902 results match your criteria organ hypoperfusion


[COVID-19-induced coagulopathy and thrombosis manifestations].

Radiologe 2021 Sep 24. Epub 2021 Sep 24.

Coagulation Center Mannheim, Mannheim, Deutschland.

Clinical Issue: Clinically, COVID-19 (coronavirus disease 2019) is increasingly seen as a systemic disease associated with multiorgan involvement through a hypercoagulatory condition in the sense of vasculopathy.

Standard Treatment: Treatment with antiplatelet drugs or heparins appears to be indicated. The current evidence, at least for acetylsalicylic acid (ASA), is lacking. Read More

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September 2021

The Effectiveness of Ischemia Modified Albumin in Determining Acute Cholecystitis and its Severity.

Clin Lab 2021 Sep;67(9)

Background: Acute cholecystitis (AC) is caused by chemical and bacterial inflammation of the gallbladder. The use of Tokyo guidelines is recommended in determining the diagnosis of AC and its clinical severity. In the early stages of AC, many cytokines are secreted due to the local inflammatory cell activation, leading to exacerbation of inflammation and organ failure. Read More

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September 2021

Preserved Cerebral Oxygenation with Worsening Global Myocardial Strain during Pediatric Chronic Hemodialysis.

J Am Soc Nephrol 2021 Sep 13. Epub 2021 Sep 13.

P Srivaths, Department of Pediatrics, Renal Section, Baylor College of Medicine, Houston, United States

Cerebral and myocardial hypoperfusion occur during hemodialysis in adults. Pediatric patients receiving chronic hemodialysis have fewer cardiovascular risk factors, yet cardiovascular morbidity remains prominent. We conducted a prospective observational study of pediatric patients receiving chronic hemodialysis to investigate whether intermittent hemodialysis is associated with adverse end organ effects in the heart or with cerebral oxygenation (regional O2 saturation [rSO2]). Read More

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September 2021

A Rare Case of Traumatic Thyroid Gland Hypoperfusion/Devascularization After a Gunshot Wound Through the Neck: Computed Tomography Findings.

Am J Case Rep 2021 Aug 30;22:e930505. Epub 2021 Aug 30.

Department of Diagnostic Radiology, University of Puerto Rico, San Juan, Puerto Rico.

BACKGROUND The thyroid gland is rarely injured in cases of penetrating neck trauma. Computed tomography (CT) plays a central role in prompt evaluation of the extent of penetrating neck trauma and can demonstrate thyroid gland injury. The current literature on thyroid gland injury is limited mostly to blunt trauma, with little emphasis on findings seen on CT imaging. Read More

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The Physiological Deep Learner: First application of multitask deep learning to predict hypotension in critically ill patients.

Artif Intell Med 2021 08 29;118:102118. Epub 2021 May 29.

Université de Paris, ECSTRRA team, Center of research in epidemiology and statistics (CRESS) - INSERM UMR 1153, 1 Parvis Notre-Dame - Pl. Jean-Paul II, Paris 75004, France; Department of Anesthesia and Perioperative Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Ave, San Francisco, 94110, CA, United States. Electronic address:

Critical care clinicians are trained to analyze simultaneously multiple physiological parameters to predict critical conditions such as hemodynamic instability. We developed the Multi-task Learning Physiological Deep Learner (MTL-PDL), a deep learning algorithm that predicts simultaneously the mean arterial pressure (MAP) and the heart rate (HR). In an external validation dataset, our model exhibited very good calibration: R of 0. Read More

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Heterogeneous impact of hypotension on organ perfusion and outcomes: a narrative review.

Authors:
Lingzhong Meng

Br J Anaesth 2021 Aug 12. Epub 2021 Aug 12.

Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA. Electronic address:

Arterial blood pressure is the driving force for organ perfusion. Although hypotension is common in acute care, there is a lack of accepted criteria for its definition. Most practitioners regard hypotension as undesirable even in situations that pose no immediate threat to life, but hypotension does not always lead to unfavourable outcomes based on experience and evidence. Read More

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The association between mean arterial pressure and outcomes in patients with cardiogenic shock: insights from the DOREMI trial.

