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Variations in arterial blood pressure are associated with parallel changes in FlowTrac/Vigileo(R) - derived cardiac output measurements: a prospective comparison studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Acute variations in arterial blood pressure alter the reliability of the Flowtrac/Vigileo(R) device with the second-generation software. This finding may help to explain the variable results of studies comparing the FTV system with other cardiac output monitoring techniques, questions the usefulness of this device for hemodynamic monitoring of patients undergoing rapid changes in arterial blood pressure, and should be kept in mind when using vasopressors during FTV-guided hemodynamic optimization. (Source: BioMed Central)
Source: BioMed Central - November 9, 2009 Category: Journals (General) Authors: Savvas EleftheriadisZisis GalatoudisVasilios DidilisIoannis BougioukasJulika SchonHermann HeinzeKlaus-Ulrich BergerMatthias Heringlake Source Type: journals

Comparison of continuous arterial pressure waveform analysis with the lithium dilution technique to monitor cardiac output in conscious dogs with systemic inflammatory response syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions and Clinical Relevance-Agreement between the PulseCO and LiDCO methods for measurement of CO was not acceptable at 4- and 8-hour intervals after calibration in conscious dogs with naturally occurring SIRS. PMID: 19878019 [PubMed - in process] (Source: American Journal of Veterinary Research)
Source: American Journal of Veterinary Research - November 1, 2009 Category: Veterinary Research Authors: Duffy AL, Butler AL, Radecki SV, Campbell VL Tags: Am J Vet Res Source Type: journals

Does CO2 flushing of the empty CPB circuit decrease the number of gaseous emboli in the prime?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, CO2 flushing of the empty circuit decreases the number of gaseous emboli in the prime compared with a conventional circuit that contains air before being primed with fluid. Knocking of the oxygenator releases gaseous emboli and the duration of re-circulating the circuit with prime influences the number of microemboli. PMID: 19864467 [PubMed - as supplied by publisher] (Source: Perfusion)
Source: Perfusion - October 28, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Nyman J, Rundby C, Svenarud P, van der Linden J Tags: Perfusion Source Type: journals

Acute Limb Ischemia Caused by Femoral Arterial Line Induces Remote Liver Injury in a Rabbit Model of Liver Ischemia/Reperfusion InjuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, femoral artery cannulation induces remote liver injury. The use of femoral arterial lines should be avoided in experimental studies concerning liver function. (Source: Angiology)
Source: Angiology - October 22, 2009 Category: Cardiology Authors: Glantzounis, G. K., Sheth, H., Thompson, C., Hafez, T. S., Kanoria, S., Pamecha, V., Davies, S., Mikhailidis, D. P., Seifalian, A. M., Davidson, B. R. Tags: Articles Source Type: journals

Acute Lung Injury May Be Missed in Kids on VentilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Given that arterial lines are used less frequently in pediatric ICUs these days, the criteria for diagnosis of acute lung injury are less often available, making it difficult to conduct randomized controlled trials of therapies in children with this condition. Reuters Health Information (Source: Medscape Critical Care Headlines)
Source: Medscape Critical Care Headlines - September 21, 2009 Category: Intensive Care Tags: Pulmonary Medicine Source Type: info

Peripartum anesthetic management of patients with aortic valve stenosis: a retrospective study and literature reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Carefully titrated regional analgesia is usually well tolerated in patients undergoing vaginal or cesarean delivery even in the presence of severe aortic stenosis. Standard monitoring is usually adequate for vaginal delivery, but invasive monitoring may facilitate management in some patients. An arterial line allows close monitoring of systemic blood pressure. Facilities for close 24-48-h post-partum observation should be available. A multidisciplinary approach is needed. (Source: International Journal of Obstetric Anesthesia)
Source: International Journal of Obstetric Anesthesia - September 3, 2009 Category: Anesthesiology Authors: A.M. Ioscovich, E. Goldszmidt, A.V. Fadeev, S. Grisaru-Granovsky, S.H. Halpern Tags: Case Series and Review Source Type: journals

Catecholamine Interference in Enzymatic Creatinine Assays [Brief Communications]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Negative interferences were pronounced for Roche enzymatic results in blood samples obtained from indwelling catheters, a phenomenon not observed in peripheral draws. Physicians and laboratorians should be alert to the possibility of a falsely low creatinine result and reevaluate questionable samples using a method unaffected by catecholamines. (Source: Clinical Chemistry)
Source: Clinical Chemistry - August 27, 2009 Category: Chemistry Authors: Saenger, A. K., Lockwood, C., Snozek, C. L., Milz, T. C., Karon, B. S., Scott, M. G., Jaffe, A. S. Tags: Brief Communications Source Type: journals

