Left ventricular outflow tract obstruction-be prepared!

Abstract:

:The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery. It is more common in the elderly, females, and in patients with hypertension, diabetes, and chronic vascular disease because of predisposing anatomical conditions such as left ventricular hypertrophy, small left ventricle size, sigmoid septum and alterations in the positions of the aortic and mitral valve annular planes. The onset of LVOTO is largely unpredictable due to a complex interplay between preload, afterload, heart rhythm and rate in susceptible patients. The consequences of missing this treatable condition may lead to life-threatening hypotension refractory to, or exacerbated by, a further increase in inotropic support. Dynamic LVOTO should be considered in any hypotensive intensive care patient. Echocardiography is perhaps the best tool to assess LVOTO and its underlying pathophysiology in the critically ill. Detection of LVOTO is a relatively simple task using a combination of two-dimensional, M-mode and spectral Doppler imaging by an operator alert to the possible diagnosis.

journal_name

Anaesth Intensive Care

authors

Evans JS,Huang SJ,McLean AS,Nalos M

doi

10.1177/0310057X1704500103

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

12-20

issue

1

eissn

0310-057X

issn

1448-0271

pii

20160422

journal_volume

45

pub_type

杂志文章
  • Immediate management of inadvertent dural puncture during insertion of a labour epidural: a survey of Australian obstetric anaesthetists.

    abstract::Immediate management of inadvertent dural puncture during insertion of an epidural needle during labour is controversial and evidence to guide clinical practice is limited. We surveyed Australian obstetric anaesthetists by anonymous postal questionnaire. Of the 671 surveys sent, 417 (62%) were returned. Following dura...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0803600117

    authors: Newman MJ,Cyna AM

    更新日期:2008-01-01 00:00:00

  • Evaluating sleep characteristics in intensive care unit and non-intensive care unit physicians.

    abstract::Healthcare workers' cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epwort...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1103900614

    authors: Ok G,Yilmaz H,Tok D,Erbüyün K,Coban S,Dinç G

    更新日期:2011-11-01 00:00:00

  • Neuroimmune mechanisms of pain: Basic science and potential therapeutic modulators.

    abstract::This narrative review aims to describe the role of peripheral and central immune responses to tissue and nerve damage in animal models, and to discuss the use of immunomodulatory agents in clinical practice and their perioperative implications. Animal models of pain have demonstrated that nerve injury activates immune...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X20902774

    authors: Lim JS,Kam PC

    更新日期:2020-05-01 00:00:00

  • A comparison of pulse contour wave analysis and ultrasonic cardiac output monitoring in the critically ill.

    abstract::Cardiac output (CO) is a key determinant of major organ blood flow and solute delivery to drug eliminating organs. As such, CO assessment is a key covariate in understanding altered drug handling in the critically ill. Newer minimally-invasive devices are providing unique platforms for such an application, although co...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1204000408

    authors: Udy AA,Altukroni M,Jarrett P,Roberts JA,Lipman J

    更新日期:2012-07-01 00:00:00

  • Adhesive properties of Micropore, Transpore, Leucoplast and Sleek.

    abstract::Adhesive tapes are a routine part of every anaesthetic. Until now there has been little clinical data on the efficacy of these tapes. This study compared Micropore Transpore, Leukoplast and Sleek to determine if any significant difference existed between the adhesive properties of these tapes. The tapes were trialled ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0203000214

    authors: Chaffer JE,Moyle E

    更新日期:2002-04-01 00:00:00

  • Maternal and fetal levels of propofol at caesarean section.

    abstract::Twenty women were given a bolus induction of propofol 2.0 mg.kg-1 for elective caesarean section. Induction to delivery times ranged from five to fourteen minutes. At delivery the maternal venous (MV) concentrations of propofol ranged from 0.53 to 1.48 micrograms.ml-1 umbilical vein (UV) 0.39 to 1.4 micrograms.ml-1 an...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9001800204

    authors: Gin T,Gregory MA,Chan K,Oh TE

    更新日期:1990-05-01 00:00:00

  • Preoperative magnesium trisilicate in infants.

