Osteotomy: The surgical cutting of a bone. (Dorland, 28th ed)Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Anseriformes: An order of BIRDS comprising the waterfowl, particularly DUCKS; GEESE; swans; and screamers.Urinary Catheterization: Passage of a CATHETER into the URINARY BLADDER or kidney.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Catheterization, Central Venous: Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein.Intermittent Urethral Catheterization: Insertion of a catheter into the urethra to drain the urine from the bladder at intervals as needed.Catheterization, Swan-Ganz: Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.Perimenopause: The transitional period before and after MENOPAUSE. Perimenopausal symptoms are associated with irregular MENSTRUAL CYCLE and widely fluctuated hormone levels. They may appear 6 years before menopause and subside 2 to 5 years after menopause.Catheters, Indwelling: Catheters designed to be left within an organ or passage for an extended period of time.Potamogetonaceae: A plant family of the order Najadales, subclass Alismatidae, class Liliopsida (monocotyledons).GeeseUrinary Retention: Inability to empty the URINARY BLADDER with voiding (URINATION).Influenza in Birds: Infection of domestic and wild fowl and other BIRDS with INFLUENZA A VIRUS. Avian influenza usually does not sicken birds, but can be highly pathogenic and fatal in domestic POULTRY.Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery and then joins the internal jugular vein to form the brachiocephalic vein.Schistosomatidae: A family of blood flukes of the class Trematoda which is found in animals and man. It Includes the genera Heterobilharzia, Schistosomatium, Schistosoma, Ornithobilharzia, Bilharziella, Trichobilharzia, Pseudobilharzia, and Austrobilharzia.Bird Diseases: Diseases of birds not considered poultry, therefore usually found in zoos, parks, and the wild. The concept is differentiated from POULTRY DISEASES which is for birds raised as a source of meat or eggs for human consumption, and usually found in barnyards, hatcheries, etc.Hypertension, Pulmonary: Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES.Women's Health: The concept covering the physical and mental conditions of women.Equipment Failure: Failure of equipment to perform to standard. The failure may be due to defects or improper use.Influenza A Virus, H5N1 Subtype: A subtype of INFLUENZA A VIRUS comprised of the surface proteins hemagglutinin 5 and neuraminidase 1. The H5N1 subtype, frequently referred to as the bird flu virus, is endemic in wild birds and very contagious among both domestic (POULTRY) and wild birds. It does not usually infect humans, but some cases have been reported.Catheters: A flexible, tubular device that is used to carry fluids into or from a blood vessel, hollow organ, or body cavity.Pulmonary Wedge Pressure: The blood pressure as recorded after wedging a CATHETER in a small PULMONARY ARTERY; believed to reflect the PRESSURE in the pulmonary CAPILLARIES.Urinary Bladder, Neurogenic: Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.Jugular Veins: Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins.Macau: Special Administrative Region of the People's Republic of China since December 20, 1999 with its own constitution. The island of Macau and adjacent islands are located off the southeast coast of China.Haemosporida: An order of heteroxenous protozoa in which the macrogamete and microgamont develop independently. A conoid is usually absent.Heart Defects, Congenital: Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.Hemostatic Techniques: Techniques for controlling bleeding.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Coumestrol: A daidzein derivative occurring naturally in forage crops which has some estrogenic activity.Menopause: The last menstrual period. Permanent cessation of menses (MENSTRUATION) is usually defined after 6 to 12 months of AMENORRHEA in a woman over 45 years of age. In the United States, menopause generally occurs in women between 48 and 55 years of age.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Punctures: Incision of tissues for injection of medication or for other diagnostic or therapeutic procedures. Punctures of the skin, for example may be used for diagnostic drainage; of blood vessels for diagnostic imaging procedures.Dominica: An island republic of the West Indies. Its capital is Roseau. It was discovered in 1493 by Columbus and held at different times by the French and the British in the 18th century. A member of the West Indies Federation, it achieved internal self-government in 1967 but became independent in 1978. It was named by Columbus who discovered it on Sunday, Domingo in Spanish, from the Latin Dominica dies, the Lord's Day. (From Webster's New Geographical Dictionary, 1988, p338 & Room, Brewer's Dictionary of Names, 1992, p151)Radial Artery: The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery.Phlebitis: Inflammation of a vein, often a vein in the leg. Phlebitis associated with a blood clot is called (THROMBOPHLEBITIS).Echocardiography, Doppler: Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.Climacteric: Physiologic period, characterized by endocrine, somatic, and psychic changes with the termination of ovarian function in the female. It may also accompany the normal diminution of sexual activity in the male.Equipment Design: Methods of creating machines and devices.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Femoral Vein: The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein.Animals, Wild: Animals considered to be wild or feral or not adapted for domestic use. It does not include wild animals in zoos for which ANIMALS, ZOO is available.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Central AmericaDucksAngiocardiography: Radiography of the heart and great vessels after injection of a contrast medium.Cardiology Service, Hospital: The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.Urinary Tract Infections: Inflammatory responses of the epithelium of the URINARY TRACT to microbial invasions. They are often bacterial infections with associated BACTERIURIA and PYURIA.Animal Migration: Periodic movements of animals in response to seasonal changes or reproductive instinct. Hormonal changes are the trigger in at least some animals. Most migrations are made for reasons of climatic change, feeding, or breeding.Cineangiography: Motion pictures of the passage of contrast medium through blood vessels.Fluoroscopy: Production of an image when x-rays strike a fluorescent screen.Cystostomy: Surgical creation of an opening (stoma) in the URINARY BLADDER for drainage.Heart Septal Defects, Ventricular: Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.Electrocardiography: Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.Far East: A geographic area of east and southeast Asia encompassing CHINA; HONG KONG; JAPAN; KOREA; MACAO; MONGOLIA; and TAIWAN.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Pulmonary Valve Stenosis: The pathologic narrowing of the orifice of the PULMONARY VALVE. This lesion restricts blood outflow from the RIGHT VENTRICLE to the PULMONARY ARTERY. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete.Angiography: Radiography of blood vessels after injection of a contrast medium.Heart Septum: This structure includes the thin muscular atrial septum between the two HEART ATRIA, and the thick muscular ventricular septum between the two HEART VENTRICLES.Birds: Warm-blooded VERTEBRATES possessing FEATHERS and belonging to the class Aves.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Radiography, Interventional: Diagnostic and therapeutic procedures that are invasive or surgical in nature, and require the expertise of a specially trained radiologist. In general, they are more invasive than diagnostic imaging but less invasive than major surgery. They often involve catheterization, fluoroscopy, or computed tomography. Some examples include percutaneous transhepatic cholangiography, percutaneous transthoracic biopsy, balloon angioplasty, and arterial embolization.Heart Septal Defects, Atrial: Developmental abnormalities in any portion of the ATRIAL SEPTUM resulting in abnormal communications between the two upper chambers of the heart. Classification of atrial septal defects is based on location of the communication and types of incomplete fusion of atrial septa with the ENDOCARDIAL CUSHIONS in the fetal heart. They include ostium primum, ostium secundum, sinus venosus, and coronary sinus defects.Cytochromes b: Cytochromes of the b group that have alpha-band absorption of 563-564 nm. They occur as subunits in MITOCHONDRIAL ELECTRON TRANSPORT COMPLEX III.Pericarditis, Constrictive: Inflammation of the PERICARDIUM that is characterized by the fibrous scarring and adhesion of both serous layers, the VISCERAL PERICARDIUM and the PARIETAL PERICARDIUM leading to the loss of pericardial cavity. The thickened pericardium severely restricts cardiac filling. Clinical signs include FATIGUE, muscle wasting, and WEIGHT LOSS.Coronary Artery Disease: Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.Cardiac Output: The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).Aortic Valve Stenosis: A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Urethral Diseases: Pathological processes involving the URETHRA.Pulmonary Circulation: The circulation of the BLOOD through the LUNGS.Heart Ventricles: The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.Iatrogenic Disease: Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.Coronary Disease: An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.Feathers: Flat keratinous structures found on the skin surface of birds. Feathers are made partly of a hollow shaft fringed with barbs. They constitute the plumage.Ventricular Function, Left: The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.Ventricular Pressure: The pressure within a CARDIAC VENTRICLE. Ventricular pressure waveforms can be measured in the beating heart by catheterization or estimated using imaging techniques (e.g., DOPPLER ECHOCARDIOGRAPHY). The information is useful in evaluating the function of the MYOCARDIUM; CARDIAC VALVES; and PERICARDIUM, particularly with simultaneous measurement of other (e.g., aortic or atrial) pressures.Urinary Catheters: Catheters inserted into the URINARY BLADDER or kidney for therapeutic or diagnostic purposes.Hot Flashes: A sudden, temporary sensation of heat predominantly experienced by some women during MENOPAUSE. (Random House Unabridged Dictionary, 2d ed)Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Heart Diseases: Pathological conditions involving the HEART including its structural and functional abnormalities.Cardiac Surgical Procedures: Surgery performed on the heart.Stroke Volume: The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.Virus Shedding: The expelling of virus particles from the body. Important routes include the respiratory tract, genital tract, and intestinal tract. Virus shedding is an important means of vertical transmission (INFECTIOUS DISEASE TRANSMISSION, VERTICAL).Cardiology: The study of the heart, its physiology, and its functions.Infant, Newborn: An infant during the first month after birth.Cardiac Care Facilities: Institutions specializing in the care of patients with heart disorders.United StatesVascular Resistance: The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.Exercise Test: Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Hysterosalpingography: Radiography of the uterus and fallopian tubes after the injection of a contrast medium.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Aneurysm, False: Not an aneurysm but a well-defined collection of blood and CONNECTIVE TISSUE outside the wall of a blood vessel or the heart. It is the containment of a ruptured blood vessel or heart, such as sealing a rupture of the left ventricle. False aneurysm is formed by organized THROMBUS and HEMATOMA in surrounding tissue.Urethra: A tube that transports URINE from the URINARY BLADDER to the outside of the body in both the sexes. It also has a reproductive function in the male by providing a passage for SPERM.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Atrial Septum: The thin membrane-like muscular structure separating the right and the left upper chambers (HEART ATRIA) of a heart.Contrast Media: Substances used to allow enhanced visualization of tissues.Hemothorax: Hemorrhage within the pleural cavity.Mitral Valve Stenosis: Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.Vena Cava, Superior: The venous trunk which returns blood from the head, neck, upper extremities and chest.Heart Bypass, Right: Diversion of the flow of blood from the entrance to the right atrium directly to the pulmonary arteries, avoiding the right atrium and right ventricle (Dorland, 28th ed). This a permanent procedure often performed to bypass a congenitally deformed right atrium or right ventricle.Certificate of Need: A certificate issued by a governmental body to an individual or organization proposing to construct or modify a health facility, or to offer a new or different service. The process of issuing the certificate is also included.European Continental Ancestry Group: Individuals whose ancestral origins are in the continent of Europe.Radiology, Interventional: Subspecialty of radiology that combines organ system radiography, catheter techniques and sectional imaging.Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart.Peritonitis: INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs.Embolism, Cholesterol: Blocking of a blood vessel by CHOLESTEROL-rich atheromatous deposits, generally occurring in the flow from a large artery to small arterial branches. It is also called arterial-arterial embolization or atheroembolism which may be spontaneous or iatrogenic. Patients with spontaneous atheroembolism often have painful, cyanotic digits of acute onset.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Urinary Bladder Diseases: Pathological processes of the URINARY BLADDER.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.African Americans: Persons living in the United States having origins in any of the black groups of Africa.Mitral Valve: The valve between the left atrium and left ventricle of the heart.Fontan Procedure: A procedure in which total right atrial or total caval blood flow is channeled directly into the pulmonary artery or into a small right ventricle that serves only as a conduit. The principal congenital malformations for which this operation is useful are TRICUSPID ATRESIA and single ventricle with pulmonary stenosis.Coronary Vessels: The veins and arteries of the HEART.Arteriovenous Fistula: An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.Hemorrhage: Bleeding or escape of blood from a vessel.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Angioplasty, Balloon: Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.Acute Coronary Syndrome: An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.Ultrasonography, Interventional: The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Pulmonary Atresia: A congenital heart defect characterized by the narrowing or complete absence of the opening between the RIGHT VENTRICLE and the PULMONARY ARTERY. Lacking a normal PULMONARY VALVE, unoxygenated blood in the right ventricle can not be effectively pumped into the lung for oxygenation. Clinical features include rapid breathing, CYANOSIS, right ventricle atrophy, and abnormal heart sounds (HEART MURMURS).Poultry: Domesticated birds raised for food. It typically includes CHICKENS; TURKEYS, DUCKS; GEESE; and others.Embolization, Therapeutic: A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.Coronary Vessel Anomalies: Malformations of CORONARY VESSELS, either arteries or veins. Included are anomalous origins of coronary arteries; ARTERIOVENOUS FISTULA; CORONARY ANEURYSM; MYOCARDIAL BRIDGING; and others.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Ductus Arteriosus, Patent: A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth.Asian Americans: Persons living in the United States having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent.Hematoma: A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue.Heart Atria: The chambers of the heart, to which the BLOOD returns from the circulation.Catheter-Related Infections: Infections resulting from the use of catheters. Proper aseptic technique, site of catheter placement, material composition, and virulence of the organism are all factors that can influence possible infection.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Heart: The hollow, muscular organ that maintains the circulation of the blood.Aortic Coarctation: A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).Heart Failure: A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.Ventricular Dysfunction, Left: A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.Cardiomyopathy, Restrictive: A form of CARDIAC MUSCLE disease in which the ventricular walls are excessively rigid, impeding ventricular filling. It is marked by reduced diastolic volume of either or both ventricles but normal or nearly normal systolic function. It may be idiopathic or associated with other diseases (ENDOMYOCARDIAL FIBROSIS or AMYLOIDOSIS) causing interstitial fibrosis.Retinal Artery Occlusion: Sudden ISCHEMIA in the RETINA due to blocked blood flow through the CENTRAL RETINAL ARTERY or its branches leading to sudden complete or partial loss of vision, respectively, in the eye.Vena Cava, Inferior: The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs.Hepatic Veins: Veins which drain the liver.Radiation ProtectionAlberta: A province of western Canada, lying between the provinces of British Columbia and Saskatchewan. Its capital is Edmonton. It was named in honor of Princess Louise Caroline Alberta, the fourth daughter of Queen Victoria. (From Webster's New Geographical Dictionary, 1988, p26 & Room, Brewer's Dictionary of Names, 1992, p12)Nitrofurazone: A topical anti-infective agent effective against gram-negative and gram-positive bacteria. It is used for superficial WOUNDS AND INJURIES and skin infections. Nitrofurazone has also been administered orally in the treatment of TRYPANOSOMIASIS.Urination Disorders: Abnormalities in the process of URINE voiding, including bladder control, frequency of URINATION, as well as the volume and composition of URINE.Tetralogy of Fallot: A combination of congenital heart defects consisting of four key features including VENTRICULAR SEPTAL DEFECTS; PULMONARY STENOSIS; RIGHT VENTRICULAR HYPERTROPHY; and a dextro-positioned AORTA. In this condition, blood from both ventricles (oxygen-rich and oxygen-poor) is pumped into the body often causing CYANOSIS.Veins: The vessels carrying blood away from the capillary beds.Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Diastole: Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.Percutaneous Coronary Intervention: A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.Bacterial Infections: Infections by bacteria, general or unspecified.Ventricular Function, Right: The hemodynamic and electrophysiological action of the right HEART VENTRICLE.Urodynamics: The mechanical laws of fluid dynamics as they apply to urine transport.Early Ambulation: Procedure to accelerate the ability of a patient to walk or move about by reducing the time to AMBULATION. It is characterized by a shorter period of hospitalization or recumbency than is normally practiced.Heart Valve Diseases: Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).Cardiomyopathy, Hypertrophic: A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).Urinary Bladder: A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION.Echocardiography, Transesophageal: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus.Whole Blood Coagulation Time: The time required by whole blood to produce a visible clot.Urination: Discharge of URINE, liquid waste processed by the KIDNEY, from the body.Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule.Blue Toe Syndrome: A condition that is caused by recurring atheroembolism in the lower extremities. It is characterized by cyanotic discoloration of the toes, usually the first, fourth, and fifth toes. Discoloration may extend to the lateral aspect of the foot. Despite the gangrene-like appearance, blue toes may respond to conservative therapy without amputation.Hirudins: Single-chain polypeptides of about 65 amino acids (7 kDa) from LEECHES that have a neutral hydrophobic N terminus, an acidic hydrophilic C terminus, and a compact, hydrophobic core region. Recombinant hirudins lack tyr-63 sulfation and are referred to as 'desulfato-hirudins'. They form a stable non-covalent complex with ALPHA-THROMBIN, thereby abolishing its ability to cleave FIBRINOGEN.Vaginal Fistula: An abnormal anatomical passage that connects the VAGINA to other organs, such as the bladder (VESICOVAGINAL FISTULA) or the rectum (RECTOVAGINAL FISTULA).Pulmonary Valve: A valve situated at the entrance to the pulmonary trunk from the right ventricle.Ecchymosis: Extravasation of blood into the skin, resulting in a nonelevated, rounded or irregular, blue or purplish patch, larger than a petechia.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.Intracranial Embolism: Blocking of a blood vessel in the SKULL by an EMBOLUS which can be a blood clot (THROMBUS) or other undissolved material in the blood stream. Most emboli are of cardiac origin and are associated with HEART DISEASES. Other non-cardiac sources of emboli are usually associated with VASCULAR DISEASES.Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb.Hospital Communication Systems: The transmission of messages to staff and patients within a hospital.Urinary Incontinence: Involuntary loss of URINE, such as leaking of urine. It is a symptom of various underlying pathological processes. Major types of incontinence include URINARY URGE INCONTINENCE and URINARY STRESS INCONTINENCE.Aortography: Radiographic visualization of the aorta and its branches by injection of contrast media, using percutaneous puncture or catheterization procedures.Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure.Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.Brachiocephalic Veins: Large veins on either side of the root of the neck formed by the junction of the internal jugular and subclavian veins. They drain blood from the head, neck, and upper extremities, and unite to form the superior vena cava.Mitral Valve Insufficiency: Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Peritoneal Dialysis, Continuous Ambulatory: Portable peritoneal dialysis using the continuous (24 hours a day, 7 days a week) presence of peritoneal dialysis solution in the peritoneal cavity except for periods of drainage and instillation of fresh solution.Ventricular Dysfunction, Right: A condition in which the RIGHT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE or MYOCARDIAL INFARCTION, and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the right ventricular wall.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Urethral Obstruction: Partial or complete blockage in any part of the URETHRA that can lead to difficulty or inability to empty the URINARY BLADDER. It is characterized by an enlarged, often damaged, bladder with frequent urges to void.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Geographic Information Systems: Computer systems capable of assembling, storing, manipulating, and displaying geographically referenced information, i.e. data identified according to their locations.Bacteriuria: The presence of bacteria in the urine which is normally bacteria-free. These bacteria are from the URINARY TRACT and are not contaminants of the surrounding tissues. Bacteriuria can be symptomatic or asymptomatic. Significant bacteriuria is an indicator of urinary tract infection.Pulmonary Veno-Occlusive Disease: Pathological process resulting in the fibrous obstruction of the small- and medium-sized PULMONARY VEINS and PULMONARY HYPERTENSION. Veno-occlusion can arise from fibrous proliferation of the VASCULAR INTIMA and VASCULAR MEDIA; THROMBOSIS; or a combination of both.Heparin: A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.Vascular System Injuries: Injuries to blood vessels caused by laceration, contusion, puncture, or crush and other types of injuries. Symptoms vary by site and mode of injuries and may include bleeding, bruising, swelling, pain, and numbness. It does not include injuries secondary to pathologic function or diseases such as ATHEROSCLEROSIS.Fetoscopes: Endoscopes for viewing the embryo, fetus and amniotic cavity.