A False AlarmEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 61-year-old man's surgery was suddenly preempted by an apparent myocardial infarction. He had been admitted for elective surgical resection of esophageal adenocarcinoma. In the operating room, he complained of sudden chest tightness, sweating, and difficulty breathing. This occurred after the placement of central venous and arterial lines but before the administration of preanesthetic or anesthetic medications. His past medical history was remarkable only for anxiety disorder and hypertension, and he reported no prior angina or other cardiac symptoms. He did not smoke or use recreational drugs, and his family history was...
Source: The American Journal of Medicine - August 21, 2009 Category: Journals (General) Authors: Manu Kaushik, Venkata M. Alla, Aryan Mooss Tags: ECG image of the month Source Type: journals

Dynamic filling index: a novel parameter to monitor circulatory filling during minimized extracorporeal bypass [Original articles]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The dynamic filling index can detect small changes in venous return and drainable volume which remain unrevealed by routinely recorded parameters. This index could be a valuable tool to monitor and control circulatory filling in individual patients supported by minimized extracorporeal bypass. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - July 29, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Simons, A. P., Reesink, K. D., Lance, M. D., van der Veen, F. H., de Jong, D. S., Weerwind, P. W., Maessen, J. G. Tags: Extracorporeal circulation, Mechanical Circulatory Assistance Original articles Source Type: journals

Transvenous Removal of an Entangled Central Venous Line Following Complex Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this brief communication is to describe of a simple and safe removal method using a transvenous rotational cutting device to divide the hemostasis suture. In order to avoid complicating bleeding, a time delay between initial placement and removal is highly recommended. For extraction, a fully equipped cardiovascular operating room with central venous and arterial lines, attached defibrillator pads, transesophageal echo monitoring, fluoroscopy, and a surgical team, including a heart and lung machine and a perfusionist standby, is mandatory. (PACE 2009; 32:1099[ndash]1100) (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - July 16, 2009 Category: Cardiology Authors: KE SUN, HERMANN AEBERT, ULRICH A. STOCK, MILAN LISY, GERHARD ZIEMER, VOLKER DOERNBERGER Tags: CASE REPORTS Source Type: journals

Reply to Letter from Inglis and PriceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We agree with the sentiments expressed by Drs. Inglis and Price; that acutely injured patients who are elderly warrant stabilization before inter-hospital transfer. Of course, what constitutes appropriate stabilization depends on the circumstances and the care setting. Especially if resources are limited at the referring facility, we interpret “stabilization” to mean diagnosis and initial management of life- or limb-threatening but treatable conditions. We therefore favor focusing on the high-yield maneuvers—establishing an airway, decompressing any hemo- or pneumothorax, applying pressure to compressible sites of ex...
Source: The Journal of Emergency Medicine - July 13, 2009 Category: Emergency Medicine Authors: Garth H. Utter, David H. Wisner, Gregory P. Victorino Tags: Letters to the Editor Source Type: journals

Haemodynamic effects of repeated doses of oxytocin during Caesarean delivery in healthy parturientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions An initial bolus of oxytocin 5 u produced prominent haemodynamic changes, whereas a second bolus produced smaller changes. This could be due to desensitization of endothelial oxytocin receptors. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - July 12, 2009 Category: Anesthesiology Authors: Langesaeter, E., Rosseland, L. A., Stubhaug, A. Tags: Obstetrics Source Type: journals

Inhibition of HA Synthase 3 mRNA Expression, with a Phosphodiesterase 3 Inhibitor, Blocks Lung Injury in a Septic Ventilated Rat ModelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract Low-molecular-weight hyaluronan produced by hyaluronan synthase 3 (HAS3) has been shown to play a role in acute lung injury secondary to high-tidal-volume ventilation. Phosphodiesterase 3 inhibitors have been shown to decrease HAS3 expression. We hypothesized that low-molecular-weight hyaluronan (LMW HA) produced by HAS3 mediates LPS-induced lung injury in the mechanically ventilated rat and that milrinone (MIL), by blocking HAS3 mRNA expression, would prevent the injury. Rats were randomized to four groups: controls with mechanical ventilation at 7 cc/kg MV, MV+LPS, MV+MIL, and MV+LPS+MIL. Ra...
Source: Lung - July 6, 2009 Category: Respiratory Medicine Tags: Lung Source Type: journals

