Inleiding Swan-Ganz catheterisatie : geschiedenis en controverse
|
|
|
- Sophie Roberts
- 5 years ago
- Views:
Transcription
1 Inleiding Swan-Ganz catheterisatie : geschiedenis en controverse catherine ingels, MD, PhD Dienst Intensieve Geneeskunde, UZLeuven 1
2 A.F. Cournand - D. Richards William Ganz & Jeremy Swan Claude Bernard Chauveau, Marey Werner Forssmann balloon-tipped, flow-directed pulmonary artery catheter 2
3 PAP CO PCWP SVO2 3
4 RV CO ~ LV 4
5 5
6 Direct measurements of the following can be obtained from an accurately placed pulmonary artery catheter (PAC): CVP Right-sided intracardiac pressures (right atrium, right ventricle) PAP Pulmonary artery occlusion pressure (PAOP; pulmonary capillary wedge pressure [PCWP]; pulmonary artery wedge pressure [PAWP]) CO SvO 2 The PAC can also indirectly measure the following: SVR = 80 x [mean artery pressure CVP]/CO PVR = 80 x [mean PAp PAOP]/CO CI = CO/body surface area Stroke volume index (SVI = CI/heart rate) Left ventricular stroke work index (LVSWI = [mean systemic artery pressure PAOP] x SVI x 0.136) Right ventricular stroke work index (RVSWI = [mean PAP CVP] x SVI x 0.136) Oxygen delivery (DO 2 = CI x 13.4 x hemoglobin concentration x arterial oxygen saturation) Oxygen uptake (VO 2 = CI x 13.4 x hemoglobin concentration x [arterial oxygen saturation venous oxygen saturation]) 6
7 1970 : SG catheter in gebruik 1976 : wetgeving medische apparatuur, niet van toepassing voor PACs : # reports van adverse events 1996 : Connors, JAMA 1996 Sep 18;276(11): The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators : National Heart, Lung and Blood Institute & FDA : werkgroep safety / utility of PACs Pulmonary artery catheterization and clinical outcomes: National Heart, Lung, and Blood Institute and Food and Drug Administration Workshop Report. Consensus Statement. Bernard, JAMA 2000 May 17;283(19): Review 4 specific recommendations: standardize, monitor, and measure physician and nurse education to improve the quality, safety, and use of clinical information derived from the PAC; conduct clinical trials investigating PAC safety and effectiveness in the following conditions: persistent/refractory CHF (NYHA class IV), low-risk coronary artery bypass graft surgery, hypoxic lung syndromes including ARDS, and severe sepsis/septic shock; systematically evaluate new device technology in critical care medicine to improve patient outcome; and encourage international collaboration. Validation of the indications and benefits of the PAC will provide an opportunity to develop a reference standard and lay the foundation for testing new devices and treatments in the critically ill. 7
8 Table 1. Observational evidence PAC, pulmonary artery catheter; AMI, acute myocardial infarction; RCT, randomized, controlled trial; CABG, coronary artery bypass grafting; ARDS, acute respiratory distress syndrome. Table 2. Randomized, controlled trial evidence PAC. Pulmonary artery catheter. Williams, Grounds, Rhodes, Current Opinion in Critical Care. 8(3): , June
9 Conclusions: PAC is a diagnostic and haemodynamic monitoring tool but not a therapeutic intervention. Our review concluded that use of a PAC did not alter the mortality, general ICU or hospital LOS, or cost for adult patients in intensive care. The quality of evidence was high for mortality and LOS but low for cost analysis. Efficacy studies are needed to determine if there are optimal PAC-guided management protocols, which when applied to specific patient groups in ICUs could result in benefits such as shock reversal, improved organ function and less vasopressor use. Newer, less-invasive haemodynamic monitoring tools need to be validated against PAC prior to clinical use in critically ill patients. Cochrane Database Syst Rev Feb 28;2:CD
10 Conclusies Hemodynamische monitoring is van essentieel belang Interpretatie van data : vaak moeilijk, vereist nodige kennis, skills Bewaar een open geest : voordelen en limitaties aan elke technologie Doelmatige en geschikte applicatie, klinisch protocol, opleiding Monitoring is niet therapeutisch! data adekwate en vroege therapie outcome Beware of false knowledge; it is more dangerous than ignorance (GB Shaw) 10
Cardiopulmonary System
Dana Oakes, BA, RRT NPS Author/Speaker Cardiopulmonary System Main Purpose Main Function Main Goal Oxygen Delivery Adequate Perfusion (deliver adequate oxygen and nutrients; remove metabolic waste) Tissue
FUNDAMENTALS OF HEMODYNAMICS, VASOACTIVE DRUGS AND IABP IN THE FAILING HEART
FUNDAMENTALS OF HEMODYNAMICS, VASOACTIVE DRUGS AND IABP IN THE FAILING HEART CINDY BITHER, MSN, ANP, ANP, AACC, CHFN CHIEF NP, ADV HF PROGRAM MEDSTAR WASHINGTON HOSPITAL CENTER CONFLICTS OF INTEREST NONE
Topics to be Covered. Cardiac Measurements. Distribution of Blood Volume. Distribution of Pulmonary Ventilation & Blood Flow
Topics to be Covered MODULE F HEMODYNAMIC MONITORING Cardiac Output Determinants of Stroke Volume Hemodynamic Measurements Pulmonary Artery Catheterization Control of Blood Pressure Heart Failure Cardiac
Cardiac Output Monitoring: Expense justified by outcome?