Estimating venous admixture using a physiological simulator. (1/146)

Estimation of venous admixture in patients with impaired gas exchange allows monitoring of disease progression, efficacy of interventions and assessment of the optimal inspired oxygen fraction. A pulmonary artery catheter allows accurate measurement, although the associated risks preclude its use solely for estimation of venous admixture. Non-invasive methods require assumed values for physiological variables. Many of the required data (e.g. haemoglobin concentration (Hb), base excess, inspired oxygen fraction, arterial oxygen (PaO2) and carbon dioxide (PaCO2) tensions, temperature) are available routinely in the intensive therapy unit. We have compared a typical iso-shunt-style estimation of venous admixture (assuming Hb, base excess, PaCO2 and temperature), and estimation using the Nottingham physiology simulator (NPS), with measured data. When the arteriovenous oxygen content difference (CaO2-CvO2) was assumed to be 50 ml litre-1, the 95% limits of agreement (LA95%) for venous admixture using the NPS were -3.9 +/- 8.5% and using an iso-shunt-style calculation, -6.4 +/- 10.6%. CaO2-CvO2 was 41.1 ml litre-1 in the patients studied, consistent with previous studies in the critically ill. When CaO2-CvO2 was assumed to be 40 ml litre-1, LA95% values were 0.5 +/- 8.2% and -2.1 +/- 10.1%, respectively.  (+info)

Time-dependent pressure distortion in a catheter-transducer system: correction by fast flush. (2/146)

BACKGROUND: Distortion of the pressure wave by a liquid-filled catheter-transducer system leads most often to an overestimation in systolic arterial blood pressure in pulmonary and systemic circulations. The pressure distortion depends on the catheter-transducer frequency response. Many monitoring systems use either mechanical or electronic filters to reduce this distortion. Such filters assume, however, that the catheter-transducer frequency response does not change over time. The current study aimed to study the changes with time of the catheter-transducer frequency response and design a flush procedure to reverse these changes back to baseline. METHODS: An in vitro setup was devised to assess the catheter-transducer frequency response in conditions approximating some of those met in a clinical environment (slow flushing, 37 degrees C, 48-h test). Several flush protocols were assessed. RESULTS: Within 48 h, catheter-transducer natural frequency decreased from 17.89 +/- 0.36 (mean +/- SD) to 7.35 +/- 0.25 Hz, and the catheter-transducer damping coefficient increased from 0.234 +/- 0.004 to 0.356 +/- 0.010. Slow and rapid flushing by the flush device built into the pressure transducer did not correct these changes, which were reversed only by manual fast flush of the transducer and of the catheter. These changes and parallel changes in catheter-transducer compliance may be explained by bubbles inside the catheter-transducer. CONCLUSIONS: Catheter-transducer-induced blood pressure distortion changes with time. This change may be reversed by a manual fast flush or "rocket flush" procedure, allowing a con. stant correction by a filter.  (+info)

Effect of the mechanical ventilatory cycle on thermodilution right ventricular volumes and cardiac output. (3/146)

The purpose of this study was to evaluate right ventricular (RV) loading and cardiac output changes, by using the thermodilution technique, during the mechanical ventilatory cycle. Fifteen critically ill patients on mechanical ventilation, with 5 cmH(2)O of positive end-expiratory pressure, mean respiratory frequency of 18 breaths/min, and mean tidal volume of 708 ml, were studied with help of a rapid-response thermistor RV ejection fraction pulmonary artery catheter, allowing 5-ml room-temperature 5% isotonic dextrose thermodilution measurements of cardiac index (CI), stroke volume (SV) index, RV ejection fraction (RVEF), RV end-diastolic volume (RVEDV), and RV end-systolic volume (RVESV) indexes at 10% intervals of the mechanical ventilatory cycle. The ventilatory modulation of CI and RV volumes varied from patient to patient, and the interindividual variability was greater for the latter variables. Within patients also, RV volumes were modulated more by the ventilatory cycle than CI and SV index. Around a mean value of 3.95 +/- 1.18 l. min(-1). m(-2) (= 100%), CI varied from 87.3 +/- 5.2 (minimum) to 114.3 +/- 5.1% (maximum), and RVESV index varied between 61.5 +/- 17.8 and 149.3 +/- 34.1% of mean 55.1 +/- 17.9 ml/m(2) during the ventilatory cycle. The variations in the cycle exceeded the measurement error even though the latter was greater for RVEF and volumes than for CI and SV index. For mean values, there was an inspiratory decrease in RVEF and increase in RVESV, whereas a rise in RVEDV largely prevented a fall in SV index. We conclude that cyclic RV afterloading necessitates multiple thermodilution measurements equally spaced in the ventilatory cycle for reliable assessment of RV performance during mechanical ventilation of patients.  (+info)

Exercise hemodynamic findings in patients with exertional dyspnea. (4/146)