Axillary artery cannulation pitfallsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present another possible drawback of axillary artery cannulation. A 69-year-old woman was admitted to the Department of Cardiac Surgery for a type A acute aortic dissection involving the innominate artery. After the usual cannulation of the right axillary artery, with a prosthetic side graft, and the right atrium, cardiopulmonary bypass (CPB) was established with no perfusion problems. At 26°C core temperature, CPB was arrested and the aorta was opened longitudinally. The entry tear was located in the ascending aorta. The innominate artery was clamped, and brain perfusion was begun through the axillary artery cannulati...
Source: The Journal of Thoracic and Cardiovascular Surgery - June 30, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Giuseppe Rescigno, Carlo Aratari, Marco L.S. Matteucci Tags: Letters to the Editor Source Type: journals

[Interstitial lung disease] Exercise peripheral oxygen saturation (Spo2) accurately reflects arterial oxygen saturation (Sao2) and predicts mortality in systemic sclerosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In patients with SSc-ILD, Spo2 is an adequate reflection of Sao2 and radial arterial lines need not be inserted during cardiopulmonary exercise tests in these patients. Given the ease of measurement and its prognostic value, Spo2 should be considered as a meaningful clinical and research outcome in patients with SSc-ILD. (Source: Thorax)
Source: Thorax - June 25, 2009 Category: Respiratory Medicine Authors: Swigris, J J, Zhou, X, Wamboldt, F S, du Bois, R, Keith, R, Fischer, A, Cosgrove, G P, Frankel, S K, Curran-Everett, D, Brown, K K Tags: Epidemiologic studies, Interstitial lung disease Source Type: journals

Continuous cardiac index monitoring: A prospective observational study of agreement between a pulmonary artery catheter and a calibrated minimally invasive techniqueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This calibrated minimally invasive (i.e. radial arterial line and peripheral IV) technique demonstrated low bias compared with CCI measured by PAC. However, the relatively wide confidence limits indicate that differences in the two measurements could still be clinically significant. (Source: Resuscitation)
Source: Resuscitation - June 10, 2009 Category: Emergency Medicine Authors: Jonathan V. McCoy, Steven M. Hollenberg, R. Phillip Dellinger, Ryan C. Arnold, Lynn Ruoss, Vincent Lotano, Priscilla Peters, Joseph E. Parrillo, Stephen Trzeciak Tags: Clinical papers Source Type: journals

An Evidence Based Study on the Minimum Volume of Blood Wastage from Arterial LinesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Frequent laboratory testing, convenience of arterial catheters and inconsistent practices contribute to blood loss in postoperative patients. EBP Question: What is the minimum discard volume required when drawing blood from arterial lines? (Source: Journal of PeriAnesthesia Nursing)
Source: Journal of PeriAnesthesia Nursing - June 1, 2009 Category: Nursing Authors: Wanda Rodriguez, Doreen McCarty, Stephanie Nolan, Joyce Kane, Mary O'Sullivan, Denise Stone Tags: Research Poster Abstracts Source Type: journals

[Institutional report - Cardiopulmonary bypass] Circulating particles during cardiac surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Shed blood is known to be a source of lipid micro-emboli in cardiac surgery. The aim of this study was to characterize the occurrence of these particles at different stages of the operation, and to study their occurrence in the circulation at multiple time-points after the retransfusion of shed blood. Forty-four patients undergoing routine surgery with cardiopulmonary bypass were included. Blood was sampled from the surgical field at different sampling locations during the operation. Shed blood was collected in a transfusion bag and retransfused. After which, blood was sampled from the arterial line of the heart-lung machi...
Source: Interactive CardioVascular and Thoracic Surgery - April 20, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Jonsson, H., Eyjolfsson, A., Scicluna, S., Paulsson, P., Johnsson, P. Tags: Institutional report - Cardiopulmonary bypass Source Type: journals