Eur Heart J Acute Cardiovasc Care 2021 Aug 12. Epub 2021 Aug 12.

CAPITAL Research Group, University of Ottawa Heart Institute, 40 Ruskin Street, H-4238, Ottawa, Ontario K1Y 4W7, Canada.

Aims: Cardiogenic shock (CS) is a state of low cardiac output resulting in end-organ hypoperfusion. Despite high in-hospital mortality rates, little evidence exists regarding the optimal mean arterial pressure (MAP) target in CS. We therefore evaluated the relationship between achieved MAP and clinical outcomes in patients with CS. Read More

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Intraoperative hypotension and its organ-related consequences in hypertensive subjects undergoing abdominal surgery: a cohort study.

Blood Press 2021 Jul 29:1-11. Epub 2021 Jul 29.

Department of Anaesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

. Intraoperative hypotension is associated with organ hypoperfusion, which is deleterious to vital organs. Little is known about the prevalence and consequences of intraoperative hypotension in subjects with arterial hypertension (AH). Read More

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A molecular explanation of cardiovascular protection through abnormal cannabidiol: Involving the dysfunctional β-adrenergic and ATP-sensitive K+ channel activity in cardiovascular compromised preterm infants.

J Biochem Mol Toxicol 2021 Sep 26;35(9):e22849. Epub 2021 Jul 26.

Faculty of Pharmacy, Minia University, Minya, Egypt.

Growing cannabis efficacy, usage frequency, legal supply, and declining awareness of danger recently led to expanded United States cannabis exposure. In turn, cannabis use among elderly people over 50 has more than tripled in a decade and has contributed toward a positive association of cannabis use with pathological conditions, which include type II diabetes, metabolic syndrome, neurovascular and cardiovascular disease. Remarkably, all these outcome results are mediated by the involvement of the ATP-sensitive K+ channel. Read More

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September 2021

A Challenging Case of Carcinoid Crisis in a Patient With Neuroendocrine Tumor.

Cureus 2021 Jun 13;13(6):e15626. Epub 2021 Jun 13.

Critical Care Medicine, Capital Health System, Trenton, USA.

The critical state of circulatory collapse and hypoperfusion that results in end-organ damage has been called shock. Carcinoid crisis is a rare cause of shock, which is difficult to identify in the presence of infection. It occurs due to the release of vasoactive amines into the systemic circulation following an inciting event. Read More

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Successful Surgical Embolectomy for a Rapidly Deteriorating Patient with Pulmonary Embolism and Hemorrhagic Stroke.

Heart Views 2021 Jan-Mar;22(1):45-49. Epub 2021 Apr 22.

Department of Cardiology and Cardiothoracic Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

Pulmonary embolism (PE) is a life-threatening condition. High-risk PE is defined as pulmonary embolism with either hemodynamic collapse, persistent hypotension, and/or organ hypoperfusion. The overall mortality rate associated with high-risk PE remains at approximately 30%. Read More

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Risk stratification in cardiogenic shock: a focus on the available evidence.

Heart Fail Rev 2021 Jul 14. Epub 2021 Jul 14.

Department of Medical Biotechnologies, Section of Cardiology, University of Siena, Siena, Italy.

Cardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient resource allocation. Read More

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Unfractionated Heparin Improves the Intestinal Microcirculation in a Canine Septic Shock Model.

Mediators Inflamm 2021 23;2021:9985397. Epub 2021 Jun 23.

Department of Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China.

Background: Alterations of microcirculation are associated with organ hypoperfusion and high mortality in septic shock. This study is aimed at investigating the effects of unfractionated heparin (UFH) on intestinal microcirculatory perfusion and systemic circulation in a septic shock model.