To determine whether upright bicycle exercise could provide useful information about disabling exertional dyspnea in the absence of severe abnormalities (as shown by traditional testing methods), we evaluated 13 such patients. There were 3 men and 10 women with a mean age of 49+/-15 (SD) years. We used pulmonary artery catheterization at rest and during upright bicycle exercise to evaluate these patients. All patients had normal left ventricular function except for 1, who had an ejection fraction of 45%. The mean duration to peak exercise was 9+/-6 minutes. Normal systolic pulmonary artery pressure was defined as 25+/-5 mmHg. Four patients had normal systolic pulmonary pressure, and 9 exhibited pulmonary hypertension with exercise. In those 9, the mean mixed pulmonary venous oxygen saturation at rest was 61%+/-9% and fell to 32%+/-9% at peak exercise. Six of the 9 patients also had some degree of resting pulmonary hypertension that worsened with exercise: their mean pulmonary artery systolic pressure at rest was 47+/-14 mmHg and rose to 75+/-25 mmHg at peak exertion (P = 0.01). The other 3 patients showed no pulmonary hypertension at rest; their mean pulmonary artery systolic pressure was 27+/-6 mmHg. However, this level rose to 53+/-4 mmHg at peak exertion (P = 0.04). In this pilot study of patients with dyspnea, 9 of 13 (69%) displayed marked pulmonary hypertension with exercise. The resting hemodynamic levels were normal in 3 (33%) of those with exercise pulmonary hypertension. We conclude that hemodynamic data from bicycle exercise tests can provide additional information regarding the mechanisms of exertional dyspnea.  (+info)

Relationships between volume and pressure measurements and stroke volume in critically ill patients. (5/146)

OBJECTIVE: To evaluate the relationships between the changes in stroke volume index (SVI), measured in both the aorta and the pulmonary artery, and the changes in intrathoracic blood volume index (ITBVI), as well as the relationship between changes in aortic SVI and changes in the pulmonary artery wedge pressure (PAWP). DESIGN: Prospective study with measurements at predetermined intervals. SETTING: Medical intensive care unit of a university hospital. PATIENTS AND METHODS: One hundred and fifty-four measurements were taken in 45 critically ill patients with varying underlying disorders. Aortic SVI and pulmonary arterial SVI were determined with thermodilution. PAWP was measured using a pulmonary artery catheter. ITBVI was determined with thermal-dye dilution, using a commercially available computer system. RESULTS: A good correlation was found between changes in ITBVI and changes in aortic SVI. However, this correlation weakened when changes in ITBVI were plotted against changes in pulmonary arterial SVI, which was in part probably due to mathematical coupling between ITBVI and aortic SVI. A good correlation between changes in ITBVI and changes in aortic SVI could also be established in most of the individual patients. No correlation was found between changes in PAWP and changes in aortic SVI. CONCLUSION: ITBVI seems to be a better predictor of SVI than PAWP. ITBVI may be more suitable than PAWP for assessing cardiac filling in clinical practice.  (+info)

Pulmonary artery catheterization and mortality in critically ill patients. (6/146)

Pulmonary artery catheters are widely used in intensive care, but evidence to support their widespread use in sparse. Some published data suggest that greater mortality is associated with use of these catheters. The largest study to date looked at > 5500 patients in several centres in America and found a greater 30 day mortality in those patients receiving a pulmonary artery catheter. We tested the hypothesis that, on our intensive care unit, mortality was greater for those patients receiving a pulmonary artery catheter. Using a propensity score to account for severity of illness, the odds ratio for mortality in those patients receiving a pulmonary artery catheter was 1.08 (95% confidence interval 0.87-1.33). We believe that continued use of the pulmonary artery catheter is safe; a large randomized controlled trial examining outcome is unlikely to provide an adequate answer.  (+info)

Percutaneous removal of a knotted pulmonary artery catheter using a tracheostomy dilator. (7/146)

STATEMENT OF FINDINGS: This case report describes removal of a knotted, subclavian, pulmonary artery catheter using a tracheostomy dilator. With this simple method an invasive procedure might be averted.  (+info)

Effects of high-dose glucose-insulin-potassium on myocardial metabolism after coronary surgery in patients with Type II diabetes. (8/146)

The effects of glucose-insulin-potassium (GIK) on cardiac metabolism have been studied previously in non-diabetic patients after cardiac surgery. Although patients with diabetes mellitus can be expected to benefit most from such treatment, the impact of GIK in diabetic patients undergoing cardiac surgery remains unexplored. Therefore the present study investigates the effects of high-dose GIK on myocardial substrate utilization after coronary surgery in patients with Type II diabetes. A total of 20 patients with Type II diabetes undergoing elective coronary surgery were randomly allocated to either post-operative high-dose GIK or standard post-operative care, including insulin infusion if necessary to keep blood glucose below 10 mmol/l. Myocardial substrate utilization was studied using the coronary sinus catheter technique. Haemodynamic state was assessed with the aid of Swan-Ganz catheters. High-dose GIK caused a shift towards carbohydrate utilization, with significant lactate uptake throughout the study period and significant uptake of glucose after 4 h. Arterial levels of non-esterified fatty acids and beta-hydroxybutyric acid decreased, and after 1 h no significant uptake of these substrates was found. Increases in the cardiac index and stroke volume index were found in patients treated with high-dose GIK. A decrease in systemic vascular resistance was found both in the control group and in the high-dose GIK group. We conclude that high-dose GIK can be used in diabetic patients after cardiac surgery to promote carbohydrate uptake at the expense of non-esterified fatty acids and beta-hydroxybutyric acid. This could have implications for treatment of the diabetic heart in association with surgery and ischaemia.  (+info)

*Mitral valve stenosis

The right heart catheterization (commonly known as Swan-Ganz catheterization) gives the physician the mean pulmonary capillary ... The left heart catheterization, on the other hand, gives the pressure in the left ventricle. By simultaneously taking these ... If a trans-septal puncture is made during right heart catheterization, however, the pressure gradient can accurately quantify ... because of the time lag in the pressure tracings seen on the right-heart catheterization and the slow Y descent seen on the ...

*List of MeSH codes (E02)

... catheterization, swan-ganz MeSH E02.148.442.110 --- catheter ablation MeSH E02.148.442.165 --- catheterization, swan-ganz MeSH ...

*List of MeSH codes (E01)

... catheterization, swan-ganz MeSH E01.370.370.380.450 --- kinetocardiography MeSH E01.370.370.380.600 --- oximetry MeSH E01.370. ... urinary catheterization MeSH E01.370.390.830 --- urography MeSH E01.370.400.925 --- work capacity evaluation MeSH E01.370. ... heart catheterization MeSH E01.370.370.380.410.200 --- catheter ablation MeSH E01.370.370.380.410.210 --- ...

*Quantium Medical Cardiac Output

The invasive methods like the still gold standard method Swan-ganz catheter (pulmonary artery catheter), based on transcardiac ... The minimally invasive methods also require catheterization, but less harmful. One of them is the Thermodilution Transpulmonary ...

*Pulmonary artery catheter

Swan, HJ; Ganz, W; Forrester, J; Marcus, H; et al. (August 1970). "Catheterization of the heart in man with use of a flow- ... The pulmonary artery catheter is frequently referred to as a Swan-Ganz catheter, in honor of its inventors Jeremy Swan and ... which had previously contracted with Swan as a consultant. After Swan developed the initial balloon tip, Ganz used Fronek's ... The standard pulmonary artery catheter has two lumens (Swan-Ganz) and is equipped with an inflatable balloon at the tip, which ...

*Cardiac output

The pulmonary artery catheter (PAC) introduced to clinical practice in 1970, also known as the Swan-Ganz catheter, provides ... The PAC remains useful in right-heart study done in cardiac catheterisation laboratories.[citation needed] The PAC is balloon ... The historically significant Swan-Ganz multi-lumen catheter allows reproducible calculation of cardiac output from a measured ... Can it replace the Swan-Ganz catheter?". The American Journal of Surgery. 196 (6): 961-68. doi:10.1016/j.amjsurg.2008.07.039. ...

*History of invasive and interventional cardiology

Ganz W, Buchbinder N, Marcus H, Mondkar A, Maddahi J, Charuzi Y, O'Connor L, Shell W, Fishbein MC, Kass R, Miyamoto A, Swan HJ ... Cardiac catheterization was first performed when Werner Forssmann, in 1929, created an incision in one of his left antecubital ... The history of invasive cardiology begins with the development of cardiac catheterization in 1711, when Stephen Hales placed ... For their work in the discovery of cardiac catheterization and hemodynamic measurements, Cournand, Forssmann, and Richards ...