Circulating particles during cardiac surgery [Institutional report - Cardiopulmonary bypass]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Shed blood is known to be a source of lipid micro-emboli in cardiac surgery. The aim of this study was to characterize the occurrence of these particles at different stages of the operation, and to study their occurrence in the circulation at multiple time-points after the retransfusion of shed blood. Forty-four patients undergoing routine surgery with cardiopulmonary bypass were included. Blood was sampled from the surgical field at different sampling locations during the operation. Shed blood was collected in a transfusion bag and retransfused. After which, blood was sampled from the arterial line of the heart-lung machi...
Source: Interactive CardioVascular and Thoracic Surgery - April 19, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Jonsson, H., Eyjolfsson, A., Scicluna, S., Paulsson, P., Johnsson, P. Tags: Institutional report - Cardiopulmonary bypass Source Type: journals

Preoperative oral pentoxifylline for management of cytokine reactions in cardiac surgery.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS: We conclude that pretreatment with oral pentoxifylline before cardiac surgery inhibits proinflammatory cytokine release caused by cardiopulmonary bypass and has some beneficial effects in protecting the myocardium during the cardioplegic arrest period in open-heart surgery, without affecting postoperative hemodynamics. PMID: 19383582 [PubMed - in process] (Source: The Heart Surgery Forum)
Source: The Heart Surgery Forum - March 31, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Iskesen I, Kurdal AT, Kahraman N, Cerrahoglu M, Sirin BH Tags: Heart Surg Forum Source Type: journals

Predictors of hemodynamic compromise with propofol during defibrillator implantation: a single center experienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Hypotension is a common occurrence during defibrillator implantation under conscious sedation. Risk factors for significant hypotension include: higher NYHA class, lower left ventricular ejection fraction, lower creatinine clearance, higher doses of propofol and longer procedure times. Content Type Journal ArticleDOI 10.1007/s10840-008-9355-6Authors Khyati Pandya, Michigan State University Thoracic and Cardiovascular Institute, Sparrow Health System 405 West Greenlawn, Suite 400 Lansing MI 48910 USAMehul B. Patel, Michigan State University Thoracic and Cardiovascular Institute, Sparrow Hea...
Source: Journal of Interventional Cardiac Electrophysiology - March 5, 2009 Category: Cardiology Tags: Journal of Interventional Cardiac Electrophysiology Source Type: journals

[Original articles] Association of IL6 and IL10 with renal dysfunction and the use of haemofiltration during cardiopulmonary bypassEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Haemofilter use during cardiopulmonary bypass does not have a protective effect on postoperative kidney function. Haemofilter has no effect on the level of IL6 and IL10. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - March 4, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Musleh, G. S., Datta, S. S., Yonan, N. N., Grotte, G. J., Prendergast, B. A., Hasan, R. I., Deyrania, A. K. Tags: Cardiac - physiology, Coronary disease, Extracorporeal circulation Original articles Source Type: journals

Early hemodynamics and metabolic changes after total abdominal evisceration for experimental multivisceral transplantation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: The deleterious hemodynamic alterations observed are probably related with the association of severe acidosis, hyperlactemia, hypoglycemia, and reduction of total circulating blood volume. Close hemodynamic and metabolic monitoring should be provided during experimental MVTx in order to promote an increase in successful rates of this complex and challenging procedure. PMID: 19377786 [PubMed - in process] (Source: Acta Cirurgica Brasileira)
Source: Acta Cirurgica Brasileira - March 1, 2009 Category: Surgery Authors: Cruz Junior RJ, Garrido AG, Silva MR Tags: Acta Cir Bras Source Type: journals

Evaluation of air handling in a new generation neonatal oxygenator with integral arterial filter.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report on the first use of the Terumo((R)) CAPIOX((R)) FX05 (Baby-FX) oxygenator with integral arterial filter, prime volume 43 ml, evaluating performance and air-handling of six Baby-FX versus thirteen Baby-RX oxygenators. The Terumo Baby-FX primes and performs as easily as the Baby-RX series. A significant prime component in the neonatal CPB circuit can be the arterial line filter (ALF). Removal of the ALF may lead to significant reduction in prime volume, decreased exposure to foreign surfaces with subsequent reduction in inflammation, and potential elimination or reduction in blood product exposures. PMID: 19654...
Source: Perfusion - March 1, 2009 Category: Cardiovascular & Thoracic Surgery Authors: Gomez D, Preston T, Olshove V, Phillips A, Galantowicz M Tags: Perfusion Source Type: journals