Methods: Twenty-four beagle dogs were randomly allocated into four groups: (a) sham group: healthy controls, (b) shock group: septic shock induced by , (c) basic therapy group: septic shock animals treated with antibiotics and 10 ml/kg/h saline, and (d) heparin group: septic shock animals treated with basic therapy plus UFH. Read More

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Treatment threshold for intra-operative hypotension in clinical practice-a prospective cohort study in older patients in the UK.

Anaesthesia 2021 Jul 6. Epub 2021 Jul 6.

Peninsula Medical School, University of Plymouth, Plymouth, UK.

Intra-operative hypotension frequently complicates anaesthesia in older patients and is implicated in peri-operative organ hypoperfusion and injury. The prevalence and corresponding treatment thresholds of hypotension are incompletely described in the UK. This study aimed to identify prevalence of intra-operative hypotension and its treatment thresholds in UK practice. Read More

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Clinical review of sick sinus syndrome and atrial fibrillation.

Herz 2021 Jun 22. Epub 2021 Jun 22.

Department of Ultrasound, the Second Affiliated Hospital of Dalian Medical University, 116027, Dalian, China.

Sick sinus syndrome (SSS) is a set of diseases with abnormal cardiac pacing, which manifests as diverse cardiac arrhythmias, especially bradycardia. The clinical presentation is inconspicuous in the early stage, but with the progression of this disease, patients may present with symptoms and signs of end-organ hypoperfusion. As a common result in the natural history of the disease, SSS coexisting with atrial fibrillation (AF) forms the basis of bradycardia-tachycardia syndrome. Read More

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Central Systolic and Diastolic Blood Pressure Pressures during Hemodialysis.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):170-173

Department of Outpatient, Bahrain Specialist Hospital, Manama, Bahrain.

Maintaining fixed dry weight and controlling cardiovascular risk factors during hemodialysis (HD) requires well-controlled blood pressure (BP) with regular measurements. Keeping the BP stable during HD is challenging in some patients with end-stage renal disease (ESRD). Accurate measurement of BP is the key, as it helps prevent intradialytic hypotension. Read More

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Elevated Arterial-Central Venous Carbon Dioxide Partial Pressure Difference Indicates Poor Prognosis in the Early Postoperative Period of Open Heart Surgery in Infants with Congenital Heart Disease.

Pediatr Cardiol 2021 Oct 9;42(7):1601-1606. Epub 2021 Jun 9.

Cardiac Intensive Care Unit, Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, China.

Background: Elevated arterial-central venous carbon dioxide partial pressure difference (AVCO) may be an important marker to predict tissue and organ hypoperfusion in adults. We analyzed the hemodynamic data of infants with congenital heart disease who underwent corrective repair with cardiopulmonary bypass (CPB) to identify whether AVCO has clinical significance in early postoperative tissue hypoperfusion, occurrence of complications, and clinical outcomes.

Methods: Infants with clinical conditions of hypoperfusion, without volume responsiveness and with ineffective initial treatment, within 3 h of cardiac surgery were enrolled in this study. Read More

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October 2021

Computed tomography imaging of septic shock. Beyond the cause: the "CT hypoperfusion complex". A pictorial essay.

Insights Imaging 2021 Jun 5;12(1):70. Epub 2021 Jun 5.

Department of General and Emergency Radiology, "Antonio Cardarelli" Hospital, Antonio Cardarelli st 9, 80131, Naples, Italy.

Septic shock is a medical emergency that represents one of the most important underlying causes for presentation to the Emergency Department. Sepsis is defined as organ dysfunction, life-threatening event caused by a deregulated inflammatory host response to infection, with a mortality risk ranging from 10 to 40%. Early sepsis identification is the cornerstone of management and diagnostic imaging can play a pivotal role in this clinical context. Read More

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Linopirdine-supplemented resuscitation fluids reduce mortality in a model of ischemia-reperfusion injury induced acute respiratory distress syndrome.

Physiol Res 2021 08 1;70(4):649-953. Epub 2021 Jun 1.

Department of Surgery, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA.