*Impedance cardiography

... also known as the Swan-Ganz catheter), which represents significant risks to the patient. In addition, this technique is costly ... substudy of the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) Trial ...
Pulmonary artery catheterization is associated with numerous complications, including serious arrhythmias. We report a case where ventricular tachycardia occurred repeatedly during attempted pulmonary artery catheterization, precluding successful catheterization. Transesophageal echocardiography was used to image the tricuspid valve and right ventricle and revealed a Sinus of Valsalva aneurysm protruding significantly into the right ventricle and obstructing advancement of the pulmonary artery catheter. Our case reveals another identifiable cause of serious arrhythmia during pulmonary artery catheterization and highlights how transesophageal echocardiography can be useful in unanticipated ways during cardiac anesthesia and surgery. ...
BACKGROUND:. Congestive heart failure constitutes one of the major categories of morbidity, particularly in the elderly, and is responsible for the utilization of significant resources, including a large number of hospitalizations (estimated at 800,000 to 2.3 million per year) and related health care costs. In 1993, 4.7 million Americans carried the diagnosis of CHF, and about 400,000 new cases are diagnosed every year. It is estimated that there are 800,000 to 1.2 million CHF patients with NYHA class III-IV symptoms. The diagnosis and treatment of CHF and its episodes of decompensation can be facilitated by pulmonary artery catheter use, but its efficacy is highly dependent on the physicians experience in the treatment of such patients. Recently, concern has been raised about the benefits of PAC, also known as Swan-Ganz catheterization.. In response to concerns about the benefits and safety of PAC, the NHLBI and the Food and Drug Administration (FDA) co-sponsored a workshop in August 1997 ...
Catheterization - Incorrect Placement of Swan-Ganz Catheter with Subsequent Embolism and Stroke. This medical exhibit features multiple images describing correct vs. incorrect placement of a Swan-Ganz catheter into the right jugular region. The medical illustrations picture the catheter inserted through the jugular vein into the adjacent carotid artery. Over time a thrombus developed at the catheter tip, which eventually broke free resulting in a clot to the brain and subsequent brain injury.
This year marked the announcement of several landmark clinical studies using hemodynamic assessment to guide clinical management of patients with acute and chronic HF. First, results from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) have recently been published (21). In the ESCAPE trial, 433 subjects admitted with acute decompensated HF were randomized to receive either pulmonary artery catheter (PAC)-guided therapy or usual care. The patient population had rather advanced HF (mean left ventricular ejection fraction [LVEF] 19%, serum creatinine 1.5 mg/dl, 6-min walk ∼400 feet). At the end of six months, the primary end point of "total number of days patients are well" did not show any differences between the two groups (21). Overall mortality at six months was similar at 19%. This prospective, randomized controlled trial may have laid to rest concerns that use of PAC in patients with advanced HF is associated with increased death ...
The Swan-Ganz™ pulmonary artery catheter (PAC) delivers a comprehensive hemodynamic profile to help assess cardiovascular function and guide treatment decisions.
BACKGROUND: The pulmonary artery catheter (PAC) has been used in a wide-range of critically ill patients. It is not indicated for routine care of heart failure (HF) but its role in cardiogenic shock (CS) has not been clarified. METHODS AND RESULTS: We conducted a retrospective cohort study using the National Inpatient Sample and identified a total of 9,431,944 adult patients between 2004 and 2014 admitted with the primary diagnosis of HF (n=8,516,528) or who developed CS (n= 915,416) during the index hospitalization. Overall, patients with PAC had increased hospital costs, length of stay and mechanical circulatory support use. In patients with HF, PAC use was associated with higher mortality (9.9% vs. 3.3% OR 3.96 p|0.001) but the excess mortality declined over time. In those with CS, PAC was associated with lower mortality (35.1% vs. 39.2% OR 0.91 p|0.001) and in-hospital cardiac arrest (14.9% vs 18.3% OR 0.77 p|0.001); this paradox persisted after propensity score matching. CONCLUSION: The use of PAC
TY - JOUR. T1 - Pulmonary artery rupture induced by a pulmonary artery catheter. T2 - A case report and review of the literature. AU - Abreu, Alexandre. AU - Campos, Michael A. AU - Krieger, Bruce P.. PY - 2004/9/1. Y1 - 2004/9/1. N2 - Placement and use of pulmonary artery catheters (PACs) carry potential risks. The authors describe a case of a patient who developed massive hemoptysis after placement of a PAC that caused a rupture of the pulmonary artery with pseudoaneurysm formation. Treatment was successfully achieved with transcatheter coil embolization. Pulmonary artery rupture and pseudoaneurysm formation are among the most serious complications of PAC use because of the associated risk of mortality. Patients with this complication may be asymptomatic or may present with variable amounts of hemoptysis immediately or days after using a PAC. The gold standard diagnostic test is pulmonary angiography, and the treatment of choice for most patients is transcatheter embolization. Physicians and ...
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... noun, Anatomy. 1. an artery conveying venous blood from the right ventricle of the heart to the lungs. noun 1. either of the two arteries that convey oxyge
The diagnosis of pulmonary hypertension (PH) requires right heart catheterization (RHC), thus this diagnostic procedure becomes the gateway through which patients enter into management of PH, regardless of the etiology.
Acute lung injury (ALI) is a prevalent and devastating condition in the intensive care unit. Although pulmonary artery catheters (PAC) provide clinicians with important data about a patients haemodynamic status, doubts about their clinical benefit and worries about safety have raised questions about their usefulness. This study was designed to address this issue, with 1000 patients recruited in 20 North American centres. Patients were recruited after being diagnosed with ALI and were managed haemodynamically according to a standardised management protocol. 513 patients were randomised to have a PAC and 487 to have a standard central venous catheter (CVC).. Both the PAC and CVC groups had similar rates of death during the first 60 days (27.4% and 26.3% respectively, p = 0.69). Mean (SE) ventilator-free days were also similar (13.2 (0.5) and 13.5 (0.5), p = 0.58), as were the number of days not spent in the intensive care unit up to day 28 (12.0 (0.4) and 12.5 (0.5), p = 0.40). Using a PAC did ...
William E. Johnston, Roger L. Royster, Jakob Vinten-Johansen, Glenn P. Gravlee, George Howard, Stephen A. Mills, William Y. Tucker; Influence of Balloon Inflation and Deflation on Location of Pulmonary Artery Catheter Tip. Anesthesiology 1987;67(1):110-115. Download citation file:. ...
(Medical Xpress) -- A new Australian study has confirmed the accuracy of a modern non-invasive cardiac output monitor that can replace a 40-year-old standard in this field.
The complete Swan-Ganz. Lalli, Susan M. // RN;Sep78, Vol. 41 Issue 9, p64 Provides insights into the effectiveness of the use of Swan-Ganz catheter in patients with heart ailment. Role of the catheter as an aid in monitoring and treating critically ill patients; Possible risks of using the catheter; Processes involved in the use of the catheter. ...
Fluid optimization in the resuscitation of shock became the mainstay of treatment following the advent of Early Goal-Directed Therapy (EGDT) by Rivers et al. in 2001 [1]. Patients presenting in shock require prompt optimization of volume status and cardiac out- put to ensure adequate perfusion. Poor optimization may be associated with prolonged hospital and intensive care unit stays. The prior gold standard, pulmonary artery catheterization, is rarely available in the emergency department setting and its invasive nature has led to recent re-evaluation of its clinical utility. However, there are new monitoring technologies that are being studied in the intensive care unit setting that may soon be available in emergency departments to aid in nursing and physician decision making to improve acute resuscitation.
Discrepancies are frequently noted between the degree of lung involvement as shown by the roentgenogram and the severity of subjective symptoms of the patient. With the advent of pulmonary functional studies, such as bronchospirometry and pulmonary artery catheterization, discrepancies were still observed between the degree of functional impairment and the degree of involvement on the roentgen-ray picture. It is also well known that there is often very little correlation between cardiorespiratory insufficiency that is observed in silicotics and the degree of pulmonary involvement as seen both on roentgenographic picture and at postmortem examination. Reisner,1 in a review of sarcoidosis, stated ...
OBJECTIVE: To compare non-invasive hemodynamic measurements obtained in pregnant and postpartum women using two automated cardiac output monitors against those obtained by two-dimensional (2D) transthoracic echocardiography (TTE). METHODS: This was a cross-comparison study into which we recruited 114 healthy women, either with normal singleton pregnancy (across all three trimesters) or within 72 hours following delivery. Cardiac output estimations were obtained non-invasively using two different monitors, Ultrasound Cardiac Output Monitor (USCOM®, which uses continuous-wave Doppler analysis of transaortic blood flow) and Non-Invasive Cardiac Output Monitor (NICOM®, which uses thoracic bioreactance), and 2D-TTE ...
8501 NONINVASIVE DETERMINATION OF CARDIAC OUTPUT THROUGHOUT PREGNANCY -- CF James, T Banner, JP Levelle, D Cato 8502 NONINVASIVE DETERMINATION OF CARDIAC OUTPUT DURING VAGINAL DELIVERY -- JP Levelle, CF James, T Banner, D Cato 8503 CARDIAC OUTPUT CHANGES DURING PROSTAGLANDIN-INDUCED SECOND TRIMESTER TERMINATION OF PREGNANCY -- JP Levelle, DC CESAREAN DELIVERY -- AM Malinow, JS Naulty, BA Helton, et al 8505 A COMPARISON OF CVF VS SWAN-GANZ CATHETER IN THE MANAGE- MENT OF THE MODERATE TO SEVERE PRE-ECLAMPTIC: A PRACTICAL APPROACH -- L Hubbard, C Lang, BB Greenhouse, F Sheikh 8506 THE ROLE OF INTRAVENOUS NITKOGLYCERIN IN THE TREATMENT OF SEVERE PREGNANCY-INDUCED HYPERTENSION COMPLICATED BY PULMONARY EDEMA -- DE Cotton, MM Jones, S Longmire, et al 8507 title not visible -- D Cotton, K Dorman, T Joyce III 8508 USE OF NIFEDIPINE AND VERAPAMIL TO COUNTERACT HYPERTENSION IN GRAVID EWES -- MC Norris, JC Rose, DM Dewan 8509 MATERNAL AND FETAL EFFECTS OF NIFEDIPINE IN THE GRAVID EWE IN THE GRAVID EWE -- DD ...
DPJ-009 Assessment of Left Ventricular Stroke Volume Using Real-Time 3D Transesophageal Echocardiography During Cardiac Surgery : Direct Comparison Against Swan-Ganz Catheter(DPJ02,Cardiovascular Surgery/CABG (IHD),Digital Poster Session (Japanese),The 73rd Annual Scientific Meeting of The Japanese Circulation Society) (2009 ...
Szabo Z, Arnqvist H, Hakanson E, Jorfeldt L, Svedjeholm R: Effects of high-dose glucose-insulin-potassium on myocardial metabolism after coronary surgery in patients with type II diabetes. Clin Sci 101:37-43, 2001. Findings. Szabo et al. investigated the use of a glucose-insulin-potassium infusion (GIK) on myocardial substrate utilization after coronary surgery in 20 patients with type 2 diabetes. Patients were randomly allocated to either postoperative high-dose GIK or standard postoperative care, including insulin infusion, if necessary, to keep blood glucose ,10 mmol/l. Myocardial substrate utilization and hemodynamic status were studied using coronary sinus catheters and Swan-Ganz catheters, respectively. Infusion of GIK caused a shift toward carbohydrate utilization, with significant lactate uptake throughout the study period and significant uptake of glucose after 4 h. Arterial levels of nonesterified fatty acids and β-hydroxybutyric acid decreased, and after 1 h no significant uptake of ...
Pantin E, MD, Kraidin J, MD, Ginsberg S, MD, Denny J, MD, and Solina A, MD: Cannulation of the Middle Cardiac Vein during MICS, Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Vol 7.Pantin E, Kraidin J, Ginsberg S, Denny J, Anderson M, Solina A: The Swan-Ganz Catheter as a Teaching Tool for the Anesthesiologist Learning Minimally Invasive Cardiac Surgery, accepted for publication in Technology and Techniques in Cardiothoracic and Vascular Surgery, 7(3), p204-207, ...
Migration of a polyethylene catheter to the pulmonary artery has occurred on three occasions within a period of 9 months. Nonsurgical removal was accomplished in all cases with a snare device constructed of ordinary materials available in most hospitals equipped to perform cardiac catheterizations. Emphasis is on careful insertion and removal of the percutaneous polyethylene devices and the avoidance of entry sites of flexibility that allow shearing movement to occur. ...
Uscom announced the publication of a study demonstrating excellent correlation and agreement (96% and 95%) of the USCOM 1A with echocardiography, the current gold standard, for measurement of heart function. The USCOM 1A also identified the need for fluid with excellent sensitivity and specificity (95%) in the prospective, observational, multi-centre trial of 121 ICU patients.. Fluid is the most common critical care and peri-operative intervention in critically ill neonates, children and adults, with more than 50% of all fluids currently used being unnecessary or harmful. Fluid management remains one of the great clinical challenges in medicine, with particular relevance in paediatrics, anaesthesia, critical care and sepsis. An accurate and widely adopted solution to this problem has potentially enormous cost effectiveness benefits for medicine worldwide. This study demonstrates the USCOM 1A to be a cost effective solution to this problem.. A recent study of fluid administration in 655,426 ...
Uscom announced the publication of a study demonstrating excellent correlation and agreement (96% and 95%) of the USCOM 1A with echocardiography, the current gold standard, for measurement of heart function. The USCOM 1A also identified the need for fluid with excellent sensitivity and specificity (95%) in the prospective, observational, multi-centre trial of 121 ICU patients.. Fluid is the most common critical care and peri-operative intervention in critically ill neonates, children and adults, with more than 50% of all fluids currently used being unnecessary or harmful. Fluid management remains one of the great clinical challenges in medicine, with particular relevance in paediatrics, anaesthesia, critical care and sepsis. An accurate and widely adopted solution to this problem has potentially enormous cost effectiveness benefits for medicine worldwide. This study demonstrates the USCOM 1A to be a cost effective solution to this problem.. A recent study of fluid administration in 655,426 ...
