The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform
Jeanlouis Trouillet - One of the best experts on this subject based on the ideXlab platform.
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tissue doppler imaging estimation of Pulmonary Artery Occlusion pressure in icu patients
Intensive Care Medicine, 2004Co-Authors: Alain Combes, Florence Arnoult, Jeanlouis TrouilletAbstract:Objective Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E/E’) measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E/E’ for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E/E’ ratio provides an accurate estimation of Pulmonary Artery Occlusion pressure (PAOP) in mechanically ventilated ICU patients.
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Tissue Doppler imaging estimation of Pulmonary Artery Occlusion pressure in ICU patients
Intensive Care Medicine, 2004Co-Authors: Alain Combes, Florence Arnoult, Jeanlouis TrouilletAbstract:Objective Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E/E’) measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E/E’ for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E/E’ ratio provides an accurate estimation of Pulmonary Artery Occlusion pressure (PAOP) in mechanically ventilated ICU patients. Design and setting Prospective, open, clinical study in the ICU of a university hospital. Patients Twenty-three consecutive mechanically ventilated patients. Interventions Volume expansion in 14 patients. Measurements and results Doppler TTE or TEE mitral inflow and TDI mitral annulus velocities were determined and compared with PAOP measured using a Swan-Ganz catheter. Of all the Doppler variables studied the best correlations were observed between PAOP and the lateral ( r =0.84) and medial ( r =0.76) annulus E/E’ ratio and remained highly significant when the analysis was restricted to TEE ( r =0.91 and 0.86) or TTE ( r =0.73 and 0.61). The sensitivities and specificities of estimating PAOP at 15 mmHg or higher were, respectively, 86% and 81% for lateral E/E’ above 7.5 and 76% and 80% for medial E/E’ above 9. PAOP changes after volume expansion (700±230 ml) were limited and accurately assessed by repeated E/E’ determinations. Conclusions In mechanically ventilated ICU patients TTE or TEE E/E’ determinations using TDI closely approximate PAOP.
Kazuo Shirouzu - One of the best experts on this subject based on the ideXlab platform.
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Retrospective investigation of Pulmonary resection in patients with high total Pulmonary vascular resistance during preoperative unilateral Pulmonary Artery Occlusion.
General thoracic and cardiovascular surgery, 2009Co-Authors: Yoshinori Nagamatsu, Akira Ohkita, Norman Y. Kimura, Goichi Nakayama, Ryozou Hayashida, Hideaki Yamana, Kazuo ShirouzuAbstract:Purpose The aim of this study was to evaluate the indications for Pulmonary resection (lobectomy) in patients with increased total Pulmonary vascular resistance (TPVR) during a preoperative unilateral Pulmonary Artery Occlusion (UPAO) test. According to our previous report, the feasibility of performing lobectomy in patients with a high risk of cardioPulmonary complications is determined on the basis of the increase in TPVR after 15 min of obstruction during the UPAO test (occluded TPVR).
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Pulmonary capacity in lung cancer patients prior to lung resection--comparison of the unilateral Pulmonary Artery Occlusion test with expired gas analysis during exercise testing.
The Kurume medical journal, 1996Co-Authors: Yoshinori Nagamatsu, Hideaki Yamana, Shinzou Takamori, Ryouzou Hayashida, Kazuo ShirouzuAbstract:We attempted to determine if expired gas analysis during exercise testing has equal value to the unilateral Pulmonary Artery Occlusion test (UPAO). Sixty-four lung cancer patients were evaluated. We performed UPAO and measured mean Pulmonary Artery pressure (PPA) and cardiac output (C.O.) 15 min later, and calculated total Pulmonary vascular resistance (TPVR). Expired gas analysis during exercise testing was performed, and the maximum oxygen consumption per unit body surface area (VO2max/m2) and the anaerobic threshold (AT/m2) were calculated. The patients were divided into two groups according to the PPA as follows: Group PPA(L) and Group PPA(H), and the TPVR as follows: Group TPVR(L) and Group TPVR(H). Comparative studies of the mean values of VO2max/m2 and AT/m2 were performed between the two groups. VO2max/m2 was significantly higher in Group PPA(L) than in Group PPA(H). VO2max/m2 was significantly higher in Group TPVR(L) than in Group TPVR(H). TPVR and VO2max/m2 showed no significant correlation, but a weak negative quadratic correlation with the equation y = 2276-246.6 logx was found. This result led a minimal acceptable levels for lung resection of Vo2max/m2 of 650 ml/min/m2 corresponding to the TPVR levels of 700 dyne.sec.cm5/m2.