Previously, we demonstrated that supplementation of resuscitation fluids with the Kv7 voltage-activated potassium channel inhibitor linopirdine reduces fluid resuscitation requirements and stabilizes hemodynamics in various rat models of hemorrhagic shock. To further evaluate the therapeutic potential of linopirdine, we tested the effects of linopirdine-supplemented resuscitation fluids in a rat model of ischemia-reperfusion injury-induced acute respiratory distress syndrome (ARDS). Ventilated rats underwent unilateral lung ischemia from t=0-75 min, followed by lung reperfusion and fluid resuscitation to a mean arterial blood pressure of 60 mmHg with normal saline (NS, n=9) or NS supplemented with 50 µg/ml linopridine (NS-L), n=7) until t=360 min. Read More

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The role of lactate in sepsis and COVID-19: Perspective from contracting skeletal muscle metabolism.

Exp Physiol 2021 May 31. Epub 2021 May 31.

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

New Findings: What is the topic of this review? Lactate is considered an important substrate for mitochondria in the muscles, heart and brain during exercise and is the main gluconeogenetic precursor in the liver and kidneys. In this light, we review the (patho)physiology of lactate metabolism in sepsis and coronavirus disease 2019 (COVID-19). What advances does it highlight? Elevated blood lactate is strongly associated with mortality in septic patients. Read More

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Epidemiology and causes of cardiogenic shock.

Curr Opin Crit Care 2021 08;27(4):401-408

TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Cardiogenic shock is a complex clinical syndrome of end-organ hypoperfusion due to impaired cardiac performance. Although cardiogenic shock has traditionally been viewed as a monolithic disorder predominantly caused by severe left ventricular dysfunction complicating acute myocardial infarction (AMI), there is increasing recognition of the diverse causes of cardiogenic shock and wide spectrum of clinical severity. The purpose of this review is to describe the contemporary epidemiology of cardiogenic shock, including trends in clinical outcomes and recent efforts to refine risk assessment. Read More

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Pathological findings in organs and tissues of patients with COVID-19: A systematic review.

PLoS One 2021 28;16(4):e0250708. Epub 2021 Apr 28.

Pan American Health Organization, Incident Management Systems for COVID-19, Washington, Columbia, United States of America.

Background: Coronavirus disease (COVID-19) is the pandemic caused by SARS-CoV-2 that has caused more than 2.2 million deaths worldwide. We summarize the reported pathologic findings on biopsy and autopsy in patients with severe/fatal COVID-19 and documented the presence and/or effect of SARS-CoV-2 in all organs. Read More

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Vasopressors in Trauma: A Never Event?

Anesth Analg 2021 07;133(1):68-79

Anesthesia and Critical Care-Réanimation, Hôpital Beaujon, Université de Paris, Paris, France.

Vasopressor use in severely injured trauma patients is discouraged due to concerns that vasoconstriction will worsen organ perfusion and result in increased mortality and organ failure in hypotensive trauma patients. Hypotensive resuscitation is advocated based on limited data that lower systolic blood pressure and mean arterial pressure will result in improved mortality. It is classically taught that hypotension and hypovolemia in trauma are associated with peripheral vasoconstriction. Read More

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Clinical Outcomes Associated With Acute Mechanical Circulatory Support Utilization in Heart Failure Related Cardiogenic Shock.

Circ Heart Fail 2021 May 27;14(5):e007924. Epub 2021 Apr 27.

The Cardiovascular Center, Tufts Medical Center, Boston, MA (K.L.T., J.L.H., N.M.H., N.K.K.).

Background: Cardiogenic shock occurring in the setting of advanced heart failure (HF-CS) is increasingly common. However, recent studies have focused almost exclusively on acute myocardial infarction-related CS. We sought to define clinical, hemodynamic, metabolic, and treatment parameters associated with clinical outcomes among patients with HF-CS, using data from the Cardiogenic Shock Working Group registry. Read More

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How to monitor cardiovascular function in critical illness in resource-limited settings.

Curr Opin Crit Care 2021 06;27(3):274-281

Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University, Bangkok, Thailand.