A body-bias voltage source having an output monitor, charge pump, and shunt. A shunt circuit having on/off control is coupled to the output monitor and to the output of the charge pump. Upon sensing that the output voltage of the charge pump is above a desired value, the output monitor may disable the charge pump circuit and may enable the shunt circuit to reduce the voltage at the output of the charge pump. When the voltage output of the charge pump is below the desired value, the output monitor may disable the shunt circuit and may enable the charge pump circuit. A shunt circuit having proportional control may be substituted for the shunt circuit with on/off control.
Hi, Medicare has a LCD for the 93503 Swan-Ganz to be payable with only certain diagnosis codes. The LCD includes this for open heart as well as heart
Comparison of cardiac output using invasive (Pulmonary Artery catheter Continuous cardiac Output), less invasive (FloTrac) and non invasive (Pulse Wave Transit Time) methods in patients undergoing off pump coronary artery bypass grafting-IJCA-Print ISSN No:-2394-4781 Online ISSN No:-2394-4994Article DOI No:-10.18231/j.
The last decades less invasive monitoring and analytical tools have been developed for the evaluation of myocardial mechanics in clinical praxis. In critical care, these are longed-for complements to pulmonary artery catheter monitoring, additionally offering previously inaccessible information. This work is aimed, during fluid-replacement and oxygen therapy, to determine the physiological interface of ventricular and vascular mechanical properties, which result in the transfer of blood from the heart to appropriate circulatory beds. In prospective clinical studies we investigated previously cardiovascular healthy adults during hyperoxemia, and during preoperative acute normovolemic hemodilution or early fluid resuscitation of severe burn victims. Echocardiography was used in all studies, transthoracic for healthy volunteers and transesophageal for patients. For vascular parameters and for control purposes pulmonary artery Swan-Ganz catheter, calibrated external pulse recordings, whole body ...
The present invention is an organizational kit designed to help anesthesiologists when providing anesthesia during major surgery such as heart, thoracic, major vascular, and/or major abdominal. The invention helps the anesthesiologist organize the different intravenous and arterial lines, catheters, monitoring cables, pressure transducers and other devices coming from or going to the patient. It also serves as an educational tool for new anesthesia students, residents, fellows and new graduate anesthesiologists to help them understand how to connect the different ports coming out from the distal end of a Swan-Ganz catheter to their matching cables, monitor lines and transducers. The invention may serve as a reference for the doses and methods of administering common drugs used by the anesthesiologist intraoperatively. The invention also helps the practitioner set up the different modes of a pacemaker machine. The invention is designed to travel with the patient from the operating room to the recovery
Cardiac surgery patients are different from many other patients for a number of reasons when it comes to resuscitation post arrest. arterial line, Swan-ganz catheter (generally), and cardiac monitor; thus allowing for very early defibrillation without the use of external cardiac massage (ECM). ECM should be avoided if at all possible due to risk of […]. ...
Guy A Richards. It should be remembered that hemodynamic monitoring is not itself diagnostic of an underlying disease process unless the patient is merely hypovolemic. The following discussion does not therefore consider what further might be wrong with this patient, but this obviously warrants further attention. It is, however, necessary to support the patient until the primary disease responds and invasive monitoring would be useful to guide the use of vasoactive agents and fluid replacement. Clinical parameters alone are relatively inaccurate with regard to hemodynamic status in critically ill patients [11].. Parameters that are of particular value are cardiac output, pulmonary artery occlusion pressure, mixed venous oxygen saturation, right ventricular end diastolic volume, and systemic vascular resistance. Whereas some parameters may be obtainable with less invasive techniques, such as Doppler esophageal monitoring, only the PAC can easily and continuously or repetitively monitor them all. ...
Culture of Pulmonary Arterial Endothelial Cells from Pulmonary Artery Catheter Balloon Tips: Considerations for Use in Pulmonary Vascular Disease The authors cultured pulmonary artery endothelial cells (PAECs) from pulmonary artery catheter balloons used during right heart catheterization, to characterize successful culture attempts and to describe PAEC behavior. [Eur Respir J] Abstract Lymphatic Endothelial Cells Prime Naïve CD8+ T Cells into Memory Cells under Steady-State Conditions Researchers showed that while many proliferating lymphatic endothelial cell-educated T cells entered early apoptosis, the remainders comprised a long-lived memory subset, with transcriptional, metabolic, and phenotypic features of central memory and stem cell-like memory T cells. [Nat Commun] Full Article Endothelial ZEB1 Promotes Angiogenesis-Dependent Bone Formation and Reverses Osteoporosis Investigators showed that the zinc-finger transcription factor ZEB1 was predominantly expressed in CD31hiendomucinhi ...
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Jugular vein and carotid artery cannulations are among the most widely used surgeries in research labs around the world. These cannulations are extremely important for confirmed intravenous delivery
직장암으로 진단받은 55세 여자가 수술 절제술 후 화학요법을 위하여 외부 병원에서 케모포트 삽입술을 받았다. 이후 일상생활에 불편함 없이 지내오던 중 시술 10일 후 비교적 갑자기 발생한 1시간 동안의 일시적인 우측 다리 위약감과 구음장애가 발생하여 본원 응급실로 내원하였다. 내원 후 시행한 신체검사 및 신경학적 진찰에서는 특이 소견이 없었으나 확산강조영상(diffusion-weighted image)에서 우측 내측 측두엽(medial temporal lobe), 시상(thalamus) 및 우측 소뇌에 급성 뇌경색을 시사하는 다발성 고신호 강도 병변이 확인되었다(Fig. A-C). 대동맥 상방 전산화단층혈관조영술(supra-aortic computed tomography angiography)에서 우측 쇄골하동맥으로 케모포트 도관이 잘못 삽입되어 있는 것이 확인되었고(Fig. D) 그 주변으로 혈관내 혈전으로 의심되는 이상 음영이 확인되었다(Fig. ...
Central venous cannulation, with or without a flow-directed pulmonary artery catheter, is commonly performed in patients undergoing cardiac surgery to measure central filling pressure and cardiac output, and to administer medications and fluids. The
To inflate the balloon element on the distal end of a pulmonary artery catheter an improved gas syringe is provided which is both volume and pressure-limited so that the syringe is capable of discharg
Whole body O2 consumption is calculated by collecting expired gas in a spirometer and determining its O2 content, which is then subtracted from the calculated O2 content of inspired gas. The arterial O2 content can be measured in an arterial sample and the mixed venous blood O2 content is obtained from a pulmonary artery catheter. In the indicator dilution method, a known amount of a substance is injected into a vein and the concentration of the indicator in serial samples of arterial blood is determined. The output of the heart is equal to the amount of indicator injected divided by its average concentration in arterial blood after a single circulation through the heart. The cardiac output for that period is calculated and then converted to output per minute. ...
Reviewers: Amy Caron, MD and Michael Y. Woo, MD. Gunst M, Ghaemmaghami V, Sperry J, et al. Accuracy of cardiac function and volume status estimates using the bedside echocardiographic assessment in trauma/critical care. J Trauma. 2008 Sep;65(3):509-16.. Methods: The purpose of this study was to develop and evaluate a tool for non-cardiologists to use for echocardiographic assessment of cardiac function and intravascular volume status in critically ill patients. The group named their assessment the BEAT examination (Bedside Echocardiographic Assessment in Trauma/Critical Care), proposing that this is a tool potentially on par with the Focused Assessment with Sonography in Trauma (FAST) exam.. The study was a prospective observational cohort analysis of consecutively admitted surgical ICU patients at a Level I adult trauma center over a 6 month period. In order to be included in the study, patients had to have had a pulmonary artery catheter (PAC) placed in order to guide resuscitation of shock; ...
Edwards has been advancing the care of the acutely ill for more than 40 years. Starting with the development of Swan-Ganz advanced hemodynamic monitoring devices for measuring cardiovascular performance in high-risk surgical and critically ill patients, Edwards continues to evolve to less-invasive and noninvasive devices to provide valuable hemodynamic insight for an expanded patient population. Edwards has continued to advance hemodynamic monitoring platforms to enable proactive clinical decisions for surgical, anesthesia and critical care clinicians. Edwards is focused on helping clinicians enhance knowledge and standardize practice to improve the quality and efficiency of care. Edwards provides evidence-based programs such as Enhanced Surgical Recovery Program that support the implementation and compliance to protocolized care pathways in the OR and ICU.. Our vascular therapies products, including genuine Fogarty catheters, continue this high standard. Developed and refined in close ...
A CRNA completes 4 years of undergrad, specializing as an RN. The last 2 years are spent specializing in nursing practice and doing actual patient care at the bedside under supervision. A far cry from emptying bedpans, this includes insertion of oral gastric tubes, IVs, drawing arterial blood gases, inserting foley and rectal catheters, reading cardiac monitors, learning to regulate IV medications...many of which are potent, and so forth. Upon graduation the RN is required to spend a determined amount of time working as a critical care nurse before they can even apply for a CRNA program. In the ICU the RN becomes skilled at patient assessment, IV monitoring, use of ventilators, reading and determining meanings of Swan-Ganz readings (inserted into the hear), titrating potent drips, etc. As yes, the RN will empty bedpans because we are not above taking personal care of a patient. Most CRNA programs require that a CRNA applicant be a certified critical care RN (CCRN) before they will even ...
Objectives: To evaluate the effectiveness of pharyngeal intraluminal pressure reeording in the seIection of patients for polysomnography among those having snoring eomplaints. Patients and Methods: The study included nine patients with snoring eomplaints alone, nine patients who experienced snoring and more lhan five apnea attaeks per hour, and 10 healthy volunteers without snoring eomplaints. With the use of Swan-Ganz eatheters, intraluminal pressures were reeorded at the levels of nasopharynx, hypopharynx, and oropharynx in the supine pasition both at rest and following the induetion of negative pressure. Results: No significant differenees were found between patient groups and eontrols in the intraluminal pressures obtained at the level of nasopharynx. However, the results obtained at the levels of hypopharynx and oropharynx differed signifieantly between patients with snoring and apnea attaeks ( ...
ENGLISH ABSTRACT: Circulatory efficiency is the relationship between oxygen consumption and global oxygen delivery. Manipulation of circulatory efficiency has been shown to be beneficial in critically ill surgical and medical adults, and in children. Circulatory efficiency is best assessed by measuring an index of mixed venous oxygenation (content, saturation and partial pressure) and viewing this in the context of oxygen consumption. Mixed venous oxygenation has until now required intermittent sampling via a pulmonary artery catheter, or by using a pulmonary artery catheter equipped with a fibre optic bundle for continuous mixed venous oxygen saturation monitoring. However, the use of the pulmonary artery catheter is declining as it has been (correctly or incorrectly) indicted of being an "invasive" tool. Attempts have been made to estimate mixed venous oxygenation non-invasively using the "NICO" monitor[6], near infrared spectroscopy[7], skeletal muscle oxygen saturation[8], thenar muscle ...
Preoperative Evaluation. I. Fluid status. 1. How would you evaluate this patients state of hydration?. 2. What are the goals of your preoperative fluid management?. 3. Describe the body water composition of a 70 kg man.. Total body water is about 60% of the ideal body weight, or 42 liters. Of this, 60% is intracellular and 40% is extracellular.. II. Cardiac status. 1. How would you assess the adequacy of digitalization?. 2. Would a serum digoxin level be helpful?. 3. What is the significance of the potassium level?. III. Pulmonary status. I. Monitoring technique. 1. What special monitors will you use in this patient? Explain.. 2. What are general complications of pulmonary artery catheterization?. Complications include carotid puncture, infection, bleeding, coiling in the right ventricle, knot formation, failure to wedge, pulmonary artery perforation, venous air embolism, arrhythmias including right bundle branch block and complete heart block, infection, and mismanagement of spurious ...
Cardiovascular physical examination -- Heart murmurs and sounds -- Electrocardiography -- Chest x-ray -- Exercise stress testing -- Ambulatory electrocardiogram monitoring -- Echocardiography -- Nuclear cardiology -- Cardiac positron emission tomography -- Cardiac magnetic resonance imaging -- Cardiac computed tomography -- Swan-Ganz catheters and cardiac hemodynamics -- Coronary angiography and intracoronary imaging and physiologic assessment -- Chest pains and angina -- Chronic stable angina -- Non--ST-elevation acute coronary syndrome -- ST-elevation myocardial infarction -- Cardiogenic shock -- Percutaneous coronary intervention -- Coronary artery bypass surgery -- Myocarditis -- Dilated cardiomyopathy -- Heart failure with preserved ejection fraction -- Hypertrophic cardiomyopathy -- Restrictive cardiomyopathy -- Acute decompensated heart failure -- Heart failure : long-term management -- Heart transplantation -- Aortic stenosis -- Aortic regurgitation -- Mitral regurgitation -- Mitral ...
