome and predictors of the in-hospital development of cardiogenic shock and its prognostic significance were analyzed in 845 patients presenting with acute myocardial infarction. Cardiogenic shock developed after hospitalization in 60 patients (7.1%). In half of these patients, cardiogenic shock developed at least 24 h after hospital admission. ...
Magovern G J - - 1989
We reviewed retrospectively the surgical results of left ventricular aneurysm reduction in 197 consecutive patients operated on in 1977-1987. There were 19 hospital deaths (9.6%) and 38 late deaths. The cumulative 5- and 10-year survival probabilities were 79% and 67%. Of the 140 late survivors, 130 underwent follow-up study in ...
Jordaens L - - 1989
Three shocks of 2 joules (2,000 volts within 0.3 msec) were given to a patient with ventricular tachycardia of right ventricular origin at the site of the earliest activation. A standard 6 Fr USCI mapping catheter was used. After the first shock the cycle length prolonged from 385 to 531 ...
Bolooki H - - 1989
Onset of cardiogenic shock in patients with various manifestations of acute myocardial ischemia has high mortality, but use of improved hemodynamic monitoring, the intra-aortic balloon pump, and early operation have improved previously dismal results. Review of published experience spanning the last 20 years indicates that 66% of patients survive after ...
Liu P H - - 1989
From July 1984 to December 1987, intra-aortic balloon pumping (IABP) was attempted percutaneously to 22 patients at the ages of 37-78 with cardiogenic shock or medically refractory heart failure complicating acute myocardial infarction (CS/MRHF-AMI). There was only one failure because of severe bilateral iliofemoral atherosclerosis. Of the 21 patients undergoing ...
Reilly J M - - 1989
Using spontaneously beating rat myocardial cells as an in vitro model of myocardial depression, recent studies demonstrated that septic shock patients' sera frequently contain a myocardial depressant substance (MDS) that is associated with a reversible decrease in left ventricular ejection fraction (LVEF). To further characterize MDS, 50 consecutive patients with ...
Raymond R M - - 1989
High energy phosphate concentrations were determined in the isolated perfused (in vitro) and intact (in situ) heart preparations in the rat during a control period and at various time intervals (1,2,4,8 or 16 h) following the intraperitoneal injection of 4 mg.kg-1 E coli endotoxin. Arterial glucose and lactate concentrations were ...
Seino Y - - 1989
This study aims to clarify the neurohumoral regulation of cardiovascular circulatory adjustments and to analyze changes in renal function and their relationship to cardiovascular hemodynamics in the early stage of heart failure. Cardiac and peripheral (calf segment) hemodynamics, neurohumoral factors and renal function were investigated in totally 139 patients with ...
Schreiber T L - - 1989
Major advances have occurred over the last two decades in the management of myocardial infarction shock, increasing the overall in-hospital survival rate from approximately 15% to more than 50% at the present time with aggressive methods of interventional cardiology. The widespread use of intravenous thrombolytic therapy during the early hours ...
Cunnion R E - - 1989
The characteristic hemodynamic profile of human septic shock consists of a normal or elevated cardiac index and a decreased systemic vascular resistance index. When a patient with septic shock has a low cardiac index, concomitant hypovolemia is usually present. Within 48 hours of the onset of septic shock, most patients ...
Dormehl I C - - 1989
Changes in intraventricular phase delays, phase angle histograms, amplitude images, and electrocardiograms (ECG) were investigated during oesophageal pacing with and without beta-blockade, after induced myocardial infarction, and during septic shock in the anaesthetized baboon model. Unavoidable triggering from the pacemaker spike and to a lesser extent increased heart rate were ...
Szabó K - - 1989
The author describes the hemodynamic changes typical of burn shock and burn disease and emphasises the typical features of the phases of burn shock ("ebb", "flow"). The author also stresses that the myocardial insufficiency of the burned patients is due to the changes of preload-afterload, disturbances of the myocardial compliance ...
Olson R D - - 1989
Toxic shock syndrome is associated with reversible cardiomyopathy. The cardiac dysfunction may be mediated by toxic shock syndrome toxin 1 (TSST-1), an exotoxin generated by Staphylococcus aureus. However, the effects of purified TSST-1 on cardiac function are unknown. In a study of the toxin's effect on myocardial function, TSST-1 (200 ...
Wilson C M - - 1988
Patients who require multiple defibrillator shocks have a poor prognosis. In healthy greyhounds the acute mortality increased as the number of transthoracic shocks (400 J) applied increased (one shock 0/6: five shocks 8/18: 10 shocks 12/17 dogs died acutely from asystole or electromechanical dissociation). The appearance on electron microscopy of ...
Law W R - - 1988
During endotoxin shock the heart becomes less responsive to the stimulatory effect of insulin on glucose uptake. In the present study we sought to determine if the heart was also less responsive to the positive inotropic effect of insulin during non-cardiogenic endotoxin shock. Responses of the heart to insulin were ...