    abstract::Three groups, each of forty children aged less than five years and prepared for elective surgery, had their gastric contents' volume and pH measured. The control group showed an incidence of 67-5 per cent with high acidity (pH equal to or less than 2-5). In the second and third groups magnesium trisilicate mixture was...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7600400303

    authors: Hutchinson BR

    更新日期:1976-08-01 00:00:00

  • Anaesthetic assistants: their role in the development and resolution of anaesthetic incidents.

    abstract::Trained anaesthetic assistants are considered essential for the safe conduct of anaesthesia. Data from 5837 AIMS (Anaesthetic Incident Monitoring Study) reports were evaluated for issues concerning anaesthetic assistants in the generation and resolution of anaesthetic incidents. "Inadequate assistance" as a contributi...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700308

    authors: Kluger MT,Bukofzer M,Bullock M

    更新日期:1999-06-01 00:00:00

  • A scavenging device for the T-piece.

    abstract::An inexpensive and convenient method of collecting waste gases from the open-tailed bag of a T-piece system is described. ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7700500318

    authors: Keneally JP,Overton JH

    更新日期:1977-08-01 00:00:00

  • Equivalent metabolic acidosis with four colloids and saline on ex vivo haemodilution.

    abstract::Colloid infusions can cause metabolic acidosis. Mechanisms and relative severity with different colloids are incompletely understood. We compared haemodilution acid-base effects of 4% albumin, 3.5% polygeline, 4% succinylated gelatin (all weak acid colloids, strong ion difference 12 mEq/l, 17.6 mEq/l and 34 mEq/l resp...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0903700304

    authors: Morgan TJ,Vellaichamy M,Cowley DM,Weier SL,Venkatesh B,Jones MA

    更新日期:2009-05-01 00:00:00

  • Preoperative hypnotherapy in the management of a child with anticipatory nausea and vomiting.

    abstract::A six-year-old boy with oesophageal strictures secondary to neonatal repair of oesophageal atresia and requiring six to eight weekly oesophageal dilatations by bouginage developed anticipatory nausea and vomiting. This was effectively managed by a course of preoperative hypnotherapy over four sessions. Resolution of a...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0703500522

    authors: Mackenzie A,Frawley GP

    更新日期:2007-10-01 00:00:00

  • Computer controlled studies in surface cooling hypothermia: the effect of carbon dioxide on brain temperature.

    abstract::A computer controlled ventilation system was employed to maintain a constant end-expired CO2 percentage (FECO2) during a series of studies on young dogs aimed at measuring brain temperature differences during surface cooling hypothermia. The conclusion is that an FECO2 of six per cent or more is desirable if brain tem...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7600400107

    authors: Brown TC,Lampard DG,Brown WA,Coles JR

    更新日期:1976-02-01 00:00:00

  • Central venous and pulmonary artery occlusion pressures following air embolism in upright sheep.

    abstract::A study on five upright (head above thorax) anaesthetised sheep demonstrated a statistically significant increase in central venous pressure and decrease in pulmonary artery occlusion pressure, following the injection of air 2 ml per kg into the pulmonary artery. In two out of the five sheep after air embolism, right-...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8401200408

    authors: Pfitzner J,McLean AG

    更新日期:1984-11-01 00:00:00

  • Comparison of isoflurane, halothane and fentanyl in patients with decreased ejection fraction undergoing coronary surgery.

    abstract::The aim of the study was to compare three anaesthetic agents in patients with ejection fraction below 0.40 subjected to coronary revascularization surgery. Twenty five elective coronary surgical patients with ejection fraction below 0.40 were prospectively studied. Premedication was pethidine 1 mg/kg and induction was...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9602400513

    authors: Urzua J,Serra M,Lema G,Canessa R,Gonzalez R,Meneses G,Irarrazaval M,Moran S

    更新日期:1996-10-01 00:00:00

  • Continuous tunnelled femoral nerve block for palliative care of a patient with metastatic osteosarcoma.

