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Results 401 - 450 of 1027
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Krishnagopalan Sreenandh - - 2002
The nature of myocardial dysfunction during sepsis and septic shock has been investigated for more than half a century. This review traces the evolution of scientific thought regarding this phenomenon during this period with particular emphasis on the current understanding of both the clinical manifestations and the molecular/cellular basis of ...
Lampert Rachel - - 2002
BACKGROUND: Observational studies have suggested that psychological stress increases the incidence of sudden cardiac death. Whether emotional or physical stressors can trigger spontaneous ventricular arrhythmias in patients at risk has not been systematically evaluated. METHODS AND RESULTS: Patients with implantable cardioverter-defibrillators (ICDs) were given diaries to record levels of defined ...
Blake James W H - - 2002
A case of emergency stent deployment to a critical vein graft lesion in a patient with an acute myocardial infarction and cardiogenic shock is described. An Angioguard vascular protection device was used, retrieving a large amount of atheromatous debris. Use of filter-type protection devices to prevent distal atheroembolism may be ...
Yashima Masaaki - - 2003
The probabilistic nature of the ventricular defibrillation threshold (DFT) remains poorly understood. We hypothesized that shock outcome is a function of the amount of myocardium in its vulnerable period (VP). The endocardial surface of five isolated, perfused swine right ventricles was mapped with 477 bipolar electrodes during ventricular fibrillation (VF). ...
Court Olivier - - 2002
Myocardial dysfunction frequently accompanies severe sepsis and septic shock. Whereas myocardial depression was previously considered a preterminal event, it is now clear that cardiac dysfunction as evidenced by biventricular dilatation and reduced ejection fraction is present in most patients with severe sepsis and septic shock. Myocardial depression exists despite a ...
Yamaguchi Hitoshi - - 2002
We hypothesized that electrical shocks that defibrillate hearts successfully also produce myocardial injury, but only in settings in which the myocardium is underperfused. Myocardial function was measured in isolated, conventionally perfused or underperfused rat hearts during sinus rhythm and conventionally perfused or underperfused hearts during ventricular fibrillation (VF) after delivery ...
Zheng Xiangsheng - - 2002
INTRODUCTION: The aim of this study was to determine the atrial defibrillation threshold (ADFT) of a first shock across the standard right atrium (RA) to distal coronary sinus (dCS) configuration followed by a second shock along the atrial septum with a standard sequential waveform (the second shock leading edge equaled ...
Ogino Ryukoh - - 2002
BACKGROUND: A bolus of 7.5% NaCl-6% Dextran 70 (HSD) is effective in resuscitating hypovolemic shock. Common hemodynamic findings with HSD are restoration of cardiac output, increased blood pressure, and improvement of peripheral circulation. However, the effect of HSD upon cardiac function is still controversial. In our previous study, when HSD ...
Price Susanna - - 2002
The mechanisms underlying myocardial dysfunction in sepsis remain poorly understood. The theoretical benefits of nitric oxide synthase (NOS) inhibition in reversing the haemodynamic changes that characterise septic shock have not been supported by clinical trials, some of which have demonstrated detrimental myocardial effects. We have therefore assessed the effects of ...
Oliveira Roselaine P - - 2002
The present review discusses the hemodynamic effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline in severe sepsis and septic shock are highlighted. Data ...
Masaki Nobuyuki - - 2002
A 65-year-old man was admitted to the National Defense Medical College Hospital for acute anterolateral myocardial infarction and cardiogenic shock. Emergency coronary angiography demonstrated occlusion of the proximal left anterior descending artery. Primary percutaneous transluminal coronary angioplasty (PTCA) was successfully performed with the support of intra-aortic balloon pumping (IABP) and ...
Chevret L - - 2002
OBJECTIVE: Neonatal vein of Galen malformation complicated by severe cardiac failure is a rare disease. The purpose was to assess the outcome of this life-threatening malformation and identify hemodynamic prognostic factors. DESIGN: Retrospective study. PATIENTS: Twenty-four newborns with cardiac failure requiring mechanical ventilation were consecutively admitted from 1986 to 2000. ...
Hu Bing-Jie - - 2002
In order to investigate the specificity of fibronectin (Fn) in the post-mortem diagnosis of myocardial infarction, the changes of Fn staining in normal, infarcted and other non-infarcted myocardial injuries resulting from myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning were studied with an immunohistochemistry and image analysis ...