Table 3lists the postoperative data. All patients were extubated on the first postoperative day (14 ± 3 h). Postoperative blood requirements were low with the Jarvik-2000 LVAD, compared with traditional LVAD implantation. Swan-Ganz catheters were removed early (2.3 ± 0.5 days). Figure 2shows the cardiac index on the first postoperative day, as a function of the pump setting. The intensive care unit stay was seven days, due to a prolonged need for vasomotor support with alpha-agonists and vasopressin (Pitressin; 4.2 ± 1.5 days) to maintain a mean arterial pressure of 65 mm Hg. All patients presently have mild hemolysis not requiring transfusion, stable hemoglobin levels, increased lactate dehydrogenase levels, slightly increased reticulocytes and low haptoglobin levels, as illustrated in Figure 3. The end-diastolic diameters of the two patients with dilated cardiomyopathy decreased with postoperative unloading. There were two major postoperative events. One patient had a transient ischemic ...
Intraoperative Course. I. Selection of monitoring. 1. How will you assess the adequacy of renal perfusion during surgery? Explain.. 2. Is a pulmonary artery catheter necessary? Explain.. 3. After placement of a pulmonary artery catheter, pulmonary artery pressure is 55/32 mmHg, and the pulmonary artery occlusion pressure is 28 mmHg. What is your interpretation?. 4. Would you want additional information? Explain.. 5. What is your treatment?. II. Choice of anesthetic agents. 1. Is ketamine appropriate for induction? Explain.. 2. What is your choice for induction? Explain.. 3. What is your choice for maintenance? Give reasons.. 4. How do you control hypertension at the time of clamping?. 5. Does heart failure or renal insufficiency affect your selection of agents? Explain.. III. Management of muscle relaxation. 1. Is atracurium an appropriate muscle relaxant in this patient? Explain.. No. Atracurium is intermediate-acting, and is not significantly metabolized by the kidneys or the liver, as it is ...
BACKGROUND In cirrhotic patients, the degree of hepatic insufficiency has been related to a physiological landmark: arterial vasodilatation. We sought to assess how the severity of disease, which was stratified according to the Child-Pugh criteria, influences the pulmonary and systemic circulation among patients undergoing liver transplantation. METHODS We studied 86 cirrhotic patients in three groups: grade A (n = 10), grade B (n = 54), and grade C (n = 22). The outurnes were classified based upon a complete hemodynamic profile obtained using a pulmonary artery catheter (RVEF, Baxter-Edwards, Calif, USA) after induction of anesthesia. The variables were mean arterial and pulmonary artery pressures and cardiac index (CI). Using standard formulae, afterload was calculated as elastance of systemic (Es) and pulmonary (Ep) arterial beds, expressed by the ratio of end-systolic pressure to stroke volume. The relation between pulmonary and systemic circulation was also evaluated by the ratio (Ep/Es).
We have investigated the relation between occurrence of myocardial oxidative stress and functional recovery during postischemic reperfusion in 20 selected patients subjected to aortocoronary bypass grafting. Patients were selected for having normal percent ejection fraction and left ventricular end-diastolic pressure before the operation. Occurrence of oxidative stress was assessed by measuring the formation and release of oxidized glutathione (GSSG) in the coronary sinus immediately before aortic cross-clamp, 1, 5, 10, and 20 minutes after removal of aortic cross-clamp, and 10 and 20 minutes after the end of cardiopulmonary bypass. Reduced glutathione (GSH), lactate, and creatine phosphokinase release were also monitored with the same timing. Standard hemodynamic measurements were recorded by means of a triple-lumen thermodilution pulmonary artery catheter before sternotomy, 15 minutes after the end of cardiopulmonary bypass, and during the 24 hours after termination of cardiopulmonary bypass. ...
Surgical/invasive procedures falling within the scope of universal protocol guidelines include, but are not limited to, cardioversions, cardiac and vascular catheterizations (ie, pulmonary artery catheter placement and vasculare cannulation), transesophageal echocardiography, endoscopies, thoracentesis, chest tube insertions, paracentesis, lumbar puncture, incisions and drainage of wounds, and so on ...
The TemporalScanner Temporal Artery Thermometer is based on infrared readings of temporal artery blood flow. Its fast, accurate, noninvasive, and easy to use.. With a single stroke, the TemporalScanner Thermometer delivers temperature readings so accurate, they correlate with the gold standards of pulmonary artery catheters, esophageal probes, rectal temperature on a patient whose temperature has stabilized. When a patients temperature is rapidly changing, temporal artery temperature will identify the changes sooner than rectal temperature, even on infants 0-12 months. Theres no disrobing or probing. Nothing to disturb a sick or sleeping patient.. The unique TemporalScanner technology stands up to the demands of a high-performance workplace - including intensive care units, perioperative areas, and emergency departments. The TemporalScanner has long been preferred by nursing staff due to ease of use, non-invasiveness, no repositioning of patients, and less operator error than other methods of ...
Extracorporeal membrane oxygenation or ECMO is used for cardiac and/or respiratory failure when all other treatment modalities fail. Initially, ECMO was used only for oxygenating the blood, but later more emphasis was laid on removing carbon dioxide and the term extracorporeal carbon dioxide removal was coined. It is increasingly being used today in all ICUs because of its sleek design and portability. Two types of ECMO are known, the veno-venous (V-V) and veno-arterial (V-A) and indications for both are different. This chapter covers the history of ECMO, ECMO and the ELSO registry, factor affecting gaseous exchange, monitoring of ECMO, and future of ECMO. Complications like bleeding, thrombosis and emboli are known which decrease the ECMO flows. Echocardiography, NIRS, central/mixed venous oxygenation with precept/ pulmonary artery catheter, serum lactate and coagulation monitoring parameters like prothrombin time and fibrinogen level are essential parameters for monitoring in smooth ECMO run ...
Adequate delivery of oxygen to the tissues is an important factor both in the initial resuscitation of the shocked patient and subsequently in the development of multiple organ failure. The advent of the pulmonary artery catheter has facilitated the
A half year of a class called "Senior Team Leading". We worked a week, then were off a week. I do not remember my instructors well. I remember no supervision other than the head nurse. We were free help, and the hospital staffed the wards with us on the cheap.There were no CT scans back then. The pulmonary artery catheter was still a gleam in Dr. Swans eye.There were no beeping IV pumps that I remember. We gave medicines from little white cups lined up on a cart.Primitive indeed by todays standards, but quieter, more hushed. Now nurses look harassed. But 40 years ago they walked slowly down the halls in neat whites ...
Intravascular ultrasound (IVUS) is the most favorable imaging modality that often used in coronary artery catheterization procedures and provides cross-sectional images of arterial wall structures and extend of atherosclerosis disease. Although several techniques have been developed to classify atherosclerotic tissues, deploying IVUS radiofrequency (RF) backscattered signals and/or grayscale images their clinical applications have seen limited success. In this paper, we propose a unified methodological framework from data collection, histology preparation, registration, feature extraction, and classification to achieve a reliable in vitro trained tissue characterization classifier for in vivo applications. Finally, the results from proposed algorithm is compared with state of the art virtual histology (VH) technique ...
USCom is a fictitious nationwide data and long-distance voice service provider in the U.S. This chapter discusses the current USCom MPLS network design, its evolution, and how USCom characteristics and objectives influenced the corresponding design decisions that were made in order to illustrate how design decisions should stem from the characteristics of your company.
... announced today that it won FDA 510(k) clearance for its Rist Cath radial access long sheath for accessing the neurovasculature through the radial artery in the wrist. The Miami Beach, Fla.-based company touts the Rist Cath as the first device specifically designed to access the neurovasculature through the radial artery, … [Read more...] about FDA clears Rist Neurovascular radial artery catheter ...
In open-chest dogs, the greater and lesser circulations were perfused by a system of pumps and oxygenator. All blood was drained from the right heart and from the left atrium. in most experiments, there was no dissection around the pulmonary hila, the aorta, or the pulmonary artery. A 30-ml. balloon (Foley catheter) was inserted into the pulmonary artery through a stab wound in the wall of the right ventricle. Pressures were recorded in the pulmonary-artery balloon and in a femoral artery. In other experiments, the main pulmonary artery was distended with blood at known pressures after hydraulic isolation with ligatures and snares.. When the main pulmonary artery was distended proximal to its bifurcation, constriction of the systemic arteries occurred. This phenomenon was abolished by local anesthesia of the wall of the main pulmonary artery, by interrupting conduction in the vagi, by a sympatholytic drug, and by reflex systemic hypotension elicited by multiple small pulmonary emboli. The ...
The 3M Littmann Cardiology III Stethoscope combines outstanding acoustic performance with exceptional versatility. Its innovative design offers a patented tunable diaphragm on each side of the chestpiece.BenefitsDouble-sided chestpiece, for adult and pediatric auscultation Pediatric side can be converted to an open bell for low frequencies using non-chill bell sleeve (included).Pressure-based sound frequency adjustment with tunable diaphragm.Parallel noise-reducing sound channels in the tubes.. Product URL : http://solutions.3m.com/wps/portal/3M/en_US/3M- ...
A: Critical care experience must be obtained in a critical care area within the United States, its territories, or a U.S. military hospital outside of the United States. During this experience, the registered professional nurse has developed critical decision making and psychomotor skills, competency in patient assessment, and the ability to use and interpret advanced monitoring techniques. A critical care area is defined as one where, on a routine basis, the registered professional nurse manages one or more of the following: invasive hemodynamic monitors (such as pulmonary artery catheter, CVP, arterial), cardiac assist devices, mechanical ventilation, and vasoactive infusions. Examples of critical care units may include but are not limited to surgical intensive care, cardiothoracic intensive care, Coronary Intensive Care, Medical Intensive Care, Pediatric Intensive Care, and neonatal intensive care. Those who have experiences in other areas may be considered provided they can demonstrate ...
Has anybody in here installed either the RGF REME Air Purifier of the APCO Air Purifier. We have distributors that want to sell us both of these, but we would like some real world experience in how they work, and how hard they are to install (especially the REME).
Lash T. L., Fox M. P., Buist D. S., Wei F., Field T. S., Frost F. J., Geiger A. M., Quinn V. P., Yood M. U., Silliman R. A.. J Clin Oncol. 2007 Jun; 25(21):3001-6.. ...
TY - JOUR. T1 - Microvascular perfusion and resistance in extracorporeal cardiopulmonary bypass under hypothermia with high-dose narcotic anesthesia--animal model.. AU - Huang, F. Y.. AU - Chen, Ta-Liang. AU - Fan, S. Z.. AU - Sun, W. Z.. PY - 1990/3. Y1 - 1990/3. N2 - Microvascular perfusion of the liver, kidney (cortex and medulla), pancreas and spleen was measured by laser-Doppler flowmetry under hypothermia in extracorporeal cardiopulmonary bypass, to determine the effectiveness of high-dose fentanyl in improving the microcirculation of these visceral organs. Twenty-four mongrel dogs in two groups were monitored by arterial catheter, Swan-Ganz catheter and laser-Doppler flowmeter. Cardiopulmonary bypass was carried out to induce hypothermia to 20 degrees C through the cannulation of inferior vena cava and aorta. Microvascular perfusion was measured by either needle or suturable probes of laser-Doppler flowmeter in liver, kidney (cortex and medulla), pancreas and spleen. With high-dose of ...
There were no severe adverse events potentially related to blood pressure and no episodes of syncope reported in this study.Analysis of the safety database from controlled clinical trials showed no apparent difference in adverse reactions in patients taking VIAGRA with and without anti-hypertensive medication.In healthy male volunteers, there was no evidence of a clinically significant effect of azithromycin (500 mg daily for 3 days) on the systemic exposure of sildenafil or its major circulating metabolite.Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION).. In one small, open-label, uncontrolled, pilot study, eight patients with stable ischemic heart disease underwent Swan-Ganz catheterization.If you accidentally take too much VIAGRA, call your doctor or go to the nearest hospital emergency room right away.Find patient medical information for Viagra oral on WebMD including its uses, side effects and ...
Dear Ms Kraus:. APCO Worldwide states that, as part of its key values and mission, it will act with integrity, honesty and transparency and will tell the truth.. Furthermore, APCO Worldwide states that it will comply with the Code of Ethics of the Council of PR Firms. The Code states:. In communicating with the public and media, member firms will maintain total accuracy and truthfulness. To preserve both the reality and perception of professional integrity, information that is found to be misleading or erroneous will be promptly corrected and the sources of communications and sponsors of activities will not be concealed.. We are extremely disturbed to see APCO Worldwide currently acting in a manner that violates all your above commitments.. The Department of Occupational Safety & Health in Malaysia has called for a ban on all forms of asbestos in order to save peoples lives. As you perhaps know, the World Health Organization and the International Labor Organization, as well as the 175 million ...
Tidal volume (VT) 7ml Kg-1 of ideal body weight, respiratory rate 10 breaths.min-1, positive end-expiratory pressure (PEEP) 5 cmH2O, inspiratory plateau time (time of inspiratory hold) equal with 50% of total inspiratory time and fresh gas flow (FGF) 5 L.min-1. A screen pneumotachograph with a differential pressure-based flow sensor (RSS100-HR; Hans Rudolph, Kansas City, MO) and a pressure transducer will be inserted between the endotracheal tube and the Y piece of the respiratory circuit, for the measurement of flow and tidal volume and inspiratory pressures respectively. At the beginning of the study a first baseline measurement was obtained after endotracheal intubation and initiation of mechanical ventilation, before the administration of the volatile agents. Thereafter, anaesthesia was maintained with 1 MAC end tidal concentration of sevoflurane, isoflurane or desflurane. Measurements of flow and pressures were recorded for five consecutive breaths every five minutes for thirty minutes at 1 ...