Shibata N - - 1988
We delivered strong shocks via electrodes on the left ventricular apex and the right atrium in seven dogs during the T wave of atrial pacing while recordings were made from 56 epicardial electrodes. After shocks that induced arrhythmias were given, the earliest activation occurred in the middle of the ventricles ...
Dretler S P - - 1988
We treated 100 consecutive ureteral calculi requiring intervention with a previously described algorithm. There were 16 ureteropelvic junction, and 18 upper, 22 mid and 44 lower ureteral calculi. Treatment was by a stent and extracorporeal shock wave lithotripsy in 10 ureteropelvic junction, 10 upper ureteral and 3 mid ureteral calculi, ...
Shibata N - - 1988
To study defibrillation, shocks were given to seven dogs during electrically induced fibrillation, while recordings were made from 56 epicardial electrodes. Shocks were given via electrodes on the left ventricular apex and the right atrium, creating an uneven shock field with much higher potential gradients in the apex than in ...
Lee W - - 1988
A multiinstitutional review of 10 pregnancies complicated by septic shock was undertaken to identify the clinical characteristics and hemodynamic alterations associated with this condition. Prolonged rupture of membranes with the subsequent development of chorioamnionitis or postpartum endometritis were risk factors that commonly preceded the diagnosis of septic shock. The majority ...
Nanas J N - - 1988
A valveless, single orifice counterpulsation device (CD) with maximum stroke volume of 100 ml was implanted on the ascending aorta of nine dogs. Its pneumatic driver was gaited by the ECG to provide aortic diastolic augmentation, with a stroke volume of 60-70 ml. In the same animals a 20 ml ...
Connolly M W - - 1988
The occurrence of unstable angina or cardiogenic shock after an acute myocardial infarction characterizes a subgroup of patients with increased morbidity and mortality. To assess the efficacy of surgical revascularization in this cohort, 96 patients who underwent coronary artery bypass grafting within 6 weeks of an acute myocardial infarction were ...
Walker C - - 1988
A 6 year old boy presented with cardiogenic shock following a mild gastroenteritis-like illness. He was subsequently found to have adrenal failure secondary to adrenoleucodystrophy. Despite adequate corticosteroid replacement and intensive cardiorespiratory support, progressive cardiac failure occurred and the patient died. High levels of endogenous catecholamines may be toxic to ...
Kuck K H - - 1988
For potential application in ablating left free-wall accessory AV pathways with direct current shocks, a new epicardial-endocardial electrode configuration, designed to focus the current field across the mitral annulus, was tested in dogs. A catheter electrode in the coronary sinus (epicardial electrode) was used as the cathode, and a catheter ...
Kerber R E - - 1988
The purposes of this study were two. First, we wanted to evaluate in patients a technique for automated adjustment of selected energy for defibrillation or cardioversion based on transthoracic impedance. Second, we wanted to define the relationship of peak current and shock success in various arrhythmias. Applying a previously validated ...
Meyer D M - - 1988
This study evaluated a possible protective and therapeutic effect of moderate hypothermia in the treatment of severe hemorrhagic shock. A modified Wiggers shock preparation was used. Normothermic dogs (Group I, N = 6) were maintained at normal body temperature throughout hemorrhagic shock and resuscitation. In Group II, hypothermia was initiated ...
Sananes C B - - 1988
When heart rate is used as the index of conditioning, rat pups younger than 15 days of age do not display an odor-shock association. This constitutes a marked delay relative to the development of a somatomotor conditioned response. The incapacity to display autonomic learning to an olfactory stimulus prior to ...
Crimi G - - 1988
Six patients with acute myocardial infarction (AMI) complicated by cardiogenic shock were studied in order to compare the haemodynamic tolerance of controlled mechanical ventilation (CMV) and high frequency jet ventilation (HFJV). The comparative analysis of the two techniques was performed with the same levels of PaO2 (CMV: 101 +/- 13 ...
Sørensen H T - - 1988
Cardiogenic shock caused by papillary muscle rupture in acute myocardial infarction is potentially reversible by surgical treatment. A case of inferior myocardial infarction in a 56-year-old previously healthy man is reported, in which the first event was papillary muscle rupture. The patient was in shock and had a mitral insufficiency ...
Dhainaut J F - - 1988
Using a rapid computerized thermodilution method, we examined the evolution of right ventricular performance in 23 patients with septic shock. Nine survived the episode of septic shock. The other 14 patients died of refractory circulatory shock. Significant right ventricular systolic dysfunction, defined as decreased ejection fraction (-39%) and right ventricular ...
Mercier J C - - 1988
Meningococcal shock still is associated with high mortality. Along with antibiotics and control of metabolic derangements, standard therapy involves monitoring and maintaining numerous cardiorespiratory variables. From 1980 to 1985, 39 children with meningococcal shock were treated in our pediatric ICU. We obtained full hemodynamic monitoring in 18 (12 survivors, six ...