Cardiac Output Monitoring: Expense justified by outcome? Stephen Streat FRACP Intensivist Department of Critical Care Medicine Auckland City Hospital CCSSA/SATS Congress Durban 28 th July 2011 1100 hrs
Hemodynamic Monitoring and Circulatory Assist Devices
Hemodynamic Monitoring and Circulatory Assist Devices Speaker: Jana Ogden Learning Unit 2: Hemodynamic Monitoring and Circulatory Assist Devices Hemodynamic monitoring refers to the measurement of pressure,
Definition- study of blood flow Haemodynamic monitoring refers to monitoring of blood in the cardiovascular system Uses Is NB in the critically ill
By Craig Definition- study of blood flow Haemodynamic monitoring refers to monitoring of blood in the cardiovascular system Uses Is NB in the critically ill pt Can assist diagnosis and decision making
Introduction. Invasive Hemodynamic Monitoring. Determinants of Cardiovascular Function. Cardiovascular System. Hemodynamic Monitoring
Introduction Invasive Hemodynamic Monitoring Audis Bethea, Pharm.D. Assistant Professor Therapeutics IV January 21, 2004 Hemodynamic monitoring is necessary to assess and manage shock Information obtained
Cath Lab Essentials: Basic Hemodynamics for the Cath Lab and ICU
Cath Lab Essentials: Basic Hemodynamics for the Cath Lab and ICU Ailin Barseghian El-Farra, MD, FACC Assistant Professor, Interventional Cardiology University of California, Irvine Department of Cardiology
Relax and Learn At the Farm 2012
Relax and Learn At the Farm Session 9: Invasive Hemodynamic Assessment and What to Do with the Data Carol Jacobson RN, MN Cardiovascular Nursing Education Associates Function of CV system is to deliver
Capture every aspect of hemodynamic status
Capture every aspect of hemodynamic status Edwards Advanced Technology Swan-Ganz Catheters Hemodynamic Monitoring Systems with Continuous CO, SvO 2, EDV, RVEF, SVR, and SV for Optimal Patient Care The
Pre-operative usage of IABP for patients for by pass surgery
Pre-operative usage of IABP for patients for by pass surgery Mitrev Z, Anguseva T, Hristov N Special hospital for surgery Filip Vtori Skopje - Macedonija Oktomvri, 2008 IABP Background Preload Afterload
( 12 17mLO 2 /dl) 1.39 Hb S v O P v O2
32 1970 Harold James Swan William Ganz N Engl J Med 1) 40 (mixed venous oxygen saturation S v O2 ) (central venous oxygen saturation Scv O2 ) (Hb) S v O2 Scv O2 1971 Ganz 2) 20 Forrester Swan Forrester
Hemodynamic Monitoring
Perform Procedure And Interpret Results Hemodynamic Monitoring Tracheal Tube Cuff Pressure Dean R. Hess PhD RRT FAARC Hemodynamic Monitoring Cardiac Rate and Rhythm Arterial Blood Pressure Central Venous
Technique. Technique. Technique. Monitoring 1. Local anesthetic? Aseptic technique Hyper-extend (if radial)
Critical Care Monitoring Hemodynamic Monitoring Arterial Blood Pressure Cannulate artery Uses 2 Technique Sites Locate artery, prep 3 1 Technique Local anesthetic? Aseptic technique Hyper-extend (if radial)
Computerized PAC Waveform Interpretation
Harvard-MIT Division of Health Sciences and Technology HST.951J: Medical Decision Support, Fall 2005 Instructors: Professor Lucila Ohno-Machado and Professor Staal Vinterbo Computerized PAC Waveform Interpretation
CARDIOVASCULAR MONITORING. Prof. Yasser Mostafa Kadah
CARDIOVASCULAR MONITORING Prof. Yasser Mostafa Kadah Introduction Cardiovascular monitoring covers monitoring of heart and circulatory functions It makes it possible to commence interventions quickly in
Brief View of Calculation and Measurement of Cardiac Hemodynamics