Arterial blood gas analysis: mplications for nursing.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nurses caring for children need to be able to understand the investigations that contribute to holistic assessment of the child. Blood gas analysis is a common investigation in critical care settings but is also used during stabilisation or preparation for transfer to critical care of children who are acutely ill. In this article the indications for arterial blood gas analysis are discussed and patient groups that may benefit from this investigation identified. The basic science behind acid-base balance and its impact on homeostasis are described. A simple guide to interpreting arterial blood gas results and the princi...
Source: Paediatric Nursing - February 1, 2009 Category: Nursing Authors: Lynch F Tags: Paediatr Nurs Source Type: journals

Haemodialysis through a cellulose membrane induces dephosphorylation of CD11b and promotes leukocyte adhesion to endothelial cells.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Leukocyte activation during HD through a cellulose membrane occurs with decreases in CD11b phosphorylation. Activation also induces increases in CD11b expression associated with enhanced leukocyte adhesion to uremic endothelial cells. PMID: 19178879 [PubMed - in process] (Source: Clinical and Investigative Medicine)
Source: Clinical and Investigative Medicine - January 31, 2009 Category: Biomedical Science Authors: Hernandez ER, Fuste B, Cases A, Tonda R, Escolar G, Ordinas A, Diaz-Ricart M Tags: Clin Invest Med Source Type: journals

Fresenius Medical Care North America - CombiSet True Flow Series - Class 2 RecallEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CombiSet True Flow Series, Hemodialysis Blood Tubing with Priming Set and Transducer Protectors, with Access Flow Reversing Connector (Twister) Product Code: 03-2794-0 Bonded CombiSets - includes priming set w/ needleless access port & Y-injection site bonded to arterial line, viral-retentive transducers and Twister device (Source: Medical Device Recalls since July 07, 2006)
Source: Medical Device Recalls since July 07, 2006 - January 24, 2009 Category: Medical Equipment Source Type: organizations

Anesthesiologists Get Their Own iPhone AppEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Last summer two anesthesiologists teamed up to create practical software applications that they themselves would find useful in the operating room. They recently released iAnesthesia:Case Logs, an iPhone app that does easy case log tracking for busy anesthesiologists. Features from the product page: Record a new anesthesia case log on the fly, even if you don't have a wireless connection (your iPhone will sync data to the CaseLogs server once it regains connectivity). Browse your Case Log History to quickly find a patient record and open the entry for easy editing (your anesthesia records are organized chronologically). R...
Source: Medgadget Anesthesiology - January 20, 2009 Category: Anesthesiology Tags: Anesthesiology Source Type: info

Time series analysis of use patterns for common invasive technologies in critically ill patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The use of invasive technologies in critically ill patients is changing and may have important implications for resource use, clinician education, and patient care. Initiatives should be considered for ensuring clinician competency during technology transitions. (Source: Journal of Critical Care)
Source: Journal of Critical Care - January 19, 2009 Category: Gastroenterology Authors: Luc R. Berthiaume, Adam D. Peets, Ulrich Schmidt, Reza Shahpori, Chip J. Doig, Paul J.E. Boiteau, Henry Thomas Stelfox Tags: Electronic Articles Source Type: journals

A hybrid hierarchical decision support system for cardiac surgical intensive care patients. Part II. Clinical implementation and evaluation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
OBJECTIVE: Patients emerging from cardiac surgery can display varying degrees of cardiovascular instability arising from potentially complex, multi-factorial and interlinked causes. Stabilization and control of the cardiovascular system are currently managed by healthcare experts using experiential knowledge, and, in some centers, manually inputted decision pathway algorithms. This paper describes a clinical trial undertaken to determine the basic functioning of a clinical decision support system (CDSS) designed and constructed by the authors to facilitate the control of the major cardiovascular components in the early...
Source: Artificial Intelligence in Medicine - December 26, 2008 Category: Bioinformatics Authors: Ross JJ, Denaï MA, Mahfouf M Tags: Artif Intell Med Source Type: journals

Leukocyte depletion during cardiac surgery with extracorporeal circulation in high risk patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Interestingly, the activation of neutrophils was more pronounced in the LF group. The use of a leucocyte depleting filter was not advantageous for this patient cohort for clinical or biomedical endpoints. Content Type Journal ArticleDOI 10.1007/s00011-008-8031-8Authors F. Bakhtiary, Johann Wolfgang Goethe University Hospital Department of Thoracic & Cardiovascular Surgery 60596 Frankfurt/Main GermanyA. Moritz, Johann Wolfgang Goethe University Hospital Department of Thoracic & Cardiovascular Surgery 60596 Frankfurt/Main GermanyP. Kleine, Johann Wolfgang Goethe University Hospital Departmen...
Source: Inflammation Research - December 25, 2008 Category: Research Tags: Inflammation Research Source Type: journals

