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Hiroshi Ito - One of the best experts on this subject based on the ideXlab platform.

  • safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector row computed tomography coronary angiography
    Circulation, 2013
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P<0.01). Heart rates before scanning in patients receiving landiolol hydrochloride were similar to those receiving other drugs. Heart rate was significantly reduced approximately 5 min after Injection of landiolol hydrochloride and increased shortly. No decrease in systolic blood pressure or other adverse effects was observed. Conclusions: Bolus Injection of landiolol hydrochloride sufficiently reduced heart rate without significantly reducing systolic blood pressure and produced a high percentage of evaluable images, suggesting that Bolus Injection of landiolol hydrochloride as an additional pretreatment is feasible in MDCT CAG. (Circ J 2013; 77: 146 – 152)

  • Safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector-row computed tomography coronary angiography.
    Circulation journal : official journal of the Japanese Circulation Society, 2012
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P

Talmage D. Egan - One of the best experts on this subject based on the ideXlab platform.

  • The safety of remifentanil by Bolus Injection
    Expert opinion on drug safety, 2005
    Co-Authors: Scott Richardson, Talmage D. Egan
    Abstract:

    Remifentanil is the newest of the fentanyl family of short-acting phenylpiperidine derivatives to be released into clinical practice. Remifentanil is a pure agonist at the μ opioid receptor with relatively little binding at the κ, σ or δ receptors. This is precisely the same profile as the other opioids currently popular in anaesthetic practice (fentanyl, alfentanil, sufentanil) and it offers the same advantages (profound analgesia, sedation, attenuation of the stress response). This has led to widespread use of remifentanil as an adjunct to general anaesthesia in a variety of clinical settings. The unique pharmacology of remifentanil, in particular its rapid offset, has more recently attracted clinicians and investigators to the use of remifentanil by Bolus Injection, especially for procedures requiring a brief, intense, opioid effect. The clinical effects of remifentanil, both therapeutic and adverse, are consistent with that of the other fentanyl congeners. However, the pharmacokinetic profile of remif...

  • Remifentanil by Bolus Injection: a safety, pharmacokinetic, pharmacodynamic, and age effect investigation in human volunteers
    British journal of anaesthesia, 2004
    Co-Authors: Talmage D. Egan, Steven E. Kern, Keith T. Muir, Julia L. White
    Abstract:

    Background Although remifentanil's short-acting pharmacokinetic profile makes it well suited for procedures during which a brief period of intense analgesia is required, setting up an infusion pump for brief procedures is inconvenient. The clinical pharmacology of remifentanil administered by Bolus Injection, a more convenient alternative, has not been explored in detail. The primary aim of this study was to examine the safety of single Bolus doses of remifentanil in conscious, healthy, adult volunteers breathing room air. Secondary aims included the evaluation of remifentanil pharmacokinetics and analgesic effects after Bolus Injection and a comparison of these issues in younger vs older adults. Methods Using a randomized, double-blind, placebo-controlled, dose-escalation, crossover study design, 64 subjects (16 over 60 years old) received remifentanil or placebo by Bolus Injection in a fixed unit dose separated by a 1 h washout period. Respiratory effects were assessed using a respiratory intervention scale. Analgesic effects were assessed using pressure algometry. A population pharmacokinetic model was constructed using non-linear, mixed-effects modelling techniques based on arterial blood samples. Computer simulations were performed to illustrate the clinical application of the pharmacokinetic model. Results Dose-related increases in both respiratory and analgesic effects were observed. In general, the respiratory depression observed was mild and easily treated with requests to breathe or the administration of oxygen, although the older cohort (and some younger subjects) experienced more substantial respiratory depression at lower doses. The pharmacokinetics of Bolus-dose remifentanil were adequately described by a two-compartment model. The pharmacokinetic simulations illustrated the potential utility of Bolus-dose remifentanil. Conclusions Bolus Injection could potentially be a safe and effective means of administering remifentanil in clinical situations requiring a brief period of intense analgesia. Because some subjects, both old and young, experienced significant respiratory depression even at low doses, careful monitoring of respiratory function is essential.

  • Midazolam and remifentanil by Bolus Injection for intensely stimulating procedures of brief duration: experience with awake laryngoscopy.
    Anesthesia and analgesia, 2002
    Co-Authors: Ken B. Johnson, Talmage D. Egan, Jeffrey D. Swenson, Robert A. Jarrett, Mathew Johnson
    Abstract:

    IMPLICATIONS The pharmacokinetic characteristics of midazolam and remifentanil administered by Bolus Injection may make them advantageous for providing brief, intense analgesia without prolonged respiratory depression. This application is particularly useful for awake, direct laryngoscopy.