Wang Yi - - 2002
OBJECTIVE: To investigate the complications and conversions in myeloproliferative disorders (MPD). METHODS: Three hundred and fifty six patients with MPD were reviewed, including 78 with etiologic thrombocythemia (ET), 93 with primary myelofibrosis (MF), 185 with polythythemia vera (PV). The clinical observation, follow-up, analysis with SPSS statistic software were performed. RESULTS: ...
Cotter Gad - - 2002
Acute heart failure (HF) is one of the most common syndromes in emergency medicine, however, its exact pathogenesis has remained largely unknown. Based on clinical and hemodynamic data we have sub-divided acute HF into four syndromes: cardiogenic shock, pulmonary edema, hypertensive crisis and exacerbated HF. Cardiogenic shock is caused by ...
Qin Hao - - 2002
BACKGROUND: Shocks that have defibrillated spontaneous ventricular fibrillation (VF) during acute ischemia or reperfusion may seem to have failed if VF recurs before the ECG amplifier recovers after shock. This could explain why the defibrillation threshold (DFT) for spontaneous VF appears markedly higher than for electrically induced VF. METHODS AND ...
Berger Alan K - - 2002
BACKGROUND: The role of early revascularization among patients with acute myocardial infarction complicated by cardiogenic shock remains controversial. Angioplasty registries, while suggesting a benefit, are subject to selection bias, and clinical trials have been underpowered to detect early benefits. If an invasive strategy is beneficial in this population, patients admitted ...
Calle Paul A - - 2002
OBJECTIVE: To study whether two different types of monophasic waveform shocks (i.e. monophasic damped sinusoidal [MDS] and monophasic truncated exponential [MTE] waveform shocks) are of equivalent efficacy. METHODS: Retrospective review of defibrillation efficacy and outcome in ventricular fibrillation/ventricular tachycardia (VF/VT) patients treated in the same EMS system with AEDs delivering ...
Swerdlow Charles D - - 2002
INTRODUCTION: The aim of this study was to identify determinants of first-shock success for defibrillation of spontaneous atrial fibrillation (AF) in ambulatory patients with an atrial implantable cardioverter defibrillator (ICD). The determinants of first-shock success in ambulatory patients with atrial ICDs are unknown. METHODS AND RESULTS: We used the generalized ...
Huang Fang-Liang - - 2002
We describe 2 children with typical hand, foot, and mouth disease due to enterovirus 71 infection, 1 of whom died. Both cases were complicated by acute fulminant shock syndrome; the patients had remarkable acute left ventricular dysfunction. The clinical experience indicates that the rapid death associated with fulminant enterovirus rhombencephalitis ...
Wood Kenneth E - - 2002
Major pulmonary embolism (PE) results whenever the combination of embolism size and underlying cardiopulmonary status interact to produce hemodynamic instability. Physical findings and standard data crudely estimate the severity of the embolic event in patients without prior cardiopulmonary disease (CPD) but are unreliable indicators in patients with prior CPD. In ...
Mina Bushra B Section of Critical Care Medicine, Department of Medicine, Lenox Hill Hospital, 100 E 77th St, New York, NY 10021, USA. - - 2002
A 61-year-old woman who was a New York City hospital employee developed fatal inhalational anthrax, but with an unknown source of anthrax exposure. The patient presented with shortness of breath, malaise, and cough that had developed 3 days prior to admission. Within hours of presentation, she developed respiratory failure and ...
Ammann Peter - - 2002
The aim of this study was to determine the long-term outcome in unselected, consecutive patients after acute percutaneous transluminal angioplasty (PTCA) for acute myocardial infarction (AMI) complicated by cardiogenic shock. This involved a follow-up study from a prospectively conducted patient registry in a tertiary referral center. A total of 59 ...
Constantinides Savvas - - 2002
We report the case of a 60-year-old female with a history of hypertension who was admitted with an acute inferior myocardial infarction. She received rescue percutaneous transluminal coronary angioplasty/stenting of an occluded right coronary artery for failed thrombolysis with a good initial result. However, this was immediately complicated by cardiogenic ...
Lin Chih-Chia - - 2002
This article describes a 16-yr-old male patient who went into shock and cardiac arrest 2 wk after surgical repair of an atrial septal defect. Cardiac tamponade was diagnosed and promptly treated, and his hemodynamic status stabilized 4 hr after the initial presentation of shock; however, paraplegia was found when the ...