Cronicon OPEN ACCESS EC CARDIOLOGY Review Article Brief View of Calculation and Measurement of Cardiac Hemodynamics Samah Alasrawi* Pediatric Cardiologist, Al Jalila Children Heart Center, Dubai, UAE *
The Hemodynamics of PH Interpreting the numbers
The Hemodynamics of PH Interpreting the numbers Todd M Bull MD Associate Professor of Medicine Division of Pulmonary Sciences and Critical Care Medicine Pulmonary Hypertension Center University of Colorado
Chapter 21. Flail Chest. Mosby items and derived items 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 21 Flail Chest 1 Figure 21-1. Flail chest. Double fractures of three or more adjacent ribs produce instability of the chest wall and paradoxical motion of the thorax. Inset, Atelectasis, a common
EVOLUCIÓN DE LA MONITORIZACIÓN CARDIOVASCULAR EN LA UCI
EVOLUCIÓN DE LA MONITORIZACIÓN CARDIOVASCULAR EN LA UCI Antonio Artigas Critical Care Center Sabadell Hospital CIBER Enfermedades Respiratorias Autonomos University of Barcelona Spain aartigas@tauli.cat
Καθετηριασμός δεξιάς κοιλίας. Σ. Χατζημιλτιάδης Καθηγητής Καρδιολογίας ΑΠΘ
Καθετηριασμός δεξιάς κοιλίας Σ. Χατζημιλτιάδης Καθηγητής Καρδιολογίας ΑΠΘ The increasing interest in pulmonary arterial hypertension (PAH), the increasing interest in implantation of LVADs, and the evolution
SCVMC RESPIRATORY CARE PROCEDURE
Page 1 of 7 New: 12/08 R: 4/11 R NC: 7/11, 7/12 B7180-63 Definitions: Inhaled nitric oxide (i) is a medical gas with selective pulmonary vasodilator properties. Vaso-reactivity is the evidence of acute
Management of Acute Shock and Right Ventricular Failure
Management of Acute Shock and Right Ventricular Failure Nader Moazami, MD Department of Thoracic and Cardiovascular Surgery and Biomedical Engineering, Cleveland Clinic NONE Disclosures CARDIOGENIC SHOCK
Swan Ganz catheter: Does it still have a role? Daniel De Backer Department of Intensive Care Erasme University Hospital Brussels, Belgium
Swan Ganz catheter: Does it still have a role? Daniel De Backer Department of Intensive Care Erasme University Hospital Brussels, Belgium How can cardiac output be measured? Thermodilution Arterial waveform
Cogent 2-in-1 Hemodynamic Monitoring System
Cogent 2-in-1 Hemodynamic Monitoring System Minimally invasive and invasive hemodynamic monitoring technologies in a single, lightweight system with wireless communication The flexibility you ve been asking
PVDOMICS: Right Heart Catheterization Training
PVDOMICS: Right Heart Catheterization Training Cardiovascular Physiology Core Cleveland Clinic, Cleveland OH November 7, 2016 NHLBI Pulmonary Vascular Disease Phenomics Program Funded by the National Heart,
Right Heart Catheterization. Franz R. Eberli MD Chief of Cardiology Stadtspital Triemli, Zurich
Right Heart Catheterization Franz R. Eberli MD Chief of Cardiology Stadtspital Triemli, Zurich Right Heart Catheterization Pressure measurements Oxygen saturation measurements Cardiac output, Vascular
Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall
Swans and Pressors Vanderbilt Surgery Summer School Ricky Shinall Shock, Swans, Pressors in 15 minutes 4 Reasons for Shock 4 Swan numbers to know 7 Pressors =15 things to know 4 Reasons for Shock Not enough
Swans and Pressors. Vanderbilt Surgery Summer School Ricky Shinall
Swans and Pressors Vanderbilt Surgery Summer School Ricky Shinall SHOCK Hypotension SHOCK Hypotension SHOCK=Reduction of systemic tissue perfusion, resulting in decreased oxygen delivery to the tissues.
03RC2 Standards of monitoring revisited, what is the evidence?