    abstract::An 18-year-old man with metastatic femoral osteosarcoma had inadequate pain control with gabapentin, naproxen and intravenous fentanyl. A tunnelled femoral nerve catheter was used to administer a continuous infusion of 0.2% ropivacaine and 4 microg/ml clonidine (10 ml/hour) until his death 88 days later During dischar...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800324

    authors: Pacenta HL,Kaddoum RN,Pereiras LA,Chidiac EJ,Burgoyne LL

    更新日期:2010-05-01 00:00:00

  • Charging for intensive care using direct nursing hours as the cost marker.

    abstract::The hypothesis that direct nursing hours correlate with the cost of a patient stay in intensive care was tested. One hundred and thirty-nine patients were studied and the data collected included: (a) direct nursing hours applied to each patient; (b) a daily TISS score: (c) a detailed costing of each patient (all costs...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9702500409

    authors: Havill JH,Caspari M,McConnell H,Alexander M,Montgomery C

    更新日期:1997-08-01 00:00:00

  • The role of preoperative cervical spine X-rays in rheumatoid arthritis.

    abstract::The cervical spine is frequently involved in rheumatoid arthritis and yet there exists no consensus on the need to screen for cervical spine subluxations preoperatively. We reviewed retrospectively 77 patients who underwent 132 operations under general or regional anaesthesia over a 44-month period. We found that whil...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9802600604

    authors: Kwek TK,Lew TW,Thoo FL

    更新日期:1998-12-01 00:00:00

  • Pulmonary extraction of catecholamines in critically ill patients.

    abstract::Plasma catecholamine concentrations in blood obtained simultaneously from the pulmonary and radial arteries of ten critically ill patients have been measured. The mean mixed venous concentrations of noradrenaline, adrenaline and dopamine were extremely high, noradrenaline 11.3 pmol/ml (SD 11.6), adrenaline 2.7 pmol/ml...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8201000404

    authors: Russell WJ,Frewin DB,Jonsson JR

    更新日期:1982-11-01 00:00:00

  • Chloroform for the King? Joseph Clover, Henry Thompson and the King of the Belgians.

    abstract::In May 1863 the British surgeon, Henry Thompson, departed for Belgium to attend Leopold, King of the Belgians. The King was in agony: he had suffered with bladder stones for months and multiple procedures, without anaesthesia, had failed to relieve his symptoms. Henry Thompson was therefore consulted about the possibi...

    journal_title:Anaesthesia and intensive care

    pub_type: 历史文章,杂志文章

    doi:

    authors: Ball C

    更新日期:2011-07-01 00:00:00

  • Intraoperative assessment of the Lawrence 3000 Doppler Cardiac Output Monitor.

    abstract::Transoesophageal Doppler cardiac output measurement was evaluated against the thermodilution method in eleven patients undergoing elective cardiac surgery. A total of 106 pairs of Doppler and thermodilution values were obtained. Cardiac output was measured over a range of 2.3 l.min-1. to 11.51 l.min-1. The mean differ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9101900219

    authors: Stein MS,Barratt SM,Purcell GJ

    更新日期:1991-05-01 00:00:00

  • The effect of remote ischaemic preconditioning on myocardial injury in patients undergoing off-pump coronary artery bypass graft surgery.

    abstract::In several recent clinical trials on cardiac surgery patients, remote ischaemic preconditioning (RIPC) showed a powerful myocardial protective effect. However the effect of RIPC has not been studied in patients undergoing off-pump coronary artery bypass graft surgery. We evaluated whether RIPC could induce myocardial ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X1003800518

    authors: Hong DM,Mint JJ,Kim JH,Sohn IS,Lim TW,Lim YJ,Bahk JH,Jeon Y

    更新日期:2010-09-01 00:00:00

  • Does a catheter over needle system reduce infusate leak in continuous peripheral nerve blockade: a randomised controlled trial.