Purpose Of Review: Hemodynamic monitoring is an essential component in the care for critically ill patients. A range of tools are available and new approaches have been developed. This review summarizes their availability, affordability and feasibility for hospital settings in resource-limited settings. Read More

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Use of Indocyanine Green Angiography for Real-Time Assessment of a Sternocleidomastoid Muscle Flap During Complex Facial Reconstruction.

Cureus 2021 Mar 18;13(3):e13970. Epub 2021 Mar 18.

Otolaryngology-Head and Neck Surgery, Cleveland Clinic Florida, Weston, USA.

Indocyanine green (ICG) angiography is a procedure that uses a fluorescent dye for a variety of medical diagnostics, including the real-time examination of blood flow in tissue. Herein, we report a case in which ICG angiography was used to assess the viability of a sternocleidomastoid (SCM) muscle flap during post-parotidectomy facial reconstruction. To our knowledge, this is the first report documenting the intraoperative use of ICG for the evaluation of SCM flap perfusion. Read More

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Randomized Controlled Trial of Ultrasound-guided Fluid Resuscitation of Sepsis-Induced Hypoperfusion and Septic Shock.

West J Emerg Med 2021 Feb 10;22(2):369-378. Epub 2021 Feb 10.

Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Department of Emergency Medicine, Faculty of Medicine, Bangkok, Thailand.

Introduction: The ultrasound measurement of inferior vena cava (IVC) diameter change during respiratory phase to guide fluid resuscitation in shock patients is widely performed, but the benefit on reducing the mortality of sepsis patients is questionable. The study objective was to evaluate the 30-day mortality rate of patients with sepsis-induced tissue hypoperfusion (SITH) and septic shock (SS) treated with ultrasound-guided fluid management (UGFM) using ultrasonographic change of the IVC diameter during respiration compared with those treated with the usual-care strategy.

Methods: This was a randomized controlled trial conducted in an urban, university-affiliated tertiary-care hospital. Read More

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February 2021

Myocardial, renal and intestinal injury in liver resection surgery-A prospective observational pilot study.

Acta Anaesthesiol Scand 2021 08 16;65(7):886-894. Epub 2021 Apr 16.

Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background: Post-operative organ complications in liver resection surgery are not uncommon. This prospective observational pilot study was performed to evaluate the incidence, degree and timing of myocardial, renal and intestinal injury in patients undergoing liver resection surgery using the low central venous pressure (LCVP) technique and the Pringle manoeuvre.

Methods: Blood samples were obtained before, during and after elective liver resection until post-operative day (POD) 5. Read More

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The placenta and preeclampsia: villain or victim?

Am J Obstet Gynecol 2021 Mar 24. Epub 2021 Mar 24.

Molecular and Clinical Sciences Research Institute, St George's University of London, London, United Kingdom; Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's University Hospitals NHS Foundation Trust, London, United Kingdom. Electronic address:

Preeclampsia is a disease whose characterization has not changed in the 150 years since the cluster of signs associated with the disorder were first described. Although our understanding of the pathophysiology of preeclampsia has advanced considerably since then, there is still little consensus regarding the true etiology of preeclampsia. As a consequence, preeclampsia has earned the moniker "disease of theories," predominantly because the underlying biological mechanisms linking clinical epidemiologic findings to observed organ dysfunction in preeclampsia are far from clear. Read More

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Fluid requirement in adult dengue haemorrhagic fever patients during the critical phase of the illness: an observational study.

BMC Infect Dis 2021 Mar 20;21(1):286. Epub 2021 Mar 20.

Colombo South Teaching Hospital, Kalubowila, Sri Lanka.

Background: Dengue fever prevalence is rising globally and it causes significant morbidity and mortality. Fluid extravasation during the critical phase of dengue haemorrhagic fever (DHF) leads to shock, multi-organ failure and death if not resuscitated appropriately with fluids. The mainstay of management is judicious fluid replacement using a guideline based, calculated fluid quota of maintenance (M) fluid plus 5% deficit (M +  5% deficit) to prevent organ hypoperfusion. Read More

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