Traumatic fracture of a central venous catheter resulting in potential migration of distal fragment: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a surgical retrieval of an indwelling portion of a traumatic rupture of the Central venous catheter following hair cutting by a confused patient secondary to Postoperative cognitive dysfunction. He had a dynamic compression screw for fixation of fractured neck of femur after previously failed surgical procedure. The second procedure was complicated with major blood loss, which required central venous and arterial line insertion for intra-operative and post-operative management. The patient was discharged to the ward following an uneventful stay on intensive care. While on the ward, he decided to trim his hair an...
Source: BioMed Central - December 14, 2008 Category: Journals (General) Authors: Shailendra Deep, Sanjay Deshpande and Philip Howe Source Type: journals

Arterial Line Pressure control enhanced Extracorporeal Blood Flow prescription in Hemodialysis PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: In hemodialysis, extracorporeal blood flow (Qb) recommendation is 300-500 mL/min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure (DALP). Methods: This prospective study included 72 patients with catheter Group 1 (G1), 1877 treatments and 35 arterio-venous (AV) fistulae Group 2 (G2), 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250mmHg. We measured ionic clearance (IK: mL/min), access recirculation, DALP (mmHg) and Qb (mL/min). Six prescription zones were identified: from an optimal A zone (Qb>400, DALP -200 to-25...
Source: BMC Nephrology - November 24, 2008 Category: Urology & Nephrology Authors: Franklin G Mora-Bravo, Alfonso Mariscal, Juan P Herrera-Felix, Salvador Magana, Guadalupe De-La-Cruz, Nelly Flores, Laura Rosales, Martha Franco and Hector Perez-Grovas Source Type: journals

World apheresis registry data from 2003 to 2007, the pediatric and adolescent side of the registry.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: The paediatric data compared to the whole registry data set are showing that aphereses are performed as safe in paediatrics as in adults. Centres are mostly handling only a few cases younger than 21. Therefore more exchange of information and experience in paediatric apheresis is warranted. PMID: 19010084 [PubMed - as supplied by publisher] (Source: Transfusion and Apheresis Science)
Source: Transfusion and Apheresis Science - November 13, 2008 Category: Hematology Authors: Witt V, Stegmayr B, Ptak J, Wikström B, Berlin G, Axelsson CG, Griskevicius A, Centoni PE, Liumbruno GM, Molfettini P, Audzijoniene J, Mokvist K, Sojka BN, Norda R, Ramlow W, Blaha M, Evergreen M, Tomaz J Tags: Transfus Apher Sci Source Type: journals

New guidance issued following problems with infusions and sampling from arterial linesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Nursing in Critical Care)
Source: Nursing in Critical Care - October 19, 2008 Category: Nursing Authors: Karen Hill Tags: News Source Type: journals

Using consensus methods to develop clinical practice guidelines for intensive care: The Intensive Care Collaborative project.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: This project has demonstrated a method for guideline development that is robust, incorporating evidence from research and clinical expertise utilising an objective egalitarian framework. PMID: 18922699 [PubMed - as supplied by publisher] (Source: Australian Critical Care)
Source: Australian Critical Care - October 13, 2008 Category: Nursing Authors: Rolls KD, Elliott D Tags: Aust Crit Care Source Type: journals

Coming to ICU Near You: Monitoring of In Vivo Drug ConcentrationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cranfield University and Sphere Medical out of Cambridge, England are announcing a collaboration to build a real time drug monitoring system for point-of-care applications. From Sphere Medical: The medical profession is increasingly discovering that in critically ill patients more frequent monitoring of the patient condition results ultimately in improved patient care. The ability to monitor trends and quickly pick up changes in the condition of the patient is a powerful aid for the clinician. Moreover, being able to monitor important parameters, such as the blood concentration of certain therapeutic drugs, frequently an...
Source: Medgadget Anesthesiology - September 18, 2008 Category: Anesthesiology Tags: Critical Care Source Type: info