Ruokonen Esko - - 2002
Severe sepsis and septic shock are relatively common problems in intensive care. The mortality in septic shock is still high, and the main causes of death are multiple organ failure and refractory hypotension. Impaired tissue perfusion due to hypovolemia, disturbed vasoregulation and myocardial dysfunction contribute to the multiple organ dysfunction. ...
Marn-Pernat A - - 2001
OBJECTIVE: Our intent was to evolve a prognosticator that would predict the likelihood that an electrical shock would restore a perfusing rhythm. Such a prognosticator was to be based on conventional electrocardiographic signals but without constraints caused by artifacts resulting from precordial compression. The adverse effects of "hands off" intervals ...
Sims J J - - 2001
INTRODUCTION: Lidocaine increases monophasic shock defibrillation energy requirement (DER) values but does not alter biphasic shock DER values. However, the mechanism of this drug/shock waveform interaction is unknown. It may be that lidocaine increases the proarrhythmic actions of monophasic shocks but not biphasic shocks. Thus, lidocaine may increase monophasic shock ...
Wagner K D - - 2001
In this study we tested the hypothesis that induction of heat shock proteins (HSPs) and antioxidant enzymes is a compensatory mechanism, which preserves the contractility of the surviving myocardium after acute myocardial infarction. For this purpose, mechanical function of isolated rat papillary muscles was tested 15 h after experimental myocardial ...
Gallagher M M - - 2001
OBJECTIVES: The purpose of this study was to design a more efficient protocol for the electrical cardioversion of atrial arrhythmias. BACKGROUND: Guidelines for electrical cardioversion of atrial arrhythmias recommend starting with low energy shocks, which are often ineffective. METHODS: We recorded the sequence of shocks in 1,838 attempts at cardioversion ...
Ferguson J J JJ - - 2001
OBJECTIVES: This study presents clinical data from the first large registry of aortic counterpulsation, a computerized database that incorporates prospectively gathered data on indications for intra-aortic balloon counterpulsation (IABP) use, patient demographics, concomitant medication and in-hospital outcomes and complications. BACKGROUND: The intra-aortic balloon pump (IABP) is widely used to provide ...
Wong S C - - 2001
OBJECTIVES: The aim of this study was to assess the impact of gender on clinical course and in-hospital mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). BACKGROUND: Previous studies have demonstrated higher mortality for women compared with men with ST elevation myocardial infarctions and higher rates ...
Wanecek M - - 2001
Cardiac dysfunction during septic shock is well described but the underlying mechanisms still remain to be resolved. This study was conducted to elucidate the involvement of endothelin in cardiac function during endotoxin shock by the use of endothelin receptor antagonism. Anaesthetised and haemodynamically stable landrace pigs received the nonpeptide mixed ...
Tabbutt S - - 2001
Septic shock presents a unique challenge in the pediatric patient. Sepsis stimulates the release of inflammatory mediators that can compromise cardiac function. Oxygen extraction abnormalities, diminished responses to adrenergic agonists, and impaired ventricular function often result. After fluid resuscitation and antibiotic therapy, careful cardiovascular assessment is needed to administer appropriate ...
Ecker R - - 2001
OBJECTIVES: Automated external defibrillators (AEDs) provide an opportunity to improve survival in out-of-hospital, ventricular fibrillation (VF) cardiac arrest by enabling laypersons not trained in rhythm recognition to deliver lifesaving therapy. The potential role of emergency dispatchers in the layperson use of AEDs is uncertain. This study was performed to examine ...
Langrill D M - - 2001
The mechanism for far-field stimulation of cardiac tissue is not known, although many hypotheses have been suggested. This paper explores a new hypothesis: the insulated plunge electrodes used in experiments to map the extracellular potential may affect the transmembrane potential when an electric field is applied to cardiac tissue. Our ...
Parrino P E - - 2001
Left ventricular remodeling after myocardial infarction is recognized as an early adaptive mechanism that later results in adverse physiologic changes. Surgical therapy for this condition includes exclusion of nonfunctional segments of ventricular wall and restoration of more normal ventricular geometry. The Dor procedure, or endoventricular patch plasty, is recognized as ...
Raedle-Hurst T M - - 2001
Inappropriate shock therapy is a frequent problem in patients with implantable cardioverter-defibrillators (ICDs), caused mostly by supraventricular rhythms. Self-terminating ventricular arrhythmias (STVAs), however, may also lead to inappropriate shock discharges even in ICDs with abortive shock capabilities. The aim of this study was to evaluate the clinical performance of a ...