Tsutomu Sakuma - One of the best experts on this subject based on the ideXlab platform.
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Chronic Pulmonary Artery Occlusion increases alveolar fluid clearance in rats.
The Journal of thoracic and cardiovascular surgery, 2007Co-Authors: Zheng Wang, Motoyasu Sagawa, Miyako Shimazaki, Yoshimichi Ueda, Tsutomu SakumaAbstract:Objective We had observed that Pulmonary Artery ligation for 14 days did not induce lung infiltration in a patient who had undergone a lobectomy for lung cancer. Our hypothesis was that long-term Pulmonary Artery ligation decreased lung water volume and/or increased alveolar fluid clearance. We determined the mechanism responsible for lung water balance in rats with chronic Pulmonary Artery Occlusion for 14 days. Methods Sprague–Dawley rats (n = 45) were used. Through a left thoracotomy, the left Pulmonary Artery was ligated for 14 days. Then, we measured lung water volume, alveolar fluid clearance, the effects of β-adrenergic agonist and antagonist, mRNA expression, and protein expression in the lungs. Results Chronic left Pulmonary Artery Occlusion increased both lung water volume and alveolar fluid clearance in the left lungs, but not in the right lungs with Pulmonary perfusion. Neither a β-agonist nor a β-antagonist changed the increase in alveolar fluid clearance. Real-time polymerase chain reaction revealed an increase in α 1 -Na,K-ATPase mRNA and a decrease of β 2 -adrenoreceptor mRNA, but no change in β 1 -Na,K-ATPase mRNA and α-, β-, γ-epithelial sodium channel mRNA, in the left lung without Pulmonary perfusion. Western blot analysis revealed an increase in α 1 -Na,K-ATPase subunit, but no change in β 1 -Na,K-ATPase subunit. Conclusion Chronic Pulmonary Artery Occlusion increases alveolar fluid clearance via α 1 -Na,K-ATPase overexpression in rats.
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Surgery for the patients whose total Pulmonary vascular resistance was over 700 dyne during unilateral Pulmonary Artery Occlusion test
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai, 1992Co-Authors: Kaoru Koike, Tsutomu Sakuma, Tatsuo Tanita, Ono S, Yugo Ashino, Kubo Y, Jotaro Shibuya, Satoru Iwabuchi, Fujimura SAbstract:To determine the indication for surgery from the point of Pulmonary function, we have performed the unilateral Pulmonary Artery Occlusion test in lung cancer patients. In these patients, we gave a surgery in 13 cases whose total Pulmonary vascular resistance were over 700 dyne.sec.cm-5/M2 per body surface area. The Pulmonary hemodynamics before and during Pulmonary Artery Occlusion were 549 +/- 82 and 798 +/- 78 dyne.sec.cm-5/M2 in total vascular resistance, 18.7 +/- 3.8 and 27.2 +/- 4.3 cmHg in mean Pulmonary arterial pressure and 2.69 +/- 0.36 and 2.73 +/- 4.3 L/min/M2 in cardiac index respectively. In 7 cases out of 13, we performed selective Pulmonary Artery Occlusion test. In Pulmonary function test, 10 cases had a chronic obstructive diseases, 2 cases had a disturbance of diffusion and one case has a contractive disease. We gave a lobectomy in 12 cases and completion pneumonectomy in one case. Two of lobectomy cases died in the early phase: 42 and 72 days after surgery due to Pulmonary complications. One of these cases needed an additional completion pneumonectomy because of bronchial fistel. Surgical complications were seen in 12 cases. These 13 cases used to be recognized that they have no indication of surgery because of low Pulmonary function, however it revealed that we can give a lobectomy through a high intensive care after surgery.
Alain Combes - One of the best experts on this subject based on the ideXlab platform.
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tissue doppler imaging estimation of Pulmonary Artery Occlusion pressure in icu patients
Intensive Care Medicine, 2004Co-Authors: Alain Combes, Florence Arnoult, Jeanlouis TrouilletAbstract:Objective Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E/E’) measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E/E’ for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E/E’ ratio provides an accurate estimation of Pulmonary Artery Occlusion pressure (PAOP) in mechanically ventilated ICU patients.