Kazuhiro Osawa - One of the best experts on this subject based on the ideXlab platform.

  • safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector row computed tomography coronary angiography
    Circulation, 2013
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P<0.01). Heart rates before scanning in patients receiving landiolol hydrochloride were similar to those receiving other drugs. Heart rate was significantly reduced approximately 5 min after Injection of landiolol hydrochloride and increased shortly. No decrease in systolic blood pressure or other adverse effects was observed. Conclusions: Bolus Injection of landiolol hydrochloride sufficiently reduced heart rate without significantly reducing systolic blood pressure and produced a high percentage of evaluable images, suggesting that Bolus Injection of landiolol hydrochloride as an additional pretreatment is feasible in MDCT CAG. (Circ J 2013; 77: 146 – 152)

  • Safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector-row computed tomography coronary angiography.
    Circulation journal : official journal of the Japanese Circulation Society, 2012
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P

Rolf W. Günther - One of the best experts on this subject based on the ideXlab platform.

  • Measurement of cardiac output from a test-Bolus Injection in multislice computed tomography.
    European radiology, 2003
    Co-Authors: Andreas H. Mahnken, Ernst Klotz, A. Hennemuth, Bettina Jung, Ralf Koos, Joachim E. Wildberger, Rolf W. Günther
    Abstract:

    The aim of this study was to assess the feasibility of non-invasive determination of cardiac function from test-Bolus data in multislice spiral computed tomography (MSCT). In 25 patients enhancement data gathered from a standardized test-Bolus Injection were analyzed. The test-Bolus examination was performed prior to a retrospectively ECG-gated MSCT of the heart. A time-attenuation curve was obtained in the ascending aorta at the level of the pulmonary arteries. A gamma variate fit was applied to the curve in order to exclude recirculation and get pure first-pass data. Using the known amount of iodine injected, cardiac output (CO), and stroke volume (SV) were determined from integration of the fitted contrast enhancement curve using a reformation of the Stewart-Hamilton equation. Results were compared with CO and SV calculated from the geometric analysis of the retrospectively gated MSCT data using the ARGUS Software (Siemens, Forchheim, Germany). The CO and SV determined from test-Bolus analysis and from geometric analysis correlated well with Pearson's correlation coefficients of 0.87 and 0.88, respectively. The standard deviation of the difference between both methods was 0.51 l/min for CO (8.6%) and 11.0 ml for SV (12.3%). Non-invasive quantification of CO seems to be feasible from a standard test-Bolus Injection. It provides valuable information on cardiac function without additional radiation or application of contrast material.

Kengo Kusano - One of the best experts on this subject based on the ideXlab platform.

  • safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector row computed tomography coronary angiography
    Circulation, 2013
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P<0.01). Heart rates before scanning in patients receiving landiolol hydrochloride were similar to those receiving other drugs. Heart rate was significantly reduced approximately 5 min after Injection of landiolol hydrochloride and increased shortly. No decrease in systolic blood pressure or other adverse effects was observed. Conclusions: Bolus Injection of landiolol hydrochloride sufficiently reduced heart rate without significantly reducing systolic blood pressure and produced a high percentage of evaluable images, suggesting that Bolus Injection of landiolol hydrochloride as an additional pretreatment is feasible in MDCT CAG. (Circ J 2013; 77: 146 – 152)

  • Safety and efficacy of a Bolus Injection of landiolol hydrochloride as a premedication for multidetector-row computed tomography coronary angiography.
    Circulation journal : official journal of the Japanese Circulation Society, 2012
    Co-Authors: Kazuhiro Osawa, Toru Miyoshi, Shuhei Sato, Noriaki Akagi, Yusuke Morimitsu, Kazufumi Nakamura, Kunihisa Kohno, Kengo Kusano, Susumu Kanazawa, Hiroshi Ito
    Abstract:

    Background: We evaluated the safety and efficacy of a Bolus Injection of landiolol hydrochloride, an ultrashort-acting β1-selective antagonist, as an additional treatment after premedication with an oral β-blocker to reduce heart rate prior to multidetector-row computed tomography (MDCT) coronary angiography (CAG). Methods and Results: A total of 458 patients who underwent MDCT CAG were retrospectively enrolled. Image quality and hemodynamic parameters were compared in patients before and after approval of landiolol hydrochloride. If heart rate reduction was insufficient after premedication with an oral β-blocker, a Bolus Injection of landiolol hydrochloride (n=66) or other drugs (n=30) was used. The percentage of evaluable images per segment in patients after approval of landiolol (99.3%) was greater than that in patients before approval of landiolol (97.4%, P