Central venous catheter-associated infections.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Most patients in the hospital need vascular access: a peripheral venous line, a short-term non-cuffed central venous catheter (CVC), a long-term cuffed CVC, an implantable port or an arterial line. Such devices, although often indispensable and of benefit, may have the disadvantage of mechanical complications, local exit-site infections or catheter-associated bloodstream infections (CRBSI). Apart from peripheral venous lines, non-cuffed CVCs are the most frequent catheter type in hospitals. The risk for CRBSI of such catheters is high with an incidence density of 2 to 7 episodes per 1000 catheter-days depending on ward...
Source: Best Practice and Research. Clinical Anaesthesiology - September 1, 2008 Category: Anesthesiology Authors: Zingg W, Cartier-Fässler V, Walder B Tags: Best Pract Res Clin Anaesthesiol Source Type: journals

Arterial to endtidal carbon dioxide gradient during pediatric laparoscopic fundoplication.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: ETCO(2) may not accurately represent arterial values during laparoscopic fundoplication, especially in the infant when carbon dioxide insufflation is used. Consideration should be given to placing an arterial line for blood gas measurement in some patients. PMID: 18717807 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - August 19, 2008 Category: Anesthesiology Authors: Sanders JC, Gerstein N Tags: Paediatr Anaesth Source Type: journals

Problems with infusions and sampling from arterial linesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The National Patient Safety Agency (NPSA) has issued a Rapid Response Report to healthcare professionals in the UK to offer guidance for arterial line use following reports of problems with infusions and sampling. From January 2005 to June 2008, the NPSA had reports of two deaths and 82 other incidents where the wrong infusion fluid was attached to the arterial line. A further 76 incidents, including one case of serious harm, related to faulty sampling technique. All of these incidents were reported to the National Reporting and Learning System (NRLS). Arterial lines are routinely used in critical care areas to obt...
Source: NHS Networks - August 13, 2008 Category: UK Health Source Type: organizations

[Special features of laparoscopic operations from an anesthesiologic viewpoint : A review.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The value of laparoscopic procedures has increased over the last decade. Many patients undergoing laparoscopic surgery also have coexisting diseases. The hemodynamic effects of intraperitoneal carbon dioxide insufflation depend on the extent of intraperitoneal pressure, severity of preexisting cardiopulmonary diseases, volume state of the patient and alterations of acid-base balance due to a capnoperitoneum. In addition to endocrinologic reactions, patient positioning also affects hemodynamic parameters. In high risk patients extended cardiopulmonary monitoring with an arterial line and repeated blood gas analysis is r...
Source: Der Anaesthesist - July 30, 2008 Category: Anesthesiology Authors: Meininger D, Byhahn C Tags: Anaesthesist Source Type: journals

Medtronic International Trade Inc - Medtronic Carmeda-coated - Class 2 RecallEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Medtronic Affinity Pediatric arterial Filter, Arterial Line Filter for Cardiopulmonary Bypass. Catalog Number: CB4014 (Source: Medical Device Recalls since July 07, 2006)
Source: Medical Device Recalls since July 07, 2006 - July 24, 2008 Category: Medical Equipment Source Type: organizations

A regional citrate anticoagulation protocol for pre-dilutional CVVHDf: The 'Modified Alabama Protocol'Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: This paper describes a practical protocol for the delivery of regional citrate anticoagulation for pre-dilutional CVVHDf. The protocol maintains the flexibility in dialysis/haemofiltration dose prescription and advises on the requirement for monitoring and necessary adjustments to prevent the development of metabolic disturbances. This may assist regional citrate to achieve wider acceptance as an alternative anticoagulation strategy for critically ill patients. PMID: 18635373 [PubMed - as supplied by publisher] (Source: Australian Critical Care)
Source: Australian Critical Care - July 15, 2008 Category: Nursing Authors: Davies H, Morgan D, Leslie G Tags: Aust Crit Care Source Type: journals

A Comparison of Noninvasive Blood Pressure Measurement on the Wrist with Invasive Arterial Blood Pressure Monitoring in Patients Undergoing Bariatric SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion The Vasotrac was more comfortable than an oscillometric device. Although the average accuracy was good, individual mean Vasotrac and noninvasive blood pressure pressures often differed considerably from arterial values. These results suggest that the Vasotrac monitor should not be substituted for an arterial catheter in super-obese patients. Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s11695-008-9607-7Authors Helmut Hager, Medical University of Vienna Department of Anesthesiology and General Intensive Care, Vienna General Hospital Waehringer Guertel 18-20 1180 Vienna Au...
Source: Obesity Surgery - July 11, 2008 Category: Surgery Tags: Obesity Surgery Source Type: journals