03RC2 Standards of monitoring revisited, what is the evidence? W. F. Buhre Division of Perioperative and Emergency Medicine, University Medical Center Utrecht, Utrecht, The Netherlands Saturday, June 6,
Intraaortic Balloon Counterpulsation- Supportive Data for a Role in Cardiogenic Shock ( Be Still My Friend )
Intraaortic Balloon Counterpulsation- Supportive Data for a Role in Cardiogenic Shock ( Be Still My Friend ) Stephen G. Ellis, MD Section Head, Interventional Cardiology Professor of Medicine Cleveland
Advanced cardiovascular monitoring
Advanced cardiovascular monitoring Eric de Waal Advanced cardiovascular monitoring E.E.C. de Waal ISBN: 978-94-90122218 Printed by Gildeprint Drukkerijen, Enschede, Netherlands E.E.C. de Waal, 2009. Cover
Nurse Driven Fluid Optimization Using Dynamic Assessments
Nurse Driven Fluid Optimization Using Dynamic Assessments 2016 1 WHAT WE BELIEVE We believe that clinicians make vital fluid and drug decisions every day with limited and inconclusive information Cheetah
Revision of 10/27/2017 Form #280 Page 1 of 12 PVDOMICS STUDY Clinical Center Right Heart Catheterization (RHC) Results Form #280
Revision of 10/27/2017 Form #280 Page 1 of 12 PVDOMICS STUDY Clinical Center Right Heart Catheterization (RHC) Results Form #280 Instructions: Review PVDOMICS MOP Chapter 100 prior to completing right
Admission of patient CVICU and hemodynamic monitoring
Admission of patient CVICU and hemodynamic monitoring Prepared by: Rami AL-Khatib King Fahad Medical City Pi Prince Salman Heart tcentre CVICU-RN Admission patient to CVICU Introduction All the patients
Management of Cardiogenic Shock. Dr Stephen Pettit, Consultant Cardiologist
Dr Stephen Pettit, Consultant Cardiologist Cardiogenic shock Management of Cardiogenic Shock Outline Definition, INTERMACS classification Medical management of cardiogenic shock PA catheters and haemodynamic
The Vigileo monitor by Edwards Lifesciences supports both the FloTrac Sensor for continuous cardiac output and the PreSep oximetry catheter for
1 2 The Vigileo monitor by Edwards Lifesciences supports both the FloTrac Sensor for continuous cardiac output and the PreSep oximetry catheter for continuous central venous oximetry (ScvO2) 3 The Vigileo
Dr. F Javier Belda Dept. Anesthesiology and Critical Care Hospital Clinico Universitario Valencia (Spain) Pulsion MAB
State of the Art Hemodynamic Monitoring III CO, preload, lung water and ScvO2 The winning combination! Dr. F Javier Belda Dept. Anesthesiology and Critical Care Hospital Clinico Universitario Valencia
Acute Coronary Syndrome. Sonny Achtchi, DO
Acute Coronary Syndrome Sonny Achtchi, DO Objectives Understand evidence based and practice based treatments for stabilization and initial management of ACS Become familiar with ACS risk stratification
Frantisek Bednar, 1,2 Tomas Budesinsky, 1,2 Hana Linkova, 1,2 and Viktor Kocka 1,2. 1. Introduction
BioMed Research International Volume 216, Article ID 6296972, 7 pages http://dx.doi.org/1.1155/216/6296972 Clinical Study Invasive Hemodynamic Assessment of Cardiac Output State after MitraClip Therapy
Mechanics of Cath Lab Support Devices
Mechanics of Cath Lab Support Devices Issam D. Moussa, MD Chief Medical Officer First Coast Cardiovascular Institute, Jacksonville, FL Professor of Medicine, UCF, Orlando, FL None DISCLOSURE Percutaneous
Prof. Dr. Iman Riad Mohamed Abdel Aal
The Use of New Ultrasound Indices to Evaluate Volume Status and Fluid Responsiveness in Septic Shock Patients Thesis Submitted for partial fulfillment of MD degree in Anesthesiology, Surgical Intensive
Presented by: Indah Dwi Pratiwi
Presented by: Indah Dwi Pratiwi Normal Fluid Requirements Resuscitation Fluids Goals of Resuscitation Maintain normal body temperature In most cases, elevate the feet and legs above the level of the heart
Disclosures. Objectives 6/16/2016. A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension
