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Bronicki Ronald A - - 2009
OBJECTIVE: To highlight and review the physiology and pathophysiology of cardiopulmonary interaction in the critically ill pediatric patient. DATA SOURCE: A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into two sections: 1) The physiologic basis of cardiopulmonary interaction, and 2) critical clinical conditions in which cardiac and/or ...
Lamia Bouchra - - 2009
OBJECTIVE: Weaning-induced pulmonary edema is a cause of weaning failure in high-risk patients. The diagnosis may require pulmonary artery catheterization to demonstrate increased pulmonary artery occlusion pressure (PAOP) during weaning. Transthoracic echocardiography can estimate left ventricular filling pressures using early (E) and late (A) peak diastolic velocities measured with Doppler ...
Chapman T H - - 2009
BACKGROUND: Sildenafil is of benefit to selected patients with pulmonary hypertension due to parenchymal lung or cardiac disease. We present data from patients with secondary pulmonary hypertension, comparing their right heart catheter results and six minute walking distance to time on treatment. METHODS: 25 patients with symptomatic secondary pulmonary hypertension ...
Sahin M - - 2009
BACKGROUND: The aim of this study was to investigate systolic pulmonary artery pressure (SPAP) and echocardiographic findings in patients with euthyroid Hashimoto's thyroiditis (HT). METHODS: Thirty (8 male, 22 female, mean age 47.4+/-10.5 yr) consecutive patients with euthyroid HT and 30 (9 male, 21 female, mean age 46.4+/-10.7 yr) healthy ...
Bernal V - - 2009
BACKGROUND: The aim of this study was to assessed the correlation of N-terminal natriuretic peptide type B (NT-proBNP) with echocardiographic and hemodynamic indexes of right ventricular (RV) function and to evaluate the sensitivity and specificity of Doppler echocardiography in the diagnosis of portopulmonary hypertension. METHODS: All patients underwent liver transplantation ...
Halpern Scott D - - 2009
BACKGROUND: Pulmonary arterial hypertension (PAH) is typically distinguished from pulmonary venous hypertension (PVH) by documenting a pulmonary capillary wedge pressure (PCWP) <or= 15 mm Hg. However, PCWP has uncertain utility in establishing PAH. We sought to determine the calibration, discrimination, and diagnostic accuracy of PCWP, using simultaneously measured left ventricular ...
Bonderman D - - 2009
The presence of PH in patients who suffer from CHF is common and predicts a poor outcome. However, precise definitions for PH associated with left heart disease, or 'out-of-proportion' PH as well as standardised vasodilator testing protocols are lacking. Moreover, apart from single-centre observations no large-scale trial to date has ...
Sanz Javier - - 2009
OBJECTIVES: This study sought to evaluate indexes of pulmonary artery (PA) stiffness in patients with pulmonary hypertension (PH) using same-day cardiac magnetic resonance (CMR) and right heart catheterization (RHC). BACKGROUND: Pulmonary artery stiffness is increased in the presence of PH, although the relationship to PH severity has not been fully ...
Xu X-Q - - 2009
High-altitude pulmonary hypertension (HAPH) is a specific disease affecting populations that live at high elevations. The prevalence of HAPH among those residing at high altitudes needs to be further defined. Whereas reduction in nitric oxide production may be one mechanism for the development of HAPH, the roles of endothelin-1 and ...
Müller Helmut M - - 2009
The degree of elevated pulmonary vascular resistance (PVR) is a crucial clinical parameter. Cardiac output (CO) and pulmonary transit time (PTT) can be ascertained by a number of radiological methods. A close functional relationship between CO, PTT and PVR would facilitate non-invasive PVR measurements. One-hundred and fifty-one measurements were made ...
Robbins Ivan M - - 2009
BACKGROUND: Pulmonary venous hypertension (PVH) is a well-described cause of pulmonary hypertension (PH) in patients with left heart disease associated with elevated left heart filling pressure. PVH results from a number of processes, including left-sided valvular disease, constrictive pericardial disease, restrictive cardiomyopathies, and left ventricular (LV) systolic dysfunction. PVH in ...
Revel Marie-Pierre - - 2009
PURPOSE: To evaluate, by using electrocardiographically (ECG)-gated multidetector computed tomography (CT), parameters such as right ventricular outflow tract (RVOT) systolic shortening and myocardial thickness and right pulmonary artery (RPA) distensibility, reported to be abnormal at echocardiography and/or magnetic resonance (MR) imaging in patients with pulmonary hypertension (PHT). MATERIALS AND METHODS: ...