O'Shaughnessy M A - - 1987
Emergent aortocoronary bypass surgery for acute myocardial infarction is controversial. We describe a patient with total occlusion of the left main coronary artery associated with acute anterior wall infarction and refractory cardiogenic shock. The patient underwent successful emergent coronary bypass surgery to manage refractory cardiogenic shock. He has subsequently experienced ...
Demas C - - 1987
The management of patients with post-traumatic myocardial contusion requires close electrocardiographic and hemodynamic monitoring. When complications such as cardiogenic shock occur, aggressive treatment using Swan-Ganz catheterization for monitoring of intravascular volume and cardiac inotropic support are necessary. Failure to restore hemodynamic stability using these measures is an indication for the ...
Patel B - - 1987
Seven patients developed clinical features simulating myocardial ischemia less than 72 hours after 12 of 13 separate intravenous 5-fluorouracil administrations; 9 episodes were associated with chest pain, 3 with hypotension, 3 with ventricular tachycardia and 1 with cardiogenic shock. Left ventricular dysfunction was demonstrated by echocardiography in 5 separate episodes, ...
Horton J W - - 1987
The release of oxygen free radicals from ischemic myocardial tissue has been implicated as a causative factor of cell membrane damage and cardiac dysfunction in hemorrhagic shock. This study was done to determine whether or not hydrogen peroxide (H2O2) and superoxide ion (O2) are responsible for cardiac injury from hemorrhagic ...
Sagie A - - 1987
The hospital records of 126 patients over 75 years of age with transmural myocardial infarction initially treated in the coronary care unit were compared with a concurrent similar group of 94 patients admitted directly to the general medical wards. The in-hospital mortality rate for both groups together was 40%. The ...
Maddens M - - 1987
Catecholamines (norepinephrine, epinephrine, and dopamine) are released into circulation in response to stress and injury and as part of the body's attempt at vasoregulation in response to circulatory failure. Norepinephrine is released from sympathetic nerve terminal, and epinephrine and dopamine are released from the adrenal medulla. Plasma levels of these ...
Mehta P M - - 1987
Systemic acidosis has a negative inotropic effect on myocardial function, which in the intact animal, is counteracted by the activation of the sympathoadrenal system. Although there are extensive animal data in this field, human studies quantifying the influence of systemic acidosis on myocardial function in various disease states is lacking. ...
Ruder M A - - 1987
The possibility of using electrical discharges to ablate right free wall accessory pathways by delivering a series of catheter shocks near the tricuspid anulus was assessed in a canine model. Before the shock, the amplitudes of the atrial and ventricular electrograms recorded from the distal electrodes were compared (A/V ratio), ...
Martínez-Brotóns F - - 1987
Alterations of the kallikrein-kinin system consistent with activation and increased consumption have been reported in septic patients and it has been suggested that this activation could contribute to the development of septic shock. The aim of this work was to confirm these alterations in septic patients and to investigate the ...
Flameng W - - 1987
Emergency aorta-coronary bypass grafting was performed early in the course of evolving myocardial infarction in 48 patients. The time interval between the onset of symptoms and reperfusion was 169 +/- 80 minutes. Quantitative assessment of postoperative thallium 201 myocardial scans in 19 patients revealed a significant salvage of myocardium after ...
Chapman P D - - 1987
The myocardial damage and arrhythmogenicity of percutaneous transcatheter shocks utilizing two different defibrillator waveforms (truncated exponential and damped sinusoidal) were compared. Ten dogs (33.7 +/- 3.6 kg) were studied. Five received left ventricular damped sinusoidal R-synchronous shocks during sinus rhythm and the other five received truncated exponential waveform shocks. Each ...
Zumbro G L - - 1987
From January, 1982, to October, 1986, 33 patients were treated with either the Pierce-Donachy prosthetic ventricle or the Bio-Medicus ventricular assist device for cardiogenic shock following a cardiac operation, myocardial infarction, or cardiac transplantation. Twenty-five patients required the assistance for postcardiotomy shock and 8, for a variety of conditions including ...
Horton J W - - 1987
An in vitro myocardial slice technique was used to quantitate alterations in cell volume regulation and membrane integrity after 2 h of hemorrhagic shock. After in vitro incubation in Krebs-Ringer-phosphate medium containing trace [14C]inulin, values (ml H2O/g dry wt) for control nonshocked myocardial slices were 4.03 +/- 0.11 (SE) for ...
Edwards J D - - 1987
When cardiogenic shock complicates right ventricular infarction it is widely appreciated that rational therapy can only be achieved by use of plasma volume expansion and inotropic agents guided by invasive monitoring (Cohn et al., 1974). In these cases, there is a high incidence of symptomatic heart block and serious atrial ...
Bailey R W - - 1987
Acute hemorrhagic ulceration of the gastric mucosa is seen frequently in patients with hypovolemic or cardiogenic shock. Although such lesions clearly are related to regional gastric ischemia, little attention has been directed at the underlying mechanism(s) mediating the ischemia itself. To this end, anesthetized pigs were subjected to sustained cardiogenic ...
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