A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension Susan P. D Anna MSN, APN-BC, CHFN June 24, 2016 Disclosures Objectives Differentiate structure and function of RV and LV
CPT Code Details
CPT Code 93572 Details Code Descriptor Intravascular Doppler velocity and/or pressure derived flow reserve measurement ( vessel or graft) during angiography pharmacologically induced stress; each additional
เอกราช อร ยะช ยพาณ ชย
30 July 2016 เอกราช อร ยะช ยพาณ ชย Heart Failure and Transplant Cardiology aekarach.a@chula.ac.th Disclosure Speaker, CME service: Merck, Otsuka, Servier Consultant, non-cme service: Novartis, Menarini
Acute Liver Failure: Supporting Other Organs
Acute Liver Failure: Supporting Other Organs Michael A. Gropper, MD, PhD Professor of Anesthesia and Physiology Director, Critical Care Medicine University of California San Francisco Acute Liver Failure
Clinical Science Working Group 6: Diagnosis & Assessment of PAH. Co-chairs: David B. Badesch, MD Marius M. Hoeper, MD. Working Group 6 Members
Clinical Science Working Group 6: Diagnosis & Assessment of PAH Co-chairs: David B. Badesch, MD Marius M. Hoeper, MD Working Group 6 Members Harm Jan Bogaard, Robin Condliffe, Robert Frantz, Dinesh Khanna,
Nothing to Disclose. Severe Pulmonary Hypertension
Severe Ronald Pearl, MD, PhD Professor and Chair Department of Anesthesiology Stanford University Rpearl@stanford.edu Nothing to Disclose 65 year old female Elective knee surgery NYHA Class 3 Aortic stenosis
Cath Lab Essentials : LV Assist Devices for Hemodynamic Support (IABP, Impella, Tandem Heart, ECMO)
Cath Lab Essentials : LV Assist Devices for Hemodynamic Support (IABP, Impella, Tandem Heart, ECMO) Michael A. Gibson, MD Assistant Professor of Medicine University of California, Irvine Division of Cardiology
Downloaded from:
Harvey, S; Young, D; Brampton, W; Cooper, A B; Doig, G; Sibbald, W; Rowan, K (2006) Pulmonary artery catheters for adult patients in intensive care. Cochrane database of systematic reviews (Online), 3
Patrick C. Cullinan, DO, NBPNS, FCCM, FACOEP, FACOI Associate Clinical Professor, UIWSOM, San Antonio, Texas Adjunct Assistant Professor, University
Patrick C. Cullinan, DO, NBPNS, FCCM, FACOEP, FACOI Associate Clinical Professor, UIWSOM, San Antonio, Texas Adjunct Assistant Professor, University of Texas Health Science Center, Department of Emergency
Calculations the Cardiac Cath Lab. Thank You to: Lynn Jones RN, RCIS, FSICP Jeff Davis RCIS, FSICP Wes Todd, RCIS CardioVillage.
Calculations the Cardiac Cath Lab Thank You to: Lynn Jones RN, RCIS, FSICP Jeff Davis RCIS, FSICP Wes Todd, RCIS CardioVillage.com Disclosure Information Calculations the Cardiac Cath Lab Darren Powell,
Early Goal-Directed Therapy
Early Goal-Directed Therapy Where do we stand? Jean-Daniel Chiche, MD PhD MICU & Dept of Host-Pathogen Interaction Hôpital Cochin & Institut Cochin, Paris-F Resuscitation targets in septic shock 1 The
LV Distension and ECLS Lungs
LV Distension and ECLS Lungs Kevin W. Hatton, MD, FCCM Interim Vice-Chair for Anesthesiology Research Division Chief, Anesthesiology Critical Care Medicine Program Director, Anesthesiology Critical Care
This PDF is available for free download from a site hosted by Medknow Publications
Indian J Crit Care Med Oct-Dec 006 Vol 10 Issue 4 IJCCM October-December 003 Vol 7 Issue 4 Research Article Correlation of mixed venous and central venous oxygen saturation and its relation to cardiac
Sepsis Wave II Webinar Series. Sepsis Reassessment
Sepsis Wave II Webinar Series Sepsis Reassessment Presenters Nova Panebianco, MD Todd Slesinger, MD Fluid Reassessment in Sepsis Todd L. Slesinger, MD, FACEP, FCCM, FCCP, FAAEM Residency Program Director
Institute of Surgical Research C Module Advance Basic Medical Skills
Institute of Surgical Research C Module Advance Basic Medical Skills C1-2 MODUL Non-invasive monitoring; Invasive hemodinamic monitoring C3-4 MODUL Laparotomy, enterotomy, Intestinal suture, Diagnostic