Accurate and reliable detection of the onset of gait initiation is essential for the correct assessment of gait. Thus, this study was aimed at evaluation of the reliability and accuracy of 3 different center of pressure-based gait onset detection algorithms: A displacement baseline-based algorithm (method 1), a velocity baseline-based algorithm (method 2), and a velocity extrema-based algorithm (method 3). The center of pressure signal was obtained during 10 gait initiation trials from 16 healthy participants and 3 participants with Parkinsons disease. Intrasession and absolute reliability of each algorithm was assessed using the intraclass correlation coefficient and the coefficient of variation of center of pressure displacement during the postural phase of gait initiation. The accuracy was evaluated using the time error of the detected onset by each algorithm relative to that of visual inspection. The authors results revealed that although all 3 algorithms had high to very high intrasession ...
Accurate and reliable detection of the onset of gait initiation is essential for the correct assessment of gait. Thus, this study was aimed at evaluation of the reliability and accuracy of 3 different center of pressure-based gait onset detection algorithms: A displacement baseline-based algorithm (method 1), a velocity baseline-based algorithm (method 2), and a velocity extrema-based algorithm (method 3). The center of pressure signal was obtained during 10 gait initiation trials from 16 healthy participants and 3 participants with Parkinsons disease. Intrasession and absolute reliability of each algorithm was assessed using the intraclass correlation coefficient and the coefficient of variation of center of pressure displacement during the postural phase of gait initiation. The accuracy was evaluated using the time error of the detected onset by each algorithm relative to that of visual inspection. The authors results revealed that although all 3 algorithms had high to very high intrasession ...
Sheaths for insertion of pulmonary artery catheter or pacing wire ... Internal jugular : Halfway between mastoid process and sternal notch, lateral to ... - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 10f87e-MTkzY
Visit website for Pulmonary Capillary Wedge Pressure (PCWP) by E/e Calculator and a list of comprehensive, up-to-date and commercial-free Cardiology Tools
Click the title to purchase the article:. Abstract:. "Acute kidney injury after cardiac surgery is associated with increased morbidity and mortality. Methods for measuring urine output in real time may better ensure renal perfusion perioperatively in contrast to the current standard of care where urine output is visually estimated after empiric epochs of time. In this study, we describe an accurate method for monitoring urine output continuously during cardiopulmonary bypass. This may provide a means for setting patient-specific targets for blood pressure and cardiopulmonary bypass flow as a potential strategy to reduce the risk for acute kidney injury."1. ...
Philip Hostetler likes to joke that heart catheterizations "run in the family." After all, his grandfather, father and brother have all undergone this procedure. So it didnt come as a complete surprise when, after experiencing some heart arrhythmia this spring, his cardiologist ordered one for him as well.. Dr. Cyril Ofori mentioned there was a new catheterization procedure he might be a condidate for called radial artery catheterization. Hostetler jumped at the chance. "I was all over it. Let me try it," said Hostetler. ...
Sydney, Australia − Non-invasive cardiac monitoring company Uscom Limited (ASX:UCM) today announced the international presentation of independent data that confirms significant life-saving and cost reduction associated with USCOM guided treatment of sepsis and septic shock.
Randomized controlled trial of 433 patients at 26 sites randomized to receive therapy guided by clinical assessment and a PAC or clinical assessment alone. The target in both groups was resolution of clinical congestion, with additional PAC targets of a pulmonary capillary wedge pressure of 15 mm Hg and a right atrial pressure of 8 mm Hg. Medications were not specified, but inotrope use was explicitly discouraged. Results: PAC did not significantly affect the primary end point of days alive and out of the hospital during the first 6 months (p = 0.99), mortality (p = 0.35), or number of days hospitalized (p = 0.67). In-hospital adverse events were more common among patients in the PAC group (21.9% vs. 11.5%, p = 0.04), although there were no deaths related to PAC use.. ...
Koncentrirana emulzija, ki cilja na znake preobčutljivosti, nelagodja in razdraženosti. Serum odpravlja rdečico, srbečico in razdraženost, hkrati pa lajša žgoč občutek na koži. Formula je prijazna do integritete kože ter podpira vlaženje, kožno bariero ter splošno dermalno obnovo. AKTIVNE TEHNOLOGIJE Bioaktivni glukozi
No presente trabalho, foi desenvolvida uma metodologia one-pot para obtenção de produtos 4-cloro-1-hidroxinaftaleno-2-oxazolinas (Cl-HNO) 4, utilizando um excesso de SOCl2 a partir da amida 3a. Para a...
The aim of this study is to evaluate the optimization of local anesthetic effect with duplex ultrasound-guided injection of lidocaine before femoral artery puncture during diagnostic or therapeutic interventional procedures.. In total, 200 patients scheduled for various diagnostic or therapeutic interventional radiology procedures requiring femoral artery puncture, will be randomized in two groups after informed consent. Patients will be randomized to undergo groin local anesthesia with the proposed method of duplex ultrasound guided injection of lidocaine versus standard injection of lidocaine with manual palpation (control group).. The protocol includes the registration of patients demographics (age, gender, risk factors for peripheral arterial disease), arterial morphological characteristics (calcifications and presence of atheromatous disease), as well as technical details of the procedure (total puncture duration, sheath size, antegrade/retrograde puncture, etc.). Primary study endpoint ...
“Expiratory holding” approach in measuring end-expiratory pulmonary artery wedge pressure for mechanically ventilated patients Wanjie Yang,1 Xuefeng Zhao,1 Qingguo Feng,1 Youzhong An,2 Kai Wei,1 Wei Wang,1 Chang Li,1 Xiuling Cheng1 1Intensive Care Unit, the Fifth Central Hospital of Tianjin, Tianjin, People’s Republic of China; 2Intensive Care Unit, Peking University People’s Hospital, Beijing, People’s Republic of China Objective: To accurately measure the end-expiratory pulmonary artery wedge pressure (PAWP) with the “expiration holding” function on the ventilator and the “pulmonary artery wedge pressure review” software on the monitor. Materials and methods: Fifty prospective measurements were made on 12 patients undergoing pulmonary artery catheter and mechanical ventilation. All measurements were divided into <8 mmHg or ≥8 mmHg subgroups according to respiratory variability, and they were then subdivided into either an airway pressure
The aim of this study was to share our observations pertaining to the anatomy and position of the right internal jugular vein with respect to carotid artery
How is Pulmonary Artery Capillary Wedge Pressure abbreviated? PACWP stands for Pulmonary Artery Capillary Wedge Pressure. PACWP is defined as Pulmonary Artery Capillary Wedge Pressure very rarely.
Elsevier has published the fifth edition of Dr. Morton J. Kerns Cardiac Catheterization Handbook, the leading medical text about cardiac catheterization.. Kern is UC Irvines Associate Chief of Cardiology and is chief of cardiology at the Long Beach Veterans Affairs Hospital.. The book is the leading medical text about cardiac catheterization and includes the latest information about transradial artery catheterization. The technique is considered more comfortable for patients and has fewer complications than the traditional femoral artery approach.. The book also:. ...
Guidelines are available for nomenclature of coronary artery segments, used in coronary artery catheterization and thrombolysis in myocardial infarction flow (TIMI flow). The TIMI flow is expressed as grade 0, grade 1, grade 2, or grade 3, from lowest flow (or severest lesion) to highest flow. |
Guidelines are available for nomenclature of coronary artery segments, used in coronary artery catheterization and thrombolysis in myocardial infarction flow (TIMI flow). The TIMI flow is expressed as grade 0, grade 1, grade 2, or grade 3, from lowest flow (or severest lesion) to highest flow. |
Cardiac output (CO) is commonly measured using the thermodilution technique at the time of right heart catheterisation (RHC). However inter-operator variability, and the operator characteristics...
A thermodilution catheter assembly for use in determining cardiac output includes a special connector for joining the catheter to the output computer. Catheter size indicator links housed in the connector automatically communicate the size of the catheter to the computer when the connection is made. As an optional feature, the connector additionally includes means to automatically energize the computer when the connection is made.
Prem Watsa and Fairfax Financial Holding Limited; Top Holdings: JNJ, ABH, DELL, FTR, ICO, Stocks: FFH,JNJ,FTR,ICO,DELL,ABH, Prem Watsa, release date:Feb 18, 2011
article{42cd1e76-58ed-4440-9f9b-09869aa11dbd, author = {Chew, Michelle and Poelaert, Jan}, issn = {0342-4642}, language = {eng}, number = {11}, pages = {1889--1894}, publisher = {Springer}, series = {Intensive Care Medicine}, title = {Accuracy and repeatability of pediatric cardiac output measurement using Doppler: 20-year review of the literature.}, url = {http://dx.doi.org/10.1007/s00134-003-1967-9}, volume = {29}, year = {2003 ...
A replacement part for the Advanced Catheterization Trainer (60150) or Female Catheterization Trainer (60155) It can be used as a stand-alone unit or inserted into lower torso shell. 60150 and 60155 will be discontinued in 2020. This replacement part will remain available until December 2022.
Optimum Medical provides clinicians a choice, with a range of catheterisation jelly. OptiLube, OptiLube Active and OptiLube Active CHG Free.
Purpose of the study: Early out-of-hospital induction of mild hypothermia after cardiac arrest needs an easy to use and accurate core temperature monitoring, which might be achievable with tracheal temperature measurement. The aim of the study was to evaluate which tracheal temperature site (Ttra) reflects best pulmonary artery temperature (Tpa) during the induction of mild hypothermia.. Methods: Eight pigs (29 -38 kg) were anesthetized and intubated with a specially designed endotracheal tube with three temperature probes: Ttra1 was attached to the wall of the tube, 1 cm proximal to the cuff-balloon, without contact to the mucosa; Ttra2 and Ttra3 were placed on the cuff-balloon with tight contact to the mucosa, whereas Ttra3 was covered by a plastic tube to protect the mucosa. Core temperature was measured with a pulmonary artery catheter (Tpa). Pigs were cooled with a new surface cooling device (Emcoolspad®, Vienna, Austria). Data are presented as mean (±SD), and mean differences (95% ...
Minimally-invasive cardiac output (CO) monitoring to follow changes in CO would be helpful in anaesthesia practice. Two Doppler systems marketed for this purpose include the CardioQ (Deltex Medical Group, Chichester, United Kingdom), which uses an oesophageal probe, and the USCOM (USCOM Ltd., Sydney, NSW, Australia), which uses a hand-held probe. The aim of the study was to assess the ability of these two methods to track CO during major surgery and to determine their relationship. Twenty patients, age 58 (26 to 81) years, (m/f) 15/5, requiring abdominal surgery were studied. The surgical procedures lasted between 128 and 408 minutes and a total of 285 data pairs (8 to 22 per case) were collected. Time plots showed good tracking ability across a wide range of CO in most patients. Correlation between the two devices was excellent in 14 patients (R-2 >0.85), good in another four (R-2 >0.64) and poor in two. Regression line data supported the hypothesis that CardioQ under-reads at low CO and ...
Motorolas APCO system, high performance digital mobile/portable radio communications for use by federal, state and local public safety agencies.
Certain statements included in this press release may be considered forward-looking statements" within the meaning of applicable securities laws. Forward-looking statements can be identified by words such as: "anticipate," "intend," "plan," "goal," "seek," "believe," "project," "estimate," "expect," "strategy," "future," "likely," "may," "should," "will," and similar references to future periods and includes, but is not limited to, statements about the intended use of proceeds of the Offering. Such statements involve known and unknown risks, uncertainties and other factors that may cause actual results, performance or achievements to be materially different from those implied by such statements, and therefore these statements should not be read as guarantees of future performance or results. All forward-looking statements are based on iCos current beliefs as well as assumptions made by and information currently available to iCo and relate to, among other things, anticipated financial ...
Thomas Jefferson University Hospital has a busy cardiac surgery service that has been ranked as one of the best in the nation. Our residents spend a minimum of two months on the cardiac anesthesia service. During this time they acquire the knowledge and technical skills needed for the anesthetic management of complex cardiac surgery patients. Our residents are exposed to a wide variety of cardiac surgical procedures including minimally invasive techniques, repair of simple congenital heart defects, the use of biventricular assist devices as a bridge to cardiac transplantation, as well as cardiac transplantation. The cardiac rotation enables the resident to become familiar with cardiac pathopysiologic conditions including severe left ventricular dysfunction, myocardial ischemia, pulmonary hypertension, and cardiac dysrhythmias. Residents have the opportunity to gain expertise in the placement of arterial lines, central venous pressure lines, and pulmonary artery catheters. Bispectral ...
Cardiac output; Adolf Eugen Fick (1829-1901) in 1870, was the first to measure cardiac output; assumes oxygen consumption is a function of rate of blood flow and rate of oxygen pick pick up by RBCs.
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Swan Ganz catheterization: MedlinePlus Medical Encyclopedia ImageSwan Ganz catheterization: MedlinePlus Medical Encyclopedia Image