Class 4 Drug Alert (Caution in use): Enoxaparin Sodium (Clexane) pre-filled syringes - supply update and advice to prescribers on shortage of 150mg syringes and use in pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Further to the drug alerts issued by the Medicines and Healthcare products Regulatory Agency (MHRA) on 24 April and 9 May concerning enoxaparin (Clexane®) pre-filled syringes contaminated with over-sulphated-chondroitin sulphate (OSCS), this class 4 drug alert provides an update on the supply situation and clinical advice. The following advice is given to prescribers (direct from source): • There is no evidence of any specific risks to pregnant women or the developing foetus from exposure to the levels of OSCS found in some enoxaparin batches. However, on a purely precautionary basis, the MHRA are recommending that...
Source: NeLM Headline News - June 6, 2008 Category: Drugs & Pharmacology Tags: 2.8.1 Parenteral anticoagulants, Venous Thromboembolism, Preventative medicines, Surgery, Drug Alerts, Department of Health (DH), European Agency for the Evaluation of Medicinal Products (EMEA) Source Type: organizations

DRUG ALERT CLASS 4 (CAUTION IN USE) - ENOXAPARIN SODIUM (CLEXANE) PRE-FILLED SYRINGES - SUPPLY UPDATE & ADVICE TO PRESCRIBERS [NON URGENT (cascade within 48 hours)] - EL(08)A/05Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Supply update and advice to prescribers on shortage of 150mg syringes and use in pregnancy Further to the drug alerts issued by the Medicines and Healthcare products Regulatory Agency (MHRA) on 24 April and 9 May concerning enoxaparin (Clexane) pre-filled syringes contaminated with over-sulphated-chondroitin sulphate (OSCS), this provides an update on the supply situation and clinical advice. Advice to prescribers • There is no evidence of any specific risks to pregnant women or the developing foetus from exposure to the levels of OSCS found in some enoxaparin batches. However, on a purely precautionary basis, we are ...
Source: NeLM/MHRA Drug Alerts - June 6, 2008 Category: Drugs & Pharmacology Source Type: organizations

Pharmacokinetics of levofloxacin after single and multiple oral doses in patients undergoing intermittent haemodialysis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The impact of intermittent haemodialysis (IHD) on the pharmacokinetics of levofloxacin after single and multiple oral doses of 500mg was assessed in 10 patients with end-stage renal failure on IHD. In the first phase of the study where a single dose was administered, IHD was initiated 90min after drug intake. In the second phase of the study where drug was administered daily for three consecutive days, IHD was started exactly after the first dose. Venous blood samples were collected at standard time intervals. Additional samples from the arterial and venous line of the fistula and from the dialysate were drawn at the f...
Source: International Journal of Antimicrobial Agents - June 3, 2008 Category: Drugs & Pharmacology Authors: Tsaganos T, Kouki P, Digenis P, Giamarellou H, Giamarellos-Bourboulis EJ, Kanellakopoulou K Tags: Int J Antimicrob Agents Source Type: journals

Neonatal Arterial Thrombosis at Birth: Case Report and Literature ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present the case of a full-term infant noted to have marked left arm swelling at birth. Doppler ultrasound of the arm demonstrated a large thrombus in the left subclavian, axillary, and brachial arteries. He underwent left arm fasciotomy and anticoagulant therapy with good recovery. We present this case with a brief review of the literature.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: American Journal of Perinatology)
Source: American Journal of Perinatology - May 29, 2008 Category: Perinatology & Neonatology Source Type: journals

MHRA Drug Safety Bulletin features advice on contaminated enoxaparin (Clexane)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The MHRA Drug Safety Bulletin has featured reinforced advice for healthcare professionals with respect to the contamination of enoxaparin (Clexane®) with over-sulphated chondroitin sulphate (OSCS). The Bulletin makes the following recommendations (taken directly from source): • There is no evidence that the level of contamination with OSCS is associated with any increased risks to patients, and the Commission on Human Medicines has advised that product on the UK market can continue to be used to avoid severe supply shortages and subsequent risks to patients. • Purely as a precaution, healthcare professionals are ...
Source: NeLM news - Cardiology - May 6, 2008 Category: Cardiology Tags: 2.8.1 Parenteral anticoagulants, Cardiovascular Medicine, Surgery, Drug Alerts, Medicines and Healthcare products Regulatory Agency (MHRA) Source Type: organizations