Abstract:
BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is considered when respiratory failure (RF) persists despite increasing conventional mechanical ventilation (CMV). High-frequency jet ventilation (HFJV) can improve ventilation with comparable mean airway pressure (PAW) to that found on CMV. This study was undertaken to determine whether HFJV is an effective treatment and alternative to ECMO for RF after congenital heart surgery. METHODS AND RESULTS:HFJV was instituted in nine patients ranging in age from 6 days to 3.3 years with congenital heart disease meeting pulmonary criteria for ECMO. Indications for HFJV were pulmonary hypertension (six), adult-type respiratory distress syndrome (two), and pneumonitis (one). Seven patients (77%) were placed on HFJV within 24 hours of operation, and two patients required HFJV 2 weeks after operation. HFJV resulted in resolution of RF in eight of nine patients (89%). After 1 hour of HFJV, the arterial pH increased from 7.40 +/- 0.1 to 7.56 +/- 0.1 (p < 0.05) and the PaCO2 decreased from 44 +/- 15 to 29 +/- 12 mm Hg (p < 0.05). During HFJV there was no change in PaO2, although the FIO2 decreased from 0.99 +/- 0.0 to 0.73 +/- 0.2 (p < 0.05). There was no change in PAW, peak inspiratory pressures, positive end-expiratory pressures, heart rate, or mean arterial blood pressure during HFJV when compared with CMV. Mean duration of HFJV was 43 hours. Four patients were extubated and discharged from the hospital. Two patients were extubated but died from sepsis. Two patients had resolution of RF, but one died at reoperation and one from multisystem organ failure. The patient who failed HFJV therapy was placed on ECMO and died. CONCLUSIONS:This study suggests that HFJV improves ventilation and is an alternative to ECMO in patients with RF after surgery for congenital heart disease.
journal_name
Circulationjournal_title
Circulationauthors
Kocis KC,Meliones JN,Dekeon MK,Callow LB,Lupinetti FM,Bove ELsubject
Has Abstractpub_date
1992-11-01 00:00:00pages
II127-32issue
5 Suppleissn
0009-7322issn
1524-4539journal_volume
86pub_type
杂志文章相关文献
CIRCULATION文献大全abstract::We examined the cardiopulmonary effects of maximum bicycle ergometer exercise in seven patients with implanted Intermedics Nova MR pacemakers for three types of pacing in a randomized sequence: VVI or AAI at 70 beats/min (SSI 70), rate-adaptive temperature-controlled pacing with the implanted Nova MR, and rate-adaptiv...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:We tested the hypothesis that long-term administration of the specific angiotensin II subtype 1 (AT1)-receptor blocker BMS-186295 will regress hypertrophy and modify left ventricular angiotensin converting enzyme (ACE) expression in rats with ascending aortic stenosis. METHODS AND RESULTS:Six weeks after su...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.6.1592
更新日期:1997-03-18 00:00:00
abstract:BACKGROUND:Mutations in sarcomere protein, PRKAG2, LAMP2, alpha-galactosidase A (GLA), and several mitochondrial genes can cause rare familial cardiomyopathies, but their contribution to increased left ventricular wall thickness (LVWT) in the community is unknown. METHODS AND RESULTS:We studied 1862 unrelated particip...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.105.593558
更新日期:2006-06-13 00:00:00
abstract:BACKGROUND:The release of endothelium-derived relaxing factors has been shown experimentally to be of pivotal importance for the maintenance of coronary blood flow during increased demand. In humans with coronary atherosclerosis, endothelial vasodilator dysfunction is not confined only to epicardial conductance vessels...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.9.2345
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:Chronic orthostatic intolerance (OI) is characterized by symptoms of inadequate cerebral perfusion with standing, in the absence of significant orthostatic hypotension. A heart rate increase of >/=30 bpm is typical. Possible underlying pathophysiologies include hypovolemia, partial dysautonomia, or a primary...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.99.13.1706
更新日期:1999-04-06 00:00:00
abstract:BACKGROUND:Adenylyl cyclases (ACs) are a family of effector molecules for G-protein-coupled receptors. The 2 ACs most abundantly expressed in cardiac myocytes are types 5 (AC5) and 6 (AC6), which have 65% amino acid homology. It has been speculated that coexpression of 2 AC types in cardiac myocytes represents redundan...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.730069