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Tissue Doppler imaging estimation of Pulmonary Artery Occlusion pressure in ICU patients
Intensive Care Medicine, 2004Co-Authors: Alain Combes, Florence Arnoult, Jeanlouis TrouilletAbstract:Objective Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E/E’) measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E/E’ for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E/E’ ratio provides an accurate estimation of Pulmonary Artery Occlusion pressure (PAOP) in mechanically ventilated ICU patients. Design and setting Prospective, open, clinical study in the ICU of a university hospital. Patients Twenty-three consecutive mechanically ventilated patients. Interventions Volume expansion in 14 patients. Measurements and results Doppler TTE or TEE mitral inflow and TDI mitral annulus velocities were determined and compared with PAOP measured using a Swan-Ganz catheter. Of all the Doppler variables studied the best correlations were observed between PAOP and the lateral ( r =0.84) and medial ( r =0.76) annulus E/E’ ratio and remained highly significant when the analysis was restricted to TEE ( r =0.91 and 0.86) or TTE ( r =0.73 and 0.61). The sensitivities and specificities of estimating PAOP at 15 mmHg or higher were, respectively, 86% and 81% for lateral E/E’ above 7.5 and 76% and 80% for medial E/E’ above 9. PAOP changes after volume expansion (700±230 ml) were limited and accurately assessed by repeated E/E’ determinations. Conclusions In mechanically ventilated ICU patients TTE or TEE E/E’ determinations using TDI closely approximate PAOP.
P Pietropaoli - One of the best experts on this subject based on the ideXlab platform.
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preload index Pulmonary Artery Occlusion pressure versus intrathoracic blood volume monitoring during lung transplantation
Anesthesia & Analgesia, 2002Co-Authors: G Della Rocca, C Coccia, L Pompei, P Di Marco, P Pietropaoli, Gabriella M CostaAbstract:UNLABELLED In this study, during lung transplantation, we analyzed a conventional preload index, the Pulmonary Artery Occlusion pressure (PAOP), and a new preload index, the intrathoracic blood volume index (ITBVI), derived from the single-indicator transPulmonary dilution technique (PiCCO System), with respect to stroke volume index (SVIpa). We also evaluated the relationships between changes (Delta) in ITBVI and PAOP and DeltaSVIpa during lung transplantation. The reproducibility and precision of all cardiac index measurements obtained with the transPulmonary single-indicator dilution technique (CIart) and with the Pulmonary Artery thermodilution technique (CIpa) were also determined. Measurements were made in 50 patients monitored with a Pulmonary Artery catheter and with a PiCCO System at six stages throughout the study. Changes in the variables were calculated by subtracting the first from the second measurement (Delta(1)) and so on (Delta(1) to Delta(5)). The linear correlation between ITBVI and SVIpa was significant (r(2)=0.41; P < 0.0001), whereas PAOP poorly correlated with SVIpa (r(2) = -0.01). Changes in ITBVI correlated with changes in SVIpa (Delta(1), r(2) = 0.30; Delta(2), r(2) = 0.57; Delta(4), r(2) = 0.26; and Delta(5), r(2) = 0.67), whereas PAOP failed. The mean bias between CIart and CIpa was 0.15 l. min(-1). m(-2) (1.37). In conclusion, ITBVI is a valid indicator of cardiac preload and may be superior to PAOP in patients undergoing lung transplantation. IMPLICATIONS The assessment of intrathoracic blood volume index (ITBVI) by the transPulmonary single-indicator technique is a useful tool in lung transplant patients, providing a valid index of cardiac preload that may be superior to Pulmonary Artery Occlusion pressure. However, more prospective, randomized studies are necessary to evaluate the role and limitations of this technique.
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preload index Pulmonary Artery Occlusion pressure and intrathoracic blood volume monitoring during lung transplantation
Critical Care, 2002Co-Authors: G Della Rocca, M G Costa, C Coccia, L Pompei, Federico Pierconti, P Di Marco, P PietropaoliAbstract:We analyzed two preload variables, Pulmonary Artery Occlusion pressure (PAOP) and intrathoracic blood volume index (ITBVