scholarly journals Ultrasound Assessment in Cardiogenic Shock Weaning: A Review of the State of the Art

2021 ◽  
Vol 10 (21) ◽  
pp. 5108
Author(s):  
Rebeca Muñoz-Rodríguez ◽  
Martín Jesús García-González ◽  
Pablo Jorge-Pérez ◽  
Marta M. Martín-Cabeza ◽  
Maria Manuela Izquierdo-Gómez ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiogenic Shock ◽  
State Of The Art ◽  
Low Cost ◽  
Invasive Mechanical Ventilation ◽  
Shock Therapy ◽  
The State ◽  
Current Evidence ◽  
Circulatory Support ◽  
Weaning Failure

Cardiogenic shock (CS) is associated with a high in-hospital mortality despite the achieved advances in diagnosis and management. Invasive mechanical ventilation and circulatory support constitute the highest step in cardiogenic shock therapy. Once established, taking the decision of weaning from such support is challenging. Intensive care unit (ICU) bedside echocardiography provides noninvasive, immediate, and low-cost monitoring of hemodynamic parameters such as cardiac output, filling pressure, structural disease, congestion status, and device functioning. Supplemented by an ultrasound of the lung and diaphragm, it is able to provide valuable information about signs suggesting a weaning failure. The aim of this article was to review the state of the art taking into account current evidence and knowledge on ICU bedside ultrasound for the evaluation of weaning from mechanical ventilation and circulatory support in cardiogenic shock.

A low-cost asymmetric carbazole-based hole-transporting material for efficient perovskite solar cells

2021 ◽  
Author(s):  
Xueqiao Li ◽  
Na Sun ◽  
Zhanfeng Li ◽  
Jinbo Chen ◽  
Qinjun Sun ◽  
...  
Keyword(s):  
Solar Cells ◽  
State Of The Art ◽  
Low Cost ◽  
Perovskite Solar Cells ◽  
The State ◽  
Hole Transporting ◽  
Hole Transporting Material

Perovskite solar cells (PSCs) have reached their highest efficiency with the state-of-the-art hole-transporting material (HTM) spiro-OMeTAD.

scholarly journals Content validity of the short version of the subscale of the State-Trait Anxiety Inventory (STAI)

2011 ◽  
Vol 19 (4) ◽  
pp. 882-887 ◽  
Author(s):  
Juana Perpiñá-Galvañ ◽  
Miguel Richart-Martínez ◽  
Maria José Cabañero-Martínez ◽  
Inmaculada Martínez-Durá
Keyword(s):  
Mechanical Ventilation ◽  
Trait Anxiety ◽  
Content Validity ◽  
Invasive Mechanical Ventilation ◽  
The State ◽  
Original Version ◽  
Spanish Version ◽  
Short Version ◽  
State Trait Anxiety Inventory ◽  
Original Scale

The goal was to describe the content validity of a short version of the state subscale of Spielberger's "State-Trait Anxiety Inventory (STAI)", based on the original version adapted to Spanish, in Spanish patients receiving invasive mechanical ventilation (IMV). The sample consisted of 16 patients receiving IMV at the Alicante Hospital (Spain), who selected the items from the full Spanish version of the STAI-state that were most relevant to them. Items 1, 5, 9, 10, 12 and 20 from the original scale are the most relevant for the Spanish patients receiving IMV and 5 of these are included in the short version of the scale (83.3% agreement). The short scale has shown adequate content validity for Spanish patients receiving IMV.

scholarly journals Utilización de la Comunicación por Radiofrecuencia para la Detección de Vehículos en Movimiento: Revisión del Estado del Arte

2018 ◽  
Vol 3 (1) ◽  
pp. 821 ◽  
Author(s):  
Antony García ◽  
Yessica Sáez ◽  
José Muñoz ◽  
Ignacio Chang ◽  
Héctor Montes Franceschi
Keyword(s):  
Fixed Point ◽  
Public Transportation ◽  
State Of The Art ◽  
Low Cost ◽  
The State ◽  
Visual Disability ◽  
Visual Disabilities ◽  
The Public ◽  
Detection Of Objects ◽  
Public Transportation System

This article presents the state of the art on the use of radiofrequency communication for the detection of objects and vehicles in motion, through the interaction between transmitter and receiver devices using ISM (Industrial, Scientific and Medical) bands. By quantifying parameters such as the absence or presence of signals and their intensity, it is possible to approximate the distance between an emitting device and a receiver, localized in the vehicle and a fixed point, respectively . The study of the methodologies used in this article aims to develop a system oriented to guide people with visual disabilities in the public transportation system, taking advantage of the main characteristics of radiofrequency communication: low cost, easy implementation and full compatibility with electronic boards built on embedded systems.Keywords: radiofrequency, ISM bands, detection of vehicles in motion, support for visual disability people, ETA

scholarly journals Potentially Effective Drugs for the Treatment of COVID-19 or MIS-C in Children: A Systematic Review

2021 ◽  
Author(s):  
Zijun Wang ◽  
Siya Zhao ◽  
Yuyi Tang ◽  
Zhili Wang ◽  
Qianling Shi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Cohort Studies ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Current Evidence ◽  
Control Group ◽  
Case Series Study

Abstract Introduction: The purpose of this systematic review is to evaluate the efficacy and safety of using potential drugs: remdesivir and glucocorticoid in treating children and adolescents with COVID-19 and intravenous immunoglobulin (IVIG) in treating MIS-C. Methods: We searched seven databases, three preprint platform, ClinicalTrials.gov, and Google from December 1, 2019, to August 5, 2021, to collect evidence of remdesivir, glucocorticoid, and IVIG which were used in children and adolescents with COVID-19 or MIS-C. Results: A total of nine cohort studies and one case series study were included in this systematic review. In terms of remdesivir, the meta-analysis of single-arm cohort studies have shown that, after the treatment, 54.7% (95%CI, 10.3% to 99.1%) experienced adverse events, 5.6% (95%CI, 1.2% to 10.1%) died, 27.0% (95%CI, 0% to 73.0%) needed extracorporeal membrane oxygenation or invasive mechanical ventilation. As for glucocorticoids, the results of the meta-analysis showed that the fixed-effect summary odds ratio for the association with mortality was 2.79 (95%CI, 0.13 to 60.87), and the mechanical ventilation rate was 3.12 (95%CI, 0.80 to 12.08) for glucocorticoids compared with the control group. In terms of IVIG, most of the included cohort studies showed that for MIS-C patients with more severe clinical symptoms, IVIG combined with methylprednisolone could achieve better clinical efficacy than IVIG alone.Conclusions: Overall, the current evidence in the included studies is insignificant and of low quality. It is recommended to conduct high-quality randomized controlled trials of remdesivir, glucocorticoids, and IVIG in children and adolescents with COVID-19 or MIS-C to provide substantial evidence for the development of guidelines.

Left heart Impella-device to bridge acute mitral regurgitation to MitraClip-procedure: a novel implementation of percutaneous mechanical circulatory support

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Vandenbriele ◽  
T Balthazar ◽  
J Wilson ◽  
S Ledot ◽  
R Smith ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Output ◽  
Mitral Regurgitation ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Surgical Intervention ◽  
Left Ventricular ◽  
Inotropic Support ◽  
Circulatory Support ◽  
Acute Mitral Regurgitation

Abstract Background Acute mitral regurgitation (MR) is an emergency, often requiring urgent surgery. Severe acute MR presenting with hemodynamic collapse is usually caused by papillary muscle rupture or dysfunction after acute myocardial infarction (AMI) or chordal rupture, resulting in flail mitral leaflet(s). Preoperative stabilization is complex due to concomitant hemodynamic collapse and hypoxic respiratory failure. Finding the right balance between both preload and inotropic support is challenging. When patients are too sick for immediate surgical intervention, mechanical circulatory support can be considered because of its ability to both unload and reduce of cardiac work while increasing coronary perfusion and cardiac output. Nevertheless, even after initial stabilization, surgical risk remains high in critically ill acute severe MR patients and transcatheter treatments such as MitraClip are increasingly being explored. Methods Between August 2017 and September 2019, patients presenting with acute severe mitral regurgitation and considered too ill for immediate surgical intervention (EURO-II score >11.2% plus pulmonary oedema necessitating mechanical ventilation and/or hemodynamic instability), were selected for an Impella-assisted LV unloading technique as bridge to MitraClip-procedure. Five patients were selected for the combined left Impella/MitraClip-procedure in two tertiary cardiac ICUs. Results The mean age was 72 years. The cause of MR was ischemic in 20% and all patients presented in cardiogenic shock state, necessitating mechanical ventilation. The overall cardiac operative risk assessment (Euro-II) score predicted a 35% chance of in-hospital mortality. Cardiac output was severely impaired (mean LVOT VTI 8.2 cm). All patients were on inotropic support and supported by an Impella-CP pVAD (mean flow 2.5 Liter per minute; mean 6.3 days of support). In all cases, we managed to reduce the LVEDP below 15 mmHg using the combination of medical therapy (afterload reduction, inotropes), mechanical ventilation and pVAD-therapy. The MR was significantly reduced by a MitraClip-procedure in each Impella supported patient. The overall survival at discharge was 80%. One patient with late referral and multiple organ failure at presentation deceased due to refractory cardiogenic shock. Overall, severe MR was reduced to grade 1+ and all four patients survived 6 months after discharge with only one readmission for decompensated heart failure. Conclusions A combined strategy of Impella and MitraClip appears to be a novel, feasible alternative for patients presenting with acute, severe MR unable to proceed to a corrective surgical procedure at presentation due to severe left ventricular forward flow failure. In these cases, the early initiation of pVAD-support may reduce the risk of development of irreversible end- organ damage and dysfunction. Exploration in a larger, randomised population is warranted to investigate this strategy further. Funding Acknowledgement Type of funding source: None

Management of cardiogenic shock complicating myocardial infarction: an update 2019

2019 ◽  
Vol 40 (32) ◽  
pp. 2671-2683 ◽  
Author(s):  
Holger Thiele ◽  
E Magnus Ohman ◽  
Suzanne de Waha-Thiele ◽  
Uwe Zeymer ◽  
Steffen Desch
Keyword(s):  
Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
State Of The Art ◽  
Treatment Strategies ◽  
Circulatory Support ◽  
Major Focus ◽  
Limited Evidence ◽  
Common Cause ◽  
Early Revascularization

Abstract Cardiogenic shock (CS) remains the most common cause of death in patients admitted with acute myocardial infarction (AMI) and mortality remained nearly unchanged in the range of 40–50% during the last two decades. Early revascularization, vasopressors and inotropes, fluids, mechanical circulatory support, and general intensive care measures are widely used for CS management. However, there is only limited evidence for any of the above treatment strategies except for revascularization and the relative ineffectiveness of intra-aortic balloon pumping. This updated review will outline the management of CS complicating AMI with major focus on state-of-the art treatment.

scholarly journals Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study

2017 ◽  
Vol 230 ◽  
pp. 191-197 ◽  
Author(s):  
Mari Hongisto ◽  
Johan Lassus ◽  
Tuukka Tarvasmaki ◽  
Alessandro Sionis ◽  
Heli Tolppanen ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiogenic Shock ◽  
Multicenter Study ◽  
Invasive Mechanical Ventilation ◽  
Prospective Multicenter Study
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