    abstract::Continuous peripheral nerve blockade is a common technique in the analgesic management for many procedures. Leakage of local anaesthetic from around the nerve catheter insertion site can increase the chance of catheter dislodgement, risks infective complications, and could divert anaesthetic away from the nerve causin...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X1804600507

    authors: Edwards RM,Currigan DA,Bradbeer S,Mitchell C

    更新日期:2018-09-01 00:00:00

  • The making of an anesthesiologist: a review of the American scene.

    abstract::Many anaesthetists practising in Australia and New Zealand realise that differences exist in the training of their counterparts in the United States. This review attempts to highlight the differences observed by two anaesthetists who have been involved in both systems. Aspects of the American Board of Anesthesiology e...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8301100319

    authors: Ronai A,Shanks CA

    更新日期:1983-08-01 00:00:00

  • High-volume spinal anaesthesia. A dose-response study of bupivacaine 0.125%.

    abstract::The clinical effects of high-volume spinal anaesthesia with bupivacaine 0.125% were studied in 30 patients presenting for postpartum sterilisation. Group A, B and C patients received 6, 8 and 10 ml of bupivacaine 0.125% respectively. Onset, duration and regression of sensory block and motor blockade, haemodynamic para...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9202000407

    authors: Tay DH,Tay SM,Thomas E

    更新日期:1992-11-01 00:00:00

  • Predictive performance of a model of anaesthetic uptake with desflurane.

    abstract::We have previously shown that a model of anaesthetic uptake and distribution, developed for use as a teaching tool, is able to predict end-tidal isoflurane and sevoflurane concentrations at least as well as commonly used propofol models predict blood levels of propofol. Models with good predictive performance may be u...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0603400215

    authors: Kennedy R

    更新日期:2006-04-01 00:00:00

  • The effects of different doses of caudal morphine with levobupivacaine on postoperative vomiting and quality of analgesia after circumcision.

    abstract::The study aim was to investigate the effect of three different morphine doses added to levobupivacaine 0.125% for caudal analgesia after circumcision surgery in children, particularly in relation to the frequency of postoperative vomiting within the first 24 hours following surgery. Two hundred and forty patients aged...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X1404200211

    authors: Dostbil A,Gursac Celik M,Aksoy M,Ahiskalioglu A,Celik EC,Alici HA,Ozbey I

    更新日期:2014-03-01 00:00:00

  • Awareness in retrieval medicine.

    abstract::Awareness is the spontaneous recall of an event(s) that occurred during general anaesthesia and surgery. The incidence of awareness is approximately 0.2% of cases where neuromuscular blockers are used and half that where they are omitted. The majority of data relating to awareness is from anaesthetic practice. We repo...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0603400519

    authors: Gibson J,Flabouris A

    更新日期:2006-10-01 00:00:00

  • Acute intracranial hypertension occurring during infusion of stable plasma protein solution.

    abstract::A case of traumatic cerebral oedema is reported in which the infusion of small volumes of stable plasma protein solution (SPPS) resulted in acute and massive increases in intracranial pressure. The batch of SPPS responsible was found to have high levels of prekallikrein activator which is thought to be the cause of th...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800416

    authors: Duncan AW,Gleeson MT

    更新日期:1980-11-01 00:00:00

  • A comparison of parametric and non-parametric approaches to target-controlled infusion of propofol.

    abstract::Nineteen adult patients of either gender received intravenous infusions of propofol, scaled to estimated lean body mass (LBM), for 150 minutes as part of a balanced anaesthetic. Arterial blood was assayed for whole blood propofol. The first subject received propofol at a fixed rate of 0.058 mg x min(-1) x kg(LBM)(-1)....

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800305

    authors: Crankshaw DP,Brown MJ,Bjorksten AR

    更新日期:2010-05-01 00:00:00

  • Anaesthesia for acute intestinal obstruction associated with cerebral arteriovenous malformation in a child.

    abstract::This case report describes the perioperative management of a child presenting with acute intestinal obstruction secondary to bowel malrotation after a recent intracranial haemorrhage associated with an intracranial arteriovenous malformation. We discuss the anaesthesia planning for this case, where the 'optimal' manag...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800133

    authors: Scarth EJ,White MC

    更新日期:2010-01-01 00:00:00