Fisher Micah R - - 2009
RATIONALE: Transthoracic Doppler echocardiography is recommended for screening for the presence of pulmonary hypertension (PH). However, some recent studies have suggested that Doppler echocardiographic pulmonary artery pressure estimates may frequently be inaccurate. OBJECTIVES: Evaluate the accuracy of Doppler echocardiography for estimating pulmonary artery pressure and cardiac output. METHODS: We conducted ...
Kostrubiec Maciej - - 2009
INTRODUCTION: In acute pulmonary embolism (APE) the increase of pulmonary vascular resistance depends on the thromboli load and potentially on the pulmonary bed contraction caused by neurohormonal reaction. Plasma levels of endothelin were reported to be elevated in pulmonary arterial hypertension. However, there are only a few studies assessing endothelin ...
Eyjolfsson Atli - - 2009
BACKGROUND: Retransfusion of the patient's own blood during surgery is used to reduce the need for allogenic blood transfusion. It has however been found that this blood contains lipid particles, which form emboli in different organs if the blood is retransfused on the arterial side. In this study, we tested ...
Tripathi Mukesh - - 2009
The state of vasoplegia in immediate post-cardiopulmonary bypass period is characterized by severe hypotension, supranormal cardiac output, low systemic vascular resistance (SVR), and resistance to vasoconstrictors. We could successfully use induced mild hypothermia to increase SVR, and could avoid very high doses of nor-epinephrine (>0.3 mcg/kg/min) in the background of ...
Papaioannou Vasilios - - 2009
Negative-pressure pulmonary edema is a well-known complication of an acute upper airway obstruction, which may rarely present as acute alveolar hemorrhage in cases of severe capillary stress failure. Hemorrhage from the central airways has also been reported as a rare manifestation of acute tracheobronchial injury, associated with severe disruption of ...
Luks Andrew M - - 2009
With the increasing popularity of adventure travel and mountain activities, it is likely that many high altitude travelers will have underlying medical problems and approach clinicians for advice about ensuring a safe sojourn. Patients with underlying pulmonary hypertension are one group who warrants significant concern during high altitude travel, because ...
Chesler Naomi C - - 2009
Pulmonary hypertension (PH) is initially a disease of the small, peripheral resistance arteries. Changes in these vessels are best assessed by measurement of pulmonary artery pressure at several levels of flow to generate multi-point pressure-flow curves. This approach is superior to the traditional single-point measurement of pulmonary vascular resistance (PVR) ...
Jyothula Soma - - 2009
Pulmonary hypertension (PH) is the hemodynamic manifestation of various pathological processes that result in elevated pulmonary artery pressures (PAP). The National Institutes of Health Registry defined pulmonary arterial hypertension as the mean PAP of more than 25 mm Hg with a pulmonary capillary wedge pressure or left atrial pressure equal ...
Casey David B - - 2009
Recent studies show that pulmonary vasodilator responses to nitrite are enhanced by hypoxia. However, the mechanism by which nitrite is converted to vasoactive nitric oxide (NO) is uncertain. In the present study, intravenous injections of sodium nitrite decreased pulmonary and systemic arterial pressures and increased cardiac output. The decreases in ...
Xu Da - - 2009
We developed a technique to continuously (i.e., automatically) monitor cardiac output (CO) and left atrial pressure (LAP) by mathematical analysis of the pulmonary artery pressure (PAP) waveform. The technique is unique to the few previous related techniques in that it jointly estimates the two hemodynamic variables and analyzes the PAP ...
Hsieh Ming-Hui - - 2008
After two consecutive patients underwent hysteroscopy that was complicated by pulmonary edema, the pneumatically inflated pressure cuff machine was checked and found that the pressure gauge was in error, with actual pressure being twice that of the recorded number. High irrigation pressures with a seemingly normal amount of irrigation fluid ...
Sargent Paul - - 2008
A 42-year-old right-handed man with major depression, posttraumatic stress disorder, gastroesophageal reflux disease, and hypertension received 7 treatments of right unilateral electroconvulsive therapy, with the only complications being elevated blood pressure up to 180/120 mm Hg and agitation upon awakening. During eighth treatment, he experienced blood pressures as high as ...
Bouissou Antoine - - 2008
OBJECTIVE: To study the effects of dopamine on systemic arterial pressure (SAP) and systemic blood flow (SBF) (estimated with the superior vena cava [SVC] flow) in preterm infants with hypotension and patent ductus arteriosus (PDA). STUDY DESIGN: Clinical and echocardiographic variables were measured before and 2 hours after starting dopamine ...