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The late hemodynamic effects of preserving the papillary muscles during mitral valve replacement have not been evaluated. METHODS AND RESULTS:Sixteen patients who had chronic mitral regurgitation due to myxomatous degeneration were randomized to preservation (Pres group, n = 8) or no preservation (No Pres g...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Thrombin plays a role in mediating ischemic injury and cardiac arrhythmias, but the mechanisms involved are poorly understood. Because voltage-gated sodium channels (VGSCs) have not previously been considered, putative effects of thrombin on VGSC function were investigated in human isolated cardiomyocytes. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000034510.64828.96
更新日期:2002-10-15 00:00:00
abstract:BACKGROUND:During heart development, the ventricular activation sequence changes from a base-to-apex to an apex-to-base pattern. We investigated the possibility of impulse propagation through remnants of atrioventricular (AV) connections in quail hearts. METHODS AND RESULTS:In 86 hearts (group A, HH30-34, n=15; group ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.658807
更新日期:2007-01-02 00:00:00
abstract::The effect of the ouabain-quinidine interaction was examined in 10 conscious dogs. Left ventricular (LV) pressure, LV dP/dt, LV diameter and left atrial (LA) diameter were measured with high-fidelity micromanometers and sonomicrometer crystals. Ouabain, 0.025 mg/kg, significantly (p less than 0.05) increased LV dP/dt,...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.5.1054
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Repolarization dispersion (Rd) is frequently mentioned as a predictor of cardiac abnormalities. We present a new measure of Rd based on the root-mean-square (RMS) curve of an ECG lead set and compare its performance with that of the commonly used QT dispersion (QTd) measure with the use of recovery times mea...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.6.685
更新日期:2000-08-08 00:00:00
abstract:BACKGROUND:A major advantage of coronary artery bypass graft surgery (CABG) relative to percutaneous coronary intervention is its durability, yet there is a paucity of information on rates and predictors of repeat coronary revascularization after CABG in the modern era. METHODS AND RESULTS:We included patients ≥65 yea...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.113.001882
更新日期:2013-04-23 00:00:00
abstract:BACKGROUND:We measured cardiovagal baroreflex gain and its vascular mechanical and neural components during dynamic baroreflex engagement in 10 young untrained men, 6 older untrained men, and 12 older, physically active men. METHODS AND RESULTS:Our newly developed assessment of beat-to-beat carotid diameters during ba...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.20.2424
更新日期:2001-05-22 00:00:00
abstract::BACKGROUND. A pace mapping technique using body surface potential maps (BSPMs) was developed to guide the positioning of an ablation catheter at the ventricular insertion point of accessory pathways (AP) in patients with the Wolff-Parkinson-White syndrome (WPW). METHODS AND RESULTS. The study was performed on 30 WPW p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.1.135
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Although the dominant product of vascular Cyclooxygenase-2 (COX-2), prostacyclin (PGI(2)), restrains atherogenesis, inhibition and deletion of COX-2 have yielded conflicting results in mouse models of atherosclerosis. Floxed mice were used to parse distinct cellular contributions of COX-2 in macrophages and ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.910687
更新日期:2010-06-22 00:00:00
abstract:BACKGROUND:The development of selective atrial antiarrhythmic agents is a current strategy for suppression of atrial fibrillation (AF). METHODS AND RESULTS:Whole-cell patch clamp techniques were used to evaluate inactivation of peak sodium channel current (I(Na)) in myocytes isolated from canine atria and ventricles. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.704890
更新日期:2007-09-25 00:00:00
abstract:BACKGROUND:Pulmonary hypertension caused by systolic left ventricular dysfunction is associated with significant morbidity and mortality; however, no treatment is approved for this indication. We hypothesized that riociguat, a novel soluble guanylate cyclase stimulator, would have beneficial hemodynamic effects in pati...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.113.001458
更新日期:2013-07-30 00:00:00
abstract:BACKGROUND:We reviewed the outcome of 76 consecutive patients (age range, 5 months to 6 years; median age, 19 months) who underwent a modified Fontan procedure after initial palliative surgery for hypoplastic left heart syndrome (HLHS) between January 1984 and December 1989. METHODS AND RESULTS:Modifications of the Fo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.1.116
更新日期:1992-01-01 00:00:00