Chattipakorn N - - 2001
BACKGROUND: To study the mechanism by which shocks succeed (SDF) or fail (FDF) to defibrillate, global cardiac activation and recovery and their relationship to defibrillation outcome were investigated for shock strengths with approximately equal SDF and FDF outcomes (DFT(50)). METHODS AND RESULTS: In 6 isolated pig hearts, dual-camera video imaging ...
Macdonald R D - - 2001
STUDY OBJECTIVE: We determined whether automated external defibrillators (AEDs) can meet the American Heart Association performance criteria to detect and shock unstable cardiac rhythms (ventricular fibrillation [VF], ventricular tachycardia [VT]) in the setting of an out-of-hospital cardiac arrest. METHODS: AED performance was reviewed for cardiac arrests occurring between January 1, ...
Winter C - - 2001
We report the case of a young man who presented with a clinical picture of acute pyelonephritis. Within 3 h of admission, the patient developed acute respiratory distress associated with tachycardia and shock, and he was transferred to the intensive care unit. Mechanical ventilation of the lungs and symptomatic treatment ...
Barbash I M - - 2001
OBJECTIVE: To determine whether the availability of on-site catheterisation and revascularisation facilities influenced hospital management and outcome of patients with acute myocardial infarction complicated by cardiogenic shock. METHODS: Patients with acute myocardial infarction were enrolled prospectively in four nationwide surveys during 1992, 1994, 1996, and 1998. The characteristics, management, and ...
Quan L - - 2001
To evaluate the significance of immunohistochemical staining of ubiquitin (heat shock protein) in the midbrain for the medico-legal diagnosis of fatal asphyxiation and drowning, we investigated forensic autopsy cases of fatal mechanical asphyxia (n = 18), manual/ligature strangulation (n = 9), hanging (n = 4), aspiration/choking (n = 5) and ...
Janssens K - - 2001
A 25-year-old woman developed meningococcal septicaemia, among others complicated by a combination of cardiogenic and distributive shock requiring full haemodynamic support in the acute phase. Besides clinical course and treatment in the acute phase, we describe treatment in the recovery phase and make some comments concerning the pathophysiology. This case ...
Tanonaka K - - 2001
The contribution of heat shock protein 72 (HSP72) to the protection of cardiac function was examined in rats with chronic heat failure (CHF) following coronary artery ligation (CAL). The CAL animals revealed functional deterioration without low cardiac output 2 wk after CAL and with low cardiac output 8 wk after ...
Halbertsma F J - - 2001
Isolated noncompaction of ventricular myocardium is a rare cardiomyopathy, presumed to originate from a developmental abnormality in the evolution of the heart, and resulting in sponge-like myocardium. Isolated ventricular noncompaction can present with a variety of symptoms, but usually includes heart failure. The diagnosis is often made by echocardiography, which ...
Lango R - - 2001
Carnitine and its derivatives have recently been shown to protect cardiac metabolism and function in ischemic heart disease and other clinical conditions of myocardial ischemia. Potential mechanisms of this effect include an increase in glucose metabolism, a reduction of toxic effects of long-chain acyl-CoA and acyl-carnitine in myocytes, an increase ...
Kaye J - - 2001
Acute cardiogenic pulmonary edema as the first presentation of pheochromocytoma is uncommon and usually rapidly fatal. A 39-yr-old man presented in acute cardiogenic shock with global ventricular dysfunction that required high-dose iv inotrope support and an intraaortic balloon pump assist device. Abdominal imaging to exclude aortic dissection revealed a 6-cm ...
Everett T H TH - - 2001
BACKGROUND: We hypothesized that frequency domain analysis of a wide bipolar interatrial electrogram describes the global organization of atrial fibrillation (AF) and should vary over time. By timing shocks to periods of high organization of AF, cardioversion efficacy should improve. METHODS AND RESULTS: A total of 15 dogs (weight, 28.2+/-3.4 ...
Barron H V - - 2001
BACKGROUND: Cardiogenic shock complicating acute myocardial infarction (AMI) remains the leading cause of death in patients hospitalized with AMI. Although several studies have demonstrated the importance of establishing and maintaining a patent infarct-related artery, it remains unclear as to whether intra-aortic balloon counterpulsation (IABP) provides incremental benefit to reperfusion therapy. ...
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