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- Hübbert, Laila, et al.
(författare)
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Axial flow pump treatment during myocardial depression in calves : an invasive hemodynamic and echocardiographic tissue Doppler study.
- 2008
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Ingår i: ASAIO journal (1992). - Philadelphia, PA USA : Lippincott Williams & Wilkins. - 1058-2916 .- 1538-943X. ; 54:4, s. 367-371
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate flow characteristics and myocardial function after implantation of an axial pump left ventricular assist device while varying afterload and during progressive myocardial depression. Ten calves were included, seven of which fulfilled the protocol. Invasive hemodynamic monitoring and echocardiography with color-coded systolic tissue Doppler velocity (TD velocity) were used during prepump conditions, at three different pump speeds, during modification of the systemic vascular resistance (SVR), and during increasing degrees of beta-blockade. The TD velocity decreased with the myocardial function whereas left ventricular size, fractional shortening, and pump speed did not correlate significantly with the TD velocity. The TD velocity correlated significantly with native stroke volume, heart rate, SVR and cardiac output but none of these alone could explain more than 20% of the changes in TD velocity. The axial flow pump studied is effective in unloading the severely depressed heart and has a high capacity for maintaining an adequate cardiac output, regardless of differing hemodynamic conditions, pump speed or decreasing LV function. Echocardiography with volumetric rendering and TD velocity imaging are valuable tools for monitoring and quantifying residual myocardial function during pump treatment.
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- Wårdell, Karin, 1959-, et al.
(författare)
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Circulatory response of cardiac assist treatment
- 2000
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Ingår i: European Conference on Microcirculation,2000. - Bologna, Italy : Monduzzi Editore, International Proceedings Division. - 9783805571227 - 9783318006209
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Konferensbidrag (refereegranskat)
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- Peterzén, Bengt, 1949-
(författare)
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Farmakologisk behandling av svår hjärtsvikt.
- 2002
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Ingår i: Farmakologisk behandling av svårt hjärtsvikt (Svenskt kardiovaskulärt vårmöte, Malmö),2002.
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Konferensbidrag (refereegranskat)
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- Peterzén, Bengt, 1949-
(författare)
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Management of patients treated with left ventricular assist devices : A clinical and experimental study
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes the management of patients treated with mechanical circulatory support devices for short- or long-term use. Twenty-four patients suffering from postcardiotomy heart failure were treated with a minimally invasive axial flow pump. The device was effective in unloading the failing left ventricle and in maintaining an adequate systemic circulation. The principles of perioperative monitoring, and pharmacological therapy are outlined. The pump was also used as an alternative to the heart-lung machine in conjunction with coronary artery bypass surgery. Together with a short-acting β-blocker, esmolol, the heart was decompressed and heart motion was reduced, facilitating bypass surgery on the beating heart. The anesthesiological considerations using this method are described.An implantable left ventricular assist device was used as a bridge to heart transplantation in 10 patients. We were interested in assessing the possibility to establish such a treatment program at a non-transplanting center. A multidisciplinary approach was enabled thanks to the organization of our Heart Center and due the close collaboration with our transplant center at Lund University. As one of the first centers in Europe, we established a well-functioning program with good results. Nine out of 10 of the bridge patients, with treatment times varying between 53 to 873 days, survived pump treatment and were eventually transplanted. The device proved to be powerful enough to support the failing heart and enable rehabilitation of the patients. Outpatient management became simpler when using the electrical device with belt-worn batteries. The uncertain durability and the high risk of device-related complications are shortcomings that limit its potential for more permanent treatment of heart failure.A new generation of small implantable axial blood flow pumps has therefore been developed. The principles of these pumps are based on the first generation axial flow pumps evaluated in this thesis. After several years of basic research and experimental studies, the first human implants have been performed. In the thesis, the hemodynamic effects of such a novel axial flow pump have been evaluated in an acute heart failure model. This technology holds great promise, both as a bridge to heart transplantation, and as a permanent circulatory support system.
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- Valadkhani, Arman, et al.
(författare)
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Postoperative complications and myocardial injury in patients receiving air or oxygen. Prospective, randomised and pilot study
- 2022
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Ingår i: Acta Anaesthesiologica Scandinavica. - : WILEY. - 0001-5172 .- 1399-6576. ; 66:10, s. 1185-1192
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Tidskriftsartikel (refereegranskat)abstract
- Background Supplementary oxygen is administered during anaesthesia to increase oxygen delivery and prevent hypoxia. Recent studies have questioned this routine. In this pilot study, our main aim was to investigate if 21% oxygen compared to >= 50% reduces the risk of postoperative complications and myocardial injury. Methods In this pragmatic, multicentre, single-blind study, patients undergoing vascular surgery were randomised to receive a fraction of inspired oxygen (FiO2) >= 0.50 and oxygen saturation determined by pulse oximetry (SpO(2)) >= 98% (group H) or FiO2 of 0.21 and SpO(2) > 90% (group N) oxygen perioperatively. The primary outcome was a composite outcome of major pre-defined postoperative complications assessed at 30 days. Myocardial injury was determined by serial troponin measurements. Data were analysed using generalised estimating equation, Mann-Whitney U test or chi-squared test, as appropriate. Results The 191 patients were randomised, and per-protocol principle was used for analyses. At 30-day follow-up, 43 out of 94 patients (46%) had a postoperative complication in group H and 36 out of 90 patients (40%) in group N, p = .46. New myocardial injury was seen in 27% versus 22% in Groups H and N respectively (p = .41). No differences in other outcomes were observed between the groups. Twelve patients (13%) in Group N had SpO(2) < 90%, six recovered spontaneously and six required supplemental oxygen. At 1-year follow-up, one patient in group H had died. Conclusion In this pilot study, postoperative complications were similar between the groups in patients randomised to FiO2 of 0.21 or >= 0.50 and no difference was found in the incidence of new myocardial injury. Larger, prospective adequately powered studies are needed.
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