Stehlik Josef - - 2009
BACKGROUND: Phosphodiesterase-5 (PDE5) inhibitors, which induce relaxation of smooth muscle with some selectivity for the pulmonary vasculature, are used in the treatment of pulmonary hypertension. In some patients, the use of PDE5 inhibitors does not result in the desired magnitude of pulmonary vasodilation. The use of additional vasodilators to further ...
Hegazi Mohamed Osama - - 2008
Pulmonary hypertension in adults with hyperthyroidism is increasingly being reported. Although the mechanism is uncertain, the reversal of pulmonary hypertension following restoration to an euthyroid state supports a causal relationship. This case report is of a 43-year-old woman who presented with Graves disease and right ventricular failure. Echocardiography showed severe ...
Della Rocca G - - 2008
BACKGROUND: The use of inhaled aerosolized prostaglandin E(1) (aerPGE(1)), a pulmonary vasodilator, has not been widely analyzed. In contrast to prostacyclin, PGE(1) has a shorter lifetime and is metabolized in a greater amount from the lungs, lowering the risk of systemic effects. The aim of this study was to analyse ...
Mogollón Jiménez M V - - 2008
INTRODUCTION: Invasive estimation of pulmonary pressure is part of the usual protocol prior to heart transplantation. The aim of this study was to compare the results of 2 different vasodilators, nitric oxide (NO) and prostacyclin, in an acute vasodilator test (AVT) for patients with pulmonary venous hypertension. MATERIALS AND METHODS: ...
Leuchte H H - - 2008
Pulmonary hypertension (PH) leads to an increased right ventricular workload, cardiac failure and death. In idiopathic pulmonary arterial hypertension (PAH) the vasodilating vasoactive intestinal peptide (aviptadil) is deficient. The aim of the present study was to test the acute effects on haemodynamics and blood gases, and the safety, of a ...
Tedford Ryan J RJ Divisions of Cardiology and Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins Medical Institutions, Johns Hopkins University, 720 Rutland Avenue, Baltimore, MD 21205, - - 2008
Pulmonary hypertension (PH) secondary to left heart failure portends a poor prognosis and is a relative contraindication to heart transplantation at many centers. We tested the hypothesis that when PH persists after adequate left ventricle unloading via recent left ventricular assist device (LVAD) therapy, phosphodiesterase type 5A inhibition would decrease ...
Li Fuhai - - 2009
This study aimed to determine whether the Rho-kinase-mediated pathway is involved in the pathogenesis of left-to-right shunt-induced pulmonary hypertension and whether fasudil exhibits acute beneficial effects on the hemodynamics of these patients. A total of 12 patients with a mean age of 12.3 years were enrolled in a self-controlled prospective ...
Nisbet Rachel E - - 2009
Obstructive sleep apnea, characterized by intermittent periods of hypoxemia, is an independent risk factor for the development of pulmonary hypertension. However, the exact mechanisms of this disorder remain to be defined. Enhanced NADPH oxidase expression and superoxide (O2(-).) generation in the pulmonary vasculature play a critical role in hypoxia-induced pulmonary ...
Behrendt Florian F - - 2008
OBJECTIVES: To develop a circulation phantom with physiologic circulation parameters, including a pulmonary and a body circulation for the evaluation of intravascular contrast material (CM) application. MATERIALS AND METHODS: The circulation phantom consists of a low-pressure venous system into which CM is injected, a pulmonary circulation, and high-pressure body circulation ...
Badejo Adeleke M AM - - 2008
The small GTP-binding protein Rho and its downstream effector, Rho-kinase, are important regulators of vasoconstrictor tone. Rho-kinase is upregulated in experimental models of pulmonary hypertension, and Rho-kinase inhibitors decrease pulmonary arterial pressure in rodents with monocrotaline and chronic hypoxia-induced pulmonary hypertension. However, less is known about responses to fasudil when ...
Peled Nir - - 2008
BACKGROUND: Pulmonary endothelium plays an important role in the mechanism of pulmonary arterial hypertension (PAH). However, there is only a few data regarding the systemic endothelium in this syndrome. This study focused on the systemic endothelial involvement in PAH. METHODS: Endothelial function was evaluated in 54 patients with idiopathic (n=28), ...
Morales David L S - - 2008
BACKGROUND: Timely extubation is a well-accepted strategy in the postoperative intensive care unit management of Fontan patients to minimize the deleterious effects of positive-pressure ventilation. In October 2002, this strategy was extended to extubating selective Fontan patients in the operating room (EOR). This retrospective study examines how EOR has affected ...