Acute Mechanical Circulatory Support Right Ventricular Support Devices
Acute Mechanical Circulatory Support Right Ventricular Support Devices Navin K. Kapur, MD, FACC, FSCAI, FAHA Associate Professor, Department of Medicine Interventional Cardiology & Advanced Heart Failure
Edwards FloTrac Sensor & Performance Assessments of the FloTrac Sensor and Vigileo Monitor
Edwards FloTrac Sensor & Edwards Vigileo Monitor Performance Assessments of the FloTrac Sensor and Vigileo Monitor 1 Topics System Configuration Performance and Validation Dr. William T. McGee, Validation
Mechanical circulatory support in cardiogenic shock The Cardiologist s view ACCA Masterclass 2017
Mechanical circulatory support in cardiogenic shock The Cardiologist s view ACCA Masterclass 2017 Pascal Vranckx MD, PhD. Medical director Cardiac Critical Care Services Hartcentrum Hasselt Belgium Disclosure
Disclosures. Objectives. RV vs LV. Structure and Function 9/25/2016. A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension
Disclosures A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension No financial relationships Susan P. D Anna MSN, APN BC, CHFN September 29, 2016 Objectives RV vs LV Differentiate
Peripheral and Cardiology Coder 2018
Peripheral and Cardiology Coder 2018 Cardiovascular Services and Procedures Prepared and Published By: MedLearn Publishing A Division of MedLearn Media, Inc. 445 Minnesota Street, Suite 514 St. Paul, MN
Cardiovascular Practice Quiz
Cardiovascular Practice Quiz 1. When caring for a patient following a cardiac catheterization with coronary angiography, which of the following findings would be of most concern to the nurse? a. Swelling
Planned, Short-Term RVAD During Durable LVAD Implant: Indications and Management
Planned, Short-Term RVAD During Durable LVAD Implant: Indications and Management Yoshifumi Naka, MD, PhD Columbia University Medical Center New York, NY Disclosure Abbott/St. Jude Med./Thoratec Consultant
IV fluid administration in sepsis. Dr David Inwald Consultant in PICU St Mary s Hospital, London CATS, London
IV fluid administration in sepsis Dr David Inwald Consultant in PICU St Mary s Hospital, London CATS, London The talk What is septic shock? What are the recommendations? What is the evidence? Do we follow
Cardiovascular Management of Septic Shock
Cardiovascular Management of Septic Shock R. Phillip Dellinger, MD Professor of Medicine Robert Wood Johnson Medical School/UMDNJ Director, Critical Care Medicine and Med/Surg ICU Cooper University Hospital
CABG for ischemic cardiomyopathy, post myocardial infarction and cardiogenic shock
CABG for ischemic cardiomyopathy, post myocardial infarction and cardiogenic shock Yoshiya Toyoda, MD, PhD William Maul Measey Professor of Surgery Chief, Cardiovascular Surgery Surgical Director, Mechanical
Introduction to Acute Mechanical Circulatory Support
Introduction to Acute Mechanical Circulatory Support Navin K. Kapur, MD, FACC, FSCAI, FAHA Associate Professor, Department of Medicine Interventional Cardiology & Advanced Heart Failure Programs Executive
Cardiogenic Shock. Carlos Cafri,, MD
Cardiogenic Shock Carlos Cafri,, MD SHOCK= Inadequate Tissue Mechanisms: Perfusion Inadequate oxygen delivery Release of inflammatory mediators Further microvascular changes, compromised blood flow and
Hemodynamic monitoring beyond cardiac output
Hemodynamic monitoring beyond cardiac output Prof Xavier MONNET Medical Intensive Care Unit Bicêtre Hospital Assistance publique Hôpitaux de Paris FRANCE Conflicts of interest Lilly GlaxoSmithKline Pulsion
The right ventricle in chronic heart failure
The right ventricle in chronic heart failure ESC 2012 Christian Opitz, Berlin There are no conflicts of interest relevant to this presentation Percent of Population Prevalence of Heart Failure by Age and
The Who, How and When of Advanced Heart Failure Therapies. Disclosures. What is Advanced Heart Failure?