abstract::The morphologic consequences of transluminal angioplasty of stenotic atherosclerotic coronary arteries are unknown. This study describes the production of aortoiliac atherosclerosis in rabbits and reports the morphologic changes after transluminal angioplasty of stenotic arterial lesions. Atherosclerotic lesions were ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.61.4.778
更新日期:1980-04-01 00:00:00
abstract::Analysis of the external brachial pulse recorded during standard blood pressure cuff deflation with use of a transducer with a wide frequency response has revealed a reproducible pattern with three distinct components that we have labeled K1, K2, and K3. K1 is a low-amplitude, low-frequency signal that is present with...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.77.6.1297
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Depression is an independent risk factor for myocardial infarction (MI). Selective serotonin reuptake inhibitors (SSRIs) may reduce this risk through attenuation of serotonin-mediated platelet activation in addition to treatment of depression itself. METHODS AND RESULTS:case-control study of first MI in smo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc4101.097519
更新日期:2001-10-16 00:00:00
abstract:BACKGROUND:Calcineurin is a calcium-regulated phosphatase that plays a major role in cardiac hypertrophy. We previously described that alternative splicing of the calcineurin Aβ (CnAβ) gene generates the CnAβ1 isoform, with a unique C-terminal region that is different from the autoinhibitory domain present in all other...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.012211
更新日期:2011-06-21 00:00:00
abstract:BACKGROUND:The identification of sites of dominant activation frequency during atrial fibrillation (AF) in humans and the effect of ablation at these sites have not been reported. METHODS AND RESULTS:Thirty-two patients undergoing AF ablation (19 paroxysmal, 13 permanent) during ongoing arrhythmia were studied. Electr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.517011
更新日期:2005-08-09 00:00:00
abstract:BACKGROUND:Platelet deposition and aggregation are central to the pathogenesis of ischemic complications of acute coronary syndromes (ACS). Pharmacodynamic effects of the platelet glycoprotein IIb/IIIa antagonist eptifibatide have been delineated in healthy subjects but not in patients with ACS. We assessed effects of ...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/hc2901.093500
更新日期:2001-07-24 00:00:00
abstract:BACKGROUND:Selection of treatment in vasovagal syndrome should be guided by the mechanism of symptoms. This study determined whether a simple drug test may assess one mechanism. METHODS AND RESULTS:To identify patients at risk of severe cardioinhibitory response of vagal origin, we infused 20 mg ATP into 316 patients ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.4.1201
更新日期:1997-08-19 00:00:00
abstract:BACKGROUND:Thrombolytic therapy of acute myocardial infarction (AMI) is evolving toward bolus administration. Derivatization of proteins with polyethylene glycol (PEG) may reduce their clearance. METHODS AND RESULTS:A staphylokinase (SakSTAR) variant with 12 amino acid substitutions to reduce its antigenicity, SakSTAR...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.102.15.1766
更新日期:2000-10-10 00:00:00
abstract:BACKGROUND:Ultrasonic angioplasty was recently shown to ablate thrombi and atherosclerotic plaques in vitro and to recanalize occluded arteries in experimental animal models. The goal of the present study was to examine the clinical feasibility of ultrasonic angioplasty. METHODS AND RESULTS:Intraoperative ultrasonic a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.6.1976
更新日期:1991-06-01 00:00:00
abstract::The relationship between fasting plasma cholesterol and triglyceride concentrations and the frequency and extensiveness of coronary artery disease (CAD) was studied in 496 subjects evaluated for chest pain by coronary arteriography at The Methodist Hospital. One hundred six of the patients had no CAD while 390 had 25%...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.56.5.875
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Children listed for heart transplantation face the highest waiting list mortality in solid-organ transplantation medicine. We examined waiting list mortality since the pediatric heart allocation system was revised in 1999 to determine whether the revised allocation system is prioritizing patients optimally a...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.108.815712
更新日期:2009-02-10 00:00:00
abstract:BACKGROUND:Two types of ischemia, pacing-induced and coronary occlusion-induced, have different effects on left ventricular diastolic properties. During pacing-induced ischemia, the diastolic pressure-volume relation is said to shift upward, whereas during coronary occlusion, it is said to shift rightward or downward. ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.9.2423
更新日期:1995-05-01 00:00:00