Hussain Arif - - 2008
Moderate to severe pulmonary hypertension is considered to be an absolute contraindication to the performance of bidirectional Glenn (BDG) shunting. However, BDG shunting has been performed in young children with pulmonary hypertension associated with unrestricted pulmonary blood flow. In this study, the medical records of patients who underwent BDG starting ...
Russell N J - - 2008
A five-month-old female Jack Russell terrier was presented for investigation of acute lethargy, anorexia, coughing, respiratory distress and weakness. Examination findings included cyanosis, a grade 3 of 6 systolic heart murmur and prolonged capillary refill time. Radiography and echocardiography revealed severe pulmonary hypertension, cor pulmonale and right-sided heart failure. Indirect ...
Sidi Avner - - 2008
In patients at risk for sudden ethanol (ETOH) intravascular absorption, prompt treatment of pulmonary hypertension (PHTN) will minimise the risk of cardiovascular decompensation. We investigated the haemodynamic effects of intravenous ETOH and the pulmonary vasodilatory effects of a sildenafil analogue (UK343-664) and nitroglycerin (NTG) during ETOH-induced PHTN in pigs. We ...
Sato Hitoshi - - 2008
A large animal model is needed to study artificial lung attachment in a setting simulating chronic lung disease with significant pulmonary hypertension (PH). This study sought to create a sheep model that develops significant PH within 60 days with a low rate of mortality. Sephadex beads were injected in the ...
Johnson Sindhu R - - 2008
OBJECTIVE: Identification of prognostic factors for survival in systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is necessary for appropriate monitoring, interventions, and timely referral for lung transplantation. Our objectives were (1) to identify factors associated with survival in SSc-PAH and (2) to evaluate the methodologic quality of prognostic studies against current ...
Ascuitto Robert - - 2008
A bidirectional Glenn shunt (BGS) was successfully incorporated into a two-ventricle repair for 10 patients (age, 3-17 years) who had congenital heart disease associated with severe pulmonary outflow obstruction. The BGS was used to volume-unload the pulmonary ventricle faced with residual outflow obstruction, thereby avoiding the need for insertion of ...
Shi Zhen-wei - - 2008
BACKGROUND: The dialysis disequilibrium syndrome is characterized by neurologic deterioration and cerebral edema which occurs after hemodialysis. The purpose of this study was to investigate the pathogenesis of acute cerebral and pulmonary edema induced by hemodialysis. METHODS: We evaluated the effects of hemodialysis on the biochemical and hemodynamic parameters of ...
Kunstyr J - - 2008
AIM: The aim of this retrospective study was to evaluate the effectiveness of Terlipressin in the treatment of severe hypotension in cardiosurgical patients and to assess the differences between the groups of survivors and nonsurvivors. METHODS: The study population was 27 patients who developed hypotension after cardiac surgery. RESULTS: All ...
Ochiai Eri - - 2008
Inhalation of Stachybotrys chartarum, a ubiquitous fungus in our living environment, has been suspected as a cause of acute idiopathic pulmonary haemorrhage in infants, but its relation to human diseases is not yet known. The aim of present study was to investigate the effect of repeated intratracheal injection of the ...
Tourneux Pierre - - 2008
OBJECTIVE: To evaluate the respiratory and the pulmonary circulatory effects of norepinephrine in newborn infants with persistent pulmonary hypertension (PPHN)-induced cardiac dysfunction. STUDY DESIGN: Inclusion criteria were: 1) Newborn infants >35 weeks gestational age; 2) PPHN treated with inhaled nitric oxide; and 3) symptoms of circulatory failure despite adequate fluid ...
Yildizdas Dincer - - 2008
Primary persistent hyperinsulinaemic hypoglycaemia is characterised by clinical symptoms that occur when blood glucose levels drop below the normal range. Diazoxide treatment remains the mainstay of medical therapy. Tolerance of diazoxide is usually excellent, but several side effects of this drug have been described. We present a 4-month-old girl who ...
Kriemler S - - 2008
The response of pulmonary artery pressure to high altitude has not been studied in children. It is also not known whether the individual response is hereditary. Therefore, the response of pulmonary artery pressure to high altitude was measured in pre-pubertal children in comparison to that in their biological fathers. Echocardiography ...
Benza Raymond L - - 2008
Treprostinil, a long-acting prostacyclin analog, diminished the symptoms of pulmonary arterial hypertension (PAH) in controlled 12-week clinical efficacy studies. This retrospective, single-center, open-label study was designed to assess the efficacy of long-term, subcutaneously administered, treprostinil-based therapy alone or in combination with bosentan for the treatment of moderate-to-severe PAH. Thirty-eight patients ...
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