Right heart catheterization involves the passage of a catheter (a thin flexible tube) into the right side of the heart to ... Right heart catheterization involves the passage of a catheter (a thin flexible tube) into the right side of the heart to ...
more infohttps://medlineplus.gov/ency/imagepages/18087.htm

Swan-Ganz - right heart catheterization: MedlinePlus Medical EncyclopediaSwan-Ganz - right heart catheterization: MedlinePlus Medical Encyclopedia

Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to ... Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to ... Swan-Ganz catheterization can also be used to detect abnormal blood flow between two areas of the heart that are not normally ... Hermann J. Cardiac catheterization. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwalds Heart ...
more infohttps://medlineplus.gov/ency/article/003870.htm

Swan-Ganz catheterization | definition of Swan-Ganz catheterization by Medical dictionarySwan-Ganz catheterization | definition of Swan-Ganz catheterization by Medical dictionary

What is Swan-Ganz catheterization? Meaning of Swan-Ganz catheterization medical term. What does Swan-Ganz catheterization mean? ... Looking for online definition of Swan-Ganz catheterization in the Medical Dictionary? Swan-Ganz catheterization explanation ... Swan-Ganz catheterization. Swan-Ganz catheterization. Interventional cardiology Insertion of a SG catheter into the pulmonary ... medical-dictionary.thefreedictionary.com/Swan-Ganz+catheterization,Swan-Ganz catheterization,/a,. *Facebook ...
more infohttps://medical-dictionary.thefreedictionary.com/Swan-Ganz+catheterization

EconPapers: Treatment Effect Bounds: An Application to Swan-Ganz CatheterizationEconPapers: Treatment Effect Bounds: An Application to Swan-Ganz Catheterization

1996) on the impact of Swan-Ganz catheterization on ... 1996) on the impact of Swan-Ganz catheterization on mortality ... Treatment Effect Bounds: An Application to Swan-Ganz Catheterization. Jay Bhattacharya, Azeem Shaikh (. ) and Edward Vytlacil ( ... Journal Article: Treatment effect bounds: An application to Swan-Ganz catheterization (2012) This item may be available ... "Treatment Effect Bounds under Monotonicity Assumptions: An Application to Swan-Ganz Catheterization." American Economic Review ...
more infohttps://econpapers.repec.org/paper/nbrnberwo/11263.htm

Understanding the Difference: Swan-Ganz Catheterization vs. Right Heart CatheterizationUnderstanding the Difference: Swan-Ganz Catheterization vs. Right Heart Catheterization

Do your physicians document right heart catheterizations when they actually performed a Swan-Ganz catheterization? How to avoid ... Lets first look at what a Swan-Ganz catheterization is and how the procedure is performed. The Swan-Ganz catheter is ... What is the difference between a diagnostic right heart catheterization (RHC) and a Swan-Ganz procedure? Since the Swan-Ganz ... page 39 addresses the coding of Swan-Ganz catheterization. Only the code for placement of the Swan-Ganz device is coded. Unless ...
more infohttps://www.mrahis.com/understanding-the-difference-swan-ganz-catheterization-vs-right-heart-catheterization/

Pulmonary Hypertension Diagnosis and Swan Ganz CatheterizationPulmonary Hypertension Diagnosis and Swan Ganz Catheterization

Learn more about pulmonary hypertension diagnosis and how Swan Ganz catheterization can help with getting an accurate and ... Tagged diagnosis, PH, Pulmonary hypertension (PH), Swan Ganz Catheterization.. Post navigation. Previous: 2nd Annual ... Also discussed is the Swan Ganz catheterization - how it works and how it can help with getting an accurate and faster ...
more infohttps://pulmonaryhypertensionnews.com/2016/05/26/10715/

Pulmonary Artery (Swan-Ganz) Catheterization | Reichmans Emergency Medicine Procedures, 3e | AccessEmergency Medicine | McGraw...Pulmonary Artery (Swan-Ganz) Catheterization | Reichman's Emergency Medicine Procedures, 3e | AccessEmergency Medicine | McGraw...

"Pulmonary Artery (Swan-Ganz) Catheterization." Reichmans Emergency Medicine Procedures, 3e Reichman EF. Reichman E.F. Ed. Eric ... Neuman J, Mann J. Neuman J, Mann J Neuman, J. Elizabeth, and Jessica Mann.Pulmonary Artery (Swan-Ganz) Catheterization. In: ... After that time, various devices and techniques evolved until Swan and Ganz developed the balloon-tipped pulmonary artery ... "Swan-Ganz catheter" has been used almost exclusively in the intensive care setting ever since, with an estimated 1 million PACs ...
more infohttps://accessemergencymedicine.mhmedical.com/content.aspx?bookid=2498§ionid=201309688

Pulmonary Artery (Swan-Ganz) Catheterization and Hemodynamic Parameters | Pocket ICU ManagementPulmonary Artery (Swan-Ganz) Catheterization and Hemodynamic Parameters | Pocket ICU Management

Catheterization and Hemodynamic Parameters answers are found in the Pocket ICU Management powered by Unbound Medicine. ... Catheterization_and_Hemodynamic_Parameters. Pulmonary Artery (Swan-Ganz) Catheterization and Hemodynamic Parameters. Pocket ICU ... Catheterization_and_Hemodynamic_Parameters. Accessed January 28, 2020.. Pulmonary Artery (Swan-Ganz) Catheterization and ... Catheterization_and_Hemodynamic_Parameters. Pulmonary Artery (Swan-Ganz) Catheterization and Hemodynamic Parameters [Internet ...
more infohttps://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534055/all/Pulmonary_Artery__Swan_Ganz__Catheterization_and_Hemodynamic_Parameters

Swan-Ganz - right heart catheterization | UF Health, University of Florida HealthSwan-Ganz - right heart catheterization | UF Health, University of Florida Health

DefinitionSwan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries ... Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to ... Swan-Ganz catheterization can also be used to detect abnormal blood flow between two areas of the heart that are not normally ... Right heart catheterization; Catheterization - right heart. How the Test is Performed. The test can be done while you are in ...
more infohttps://ufhealth.org/swan-ganz-right-heart-catheterization

Swan-Ganz - right heart catheterization: Research Studies | UF Health, University of Florida HealthSwan-Ganz - right heart catheterization: Research Studies | UF Health, University of Florida Health

... right heart catheterizationSwan-Ganz - right heart catheterization: Research Studies. Swan-Ganz - right heart catheterization: ...
more infohttps://ufhealth.org/swan-ganz-right-heart-catheterization/research-studies

Catheterization - Incorrect Placement of Swan-Ganz Catheter with Subsequent Embolism and Stroke | Doctor StockCatheterization - Incorrect Placement of Swan-Ganz Catheter with Subsequent Embolism and Stroke | Doctor Stock

incorrect placement of a Swan-Ganz catheter into the right jugular region. The medical illustrations picture the catheter ... Incorrect Placement of Swan-Ganz Catheter with Subsequent Embolism and Stroke. This medical exhibit features multiple images ... Catheterization - Incorrect Placement of Swan-Ganz Catheter with Subsequent Embolism and Stroke. This medical exhibit features ... incorrect placement of a Swan-Ganz catheter into the right jugular region. The medical illustrations picture the catheter ...
more infohttps://doctorstock.photoshelter.com/img-show?_bqG=24&_bqH=eJwrMU91Twv0i0qMcExOTCnPTTLOLHCMLHTxz_W0MjG3MjK1MjQAAivPeJdgZ9vkxKL8kswUNTAv3tHPxbYEyA4Ndg2K93SxDQWpLDc3SCktr0hO9y1Xi3d0DrEtTk0sSs4AALTzIOk-&GI_ID=

Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) - Full Text View -...Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) - Full Text View -...

Recently, concern has been raised about the benefits of PAC, also known as Swan-Ganz catheterization. ... Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE). The safety and ... To compare the efficacy of Pulmonary Artery Catheterization (PAC)-directed treatment strategy to a non-invasive treatment ... Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA. 2005 ...
more infohttps://clinicaltrials.gov/ct2/show/study/NCT00000619?show_desc=Y

The Gale Encyclopedia of Nursing and Allied Health, 4th Edition - Gale - 978-1410363206
	The Gale Encyclopedia of Nursing and Allied Health, 4th Edition - Gale - 978-1410363206

Swan-Ganz catheterization.. Syncope.. Syphilis.. Syphilis tests.. Syringe and needle.. Tai chi.. Taste.. Technetium heart scan ... Catheterization, female.. Catheterization, male.. Cell division.. Cell membranes.. Cellular functions.. Centers for Medicare ... Cardiac catheterization.. Cardiac cycle.. Cardiac marker tests.. Cardiac monitor.. Cardiac rehabilitation.. Cardiac technology. ...
more infohttps://www.cengage.com/search/productOverview.do?N=197+4294917619+4294892091&Ntk=P_EPI&Ntt=137915243091627258019532233711986860275&Ntx=mode%2Bmatchallpartial

Dr. Douglas Mienk, MD - Clare, MI - Internal Medicine | Healthgrades.comDr. Douglas Mienk, MD - Clare, MI - Internal Medicine | Healthgrades.com

Right Heart Catheterization (Swan-Ganz). *Stress Test. *Thoracentesis. Background Check. Malpractice Claims not available. What ...
more infohttps://www.healthgrades.com/physician/dr-douglas-mienk-24tg9

Dr. Nikhilesh Agarwal, MD - York, PA - General Surgery & Surgery | Healthgrades.comDr. Nikhilesh Agarwal, MD - York, PA - General Surgery & Surgery | Healthgrades.com

Right Heart Catheterization (Swan-Ganz). *Small Bowel Resection. *Small Bowel Surgery. *Splenectomy ...
more infohttps://www.healthgrades.com/physician/dr-nikhilesh-agarwal-x59q9

The pulmonary physician in critical care • Illustrative case 7: Assessment and management of massive haemoptysis | ThoraxThe pulmonary physician in critical care • Illustrative case 7: Assessment and management of massive haemoptysis | Thorax

32 The development and application of coaxial microcatheter systems allows more selective catheterisation and embolisation of ...
more infohttp://thorax.bmj.com/content/58/9/814

Nitrate and Hypertension in Heart Transplanted PatientsNitrate and Hypertension in Heart Transplanted Patients

Catheterization, Swan-ganz. Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, ... Methods: We included 18 hypertensive patients (HT) scheduled for elective cardiac catheterization after heart transplantation ...
more infohttps://www.bioportfolio.com/resources/trial/101005/Nitrate-and-Hypertension-in-Heart-Transplanted-Patients.html

Migration of covered stents from hemodialysis A-V access to the pulmonary artery: percutaneous stent retrieval and procedural...Migration of covered stents from hemodialysis A-V access to the pulmonary artery: percutaneous stent retrieval and procedural...

Catheterization, Swan-Ganz*. Device Removal*. Female. Foreign-Body Migration / etiology, radiography, therapy*. Graft Occlusion ... Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & ...
more infohttp://www.biomedsearch.com/nih/Migration-covered-stents-from-hemodialysis/20882665.html

Clinical Study to Evaluate the Catheter Robotics Amigo for Performing Right-Sided Electrophysiology Mapping StudiesClinical Study to Evaluate the Catheter Robotics Amigo for Performing Right-Sided Electrophysiology Mapping Studies

Catheterization, Swan-ganz. Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, ... It can be measured directly by using a pressure catheter (see HEART CATHETERIZATION). It can be also estimated using various ...
more infohttps://www.bioportfolio.com/resources/trial/64079/Clinical-Study-to-Evaluate-the-Catheter-Robotics-Amigo-for-Performing-Right-Sided.html

Encyclopedia of Intensive Care Medicine - Springer Science+Business Media - Literati by CredoEncyclopedia of Intensive Care Medicine - Springer Science+Business Media - Literati by Credo

Swan-Ganz Catheterization. *Sylvatic. *Sympathetic Denervation. *Synchronized Assist. *Synchronized Ventilation. *Syncope. * ...
more infohttps://corp.credoreference.com/component/booktracker/edition/8192.html

Gale Encyclopedia of Nursing and Allied Health - Gale - Literati by CredoGale Encyclopedia of Nursing and Allied Health - Gale - Literati by Credo

Swan-Ganz Catheterization. *Syncope. *Syphilis. *Syphilis Tests. *Syringe and Needle. *T. *Tai Chi ...
more infohttp://corp.credoreference.com/component/booktracker/edition/11150.html

Jay BhattacharyaJay Bhattacharya

Treatment Effect Bounds: An Application to Swan-Ganz Catheterization. with Azeem Shaikh, Edward Vytlacil: w11263. Published:. * ... "Treatment Effect Bounds under Monotonicity Assumptions: An Application to Swan-Ganz Catheterization." American Economic Review ... "Treatment effect bounds: An application to Swanâ Ganz catheterization," Journal of Econometrics, Elsevier, vol. 168(2), pages ...
more infohttps://nber.org/people/jay_bhattacharya
  • 1996) study assumes that there are no unobserved differences between patients who are catheterized and patients who are not catheterized and finds that catheterization increases patient mortality. (repec.org)