The Who, How and When of Advanced Heart Failure Therapies 9 th Annual Dartmouth Conference on Advances in Heart Failure Therapies Dartmouth-Hitchcock Medical Center Lebanon, NH May 20, 2013 Joseph G. Rogers,
Impedance Cardiography (ICG) Method, Technology and Validity
Method, Technology and Validity Hemodynamic Basics Cardiovascular System Cardiac Output (CO) Mean arterial pressure (MAP) Variable resistance (SVR) Aortic valve Left ventricle Elastic arteries / Aorta
Aortic Dissection Causes of Death
Aortic Dissection Causes of Death Rupture aorta 33.3% Unspecified 33.3% Neurological l deficit it 13.9% Visceral ischemia/kidney failure 11.5% Cardiac tamponade 7.9% (Circulation 2002;105:200-6) Medical
Closing ASDs with pulmonary hypertension. Shakeel A Qureshi Evelina Children s Hospital London
Closing ASDs with pulmonary hypertension Shakeel A Qureshi Evelina Children s Hospital London Ho Chi Minh, Vietnam, January 2012 ACC/AHA 2008 Guidelines ASD closure Closure is indicated for right atrial
FLUID RESUSCITATION AND MONITORING IN SEPSIS PROTOCOLIZED VS USUAL CARE DEEPA BANGALORE GOTUR MD, FCCP ASSISTANT PROFESSOR, WEILL CORNELL MEDICAL
FLUID RESUSCITATION AND MONITORING IN SEPSIS PROTOCOLIZED VS USUAL CARE DEEPA BANGALORE GOTUR MD, FCCP ASSISTANT PROFESSOR, WEILL CORNELL MEDICAL COLLEGE NOVEMBER 10 TH 2017 TEXAS SCCM SYMPOSIUM Disclosures
Pulmonary Artery Catheter Helpful Hints 2017
Pulmonary Artery Catheter Helpful Hints 2017 Swan Ganz Catheter 1) Gather Equipment Hint1: Introducer is the actual catheter [Cordis is a brand name: at GW we use Arrow brand] Hint 2: 9 Fr Introducer for
Role of right ventricular infarction in cardiogenic shock
British Heart Journal, 1979, 42, 719-725 Role of right ventricular infarction in cardiogenic shock associated with inferior myocardial infarction1 HENRY GEWIRTZ,2 HERMAN K. GOLD, JOHN T. FALLON, RICHARD
Effects of mechanical ventilation on organ function. Masterclass ICU nurses
Effects of mechanical ventilation on organ function Masterclass ICU nurses Case Male, 60 - No PMH - L 1.74 m and W 85 kg Pneumococcal pneumonia Stable hemodynamics - No AKI MV in prone position (PEEP 16
Investigational Device only in the U.S. Not available for sale in the U.S. ACCESS EU European Society of Cardiology
Early hemodynamic and echocardiographic outcomes after percutaneous MitraClip therapy in patients with mitral regurgitation. Preliminary results of the MitraClip arm of the ACCESS EUROPE registry. Jörg
EACTS Adult Cardiac Database
EACTS Adult Cardiac Database Quality Improvement Programme List of changes to Version 2.0, 13 th Dec 2018, compared to version 1.0, 1 st May 2014. INTRODUCTORY NOTES This document s purpose is to list
THE PULMONARY ARTERY CATHeter
REVIEW Impact of the Pulmonary Artery Catheter in Critically Ill Patients Meta-analysis of Randomized Clinical Trials Monica R. Shah, MD, MHS, MSJ Vic Hasselblad, PhD Lynne W. Stevenson, MD Cynthia Binanay,
Shock - from Diagnostic to Therapeutic Implications
Shock - from Diagnostic to Therapeutic Implications Rui Moreno, MD, PhD, Professor UCINC, Hospital de São José Centro Hospitalar de Lisboa Central, E.P.E. LEARNING OBJECTIVES Review the markers of tissue
Assist Devices in STEMI- Intra-aortic Balloon Pump
Assist Devices in STEMI- Intra-aortic Balloon Pump Ioannis Iakovou, MD, PhD Onassis Cardiac Surgery Center Athens, Greece Cardiogenic shock 5-10% of pts after a heart attack 60000-70000 pts in Europe/year
Disclosures. Objectives 10/11/17. Short Term Mechanical Circulatory Support for Advanced Cardiogenic Shock. I have no disclosures to report
Short Term Mechanical Circulatory Support for Advanced Cardiogenic Shock Christopher K. Gordon MSN, ACNP-BC Disclosures I have no disclosures to report 1. Pathophysiology 2. Epidemiology 3. Assessment
ΔΙΑΧΕΙΡΙΣΗ ΑΣΘΕΝΩΝ ΜΕ ΜΕΣΟΚΟΛΠΙΚΗ ΕΠΙΚΟΙΝΩΝΙΑ ΖΑΧΑΡΑΚΗ ΑΓΓΕΛΙΚΗ ΚΑΡΔΙΟΛΟΓΟΣ ΗΡΑΚΛΕΙΟ - ΚΡΗΤΗ
ΔΙΑΧΕΙΡΙΣΗ ΑΣΘΕΝΩΝ ΜΕ ΜΕΣΟΚΟΛΠΙΚΗ ΕΠΙΚΟΙΝΩΝΙΑ ΖΑΧΑΡΑΚΗ ΑΓΓΕΛΙΚΗ ΚΑΡΔΙΟΛΟΓΟΣ ΗΡΑΚΛΕΙΟ - ΚΡΗΤΗ European Accreditation in TTE, TEE and CHD Echocardiography NOTHING TO DECLARE ATRIAL SEPTAL DEFECT TYPES SECUNDUM
2017 Cardiology Survival Guide
2017 Cardiology Survival Guide Chapter 4: Cardiac Catheterization/Percutaneous Coronary Intervention A cardiac catheterization involves a physician inserting a thin plastic tube (catheter) into an artery
PA Catheters - Useful or Not
PA Catheters - Useful or Not Perioperative in Liver Transplantation ILTS/ASA, San Francisco, 2003 Claus U. Niemann, MD Department of Anesthesia and Perioperative Division of Liver Transplantation University
Acute Myocardial Infarction Complicated by Cardiogenic Shock
Acute Myocardial Infarction Complicated by Cardiogenic Shock Navin K. Kapur, MD, FACC, FSCAI Assistant Professor, Division of Cardiology Director, Acute Circulatory Support Program Director, Interventional
Cardiogenic Shock Protocol
Cardiogenic Shock Protocol Impella Devices Best Practices in AMI Cardiogenic Shock Identify 1-3 SBP < 90 mmhg or on inotropes /pressors Cold, clammy, tachycardia Lactate elevated > 2 mmoi /L Stabilize
Rownak Jahan Tamanna 1, Rowshan Jahan 2, Abduz Zaher 3 and Abdul Kader Akhanda. 3 ORIGINAL ARTICLES
University Heart Journal Vol. 4 No. 2 July 2008 ORIGINAL ARTICLES Correlation of Doppler echocardiography with cardiac catheterization in estimating pulmonary capillary wedge pressure: A tertiary level
Diagnostic & Therapeutic Cardiac Catheterization Coder 2017
Diagnostic & Therapeutic Cardiac Catheterization Coder 2017 Including peripheral and cardiovascular services and procedures Prepared and Published By: MedLearn Publishing A Division of Panacea Healthcare
ECMO Primer A View to the Future
ECMO Primer A View to the Future Todd J. Kilbaugh Assistant Professor of Anesthesiology, Critical Care Medicine, and Pediatrics Director of The ECMO Center at the Children s Hospital of Philadelphia Disclosures
Rationale for Prophylactic Support During Percutaneous Coronary Intervention
Rationale for Prophylactic Support During Percutaneous Coronary Intervention Navin K. Kapur, MD, FACC, FSCAI Assistant Director, Interventional Cardiology Director, Interventional Research Laboratories
The increased use of off-pump coronary artery bypass
Hemodynamic Changes During Posterior Vessel Off-Pump Coronary Artery Bypass: Comparison Between Deep Pericardial Sutures and Vacuum- Assisted Apical Suction Device Woo-Ik Chang, MD, Ki-Bong Kim, MD, Jin
Ischemic Heart Disease Interventional Treatment
Ischemic Heart Disease Interventional Treatment Cardiac Catheterization Laboratory Procedures (N = 11,61) is a regional and national referral center for percutaneous coronary intervention (PCI). A total
Case year old female nursing home resident with a hx CAD, PUD, recent hip fracture Transferred to ED with decreased mental status BP in ED 80/50
Case 1 65 year old female nursing home resident with a hx CAD, PUD, recent hip fracture Transferred to ED with decreased mental status BP in ED 80/50 Case 1 65 year old female nursing home resident with
What is. InSpectra StO 2?
What is InSpectra StO 2? www.htibiomeasurement.com What is InSpectra StO 2? Hemoglobin O 2 saturation is measured in three areas: 1) Arterial (SaO 2, SpO 2 ) Assesses how well oxygen is loading onto hemoglobin
A Validated Practical Risk Score to Predict the Need for RVAD after Continuous-flow LVAD
A Validated Practical Risk Score to Predict the Need for RVAD after Continuous-flow LVAD SK Singh MD MSc, DK Pujara MBBS, J Anand MD, WE Cohn MD, OH Frazier MD, HR Mallidi MD Division of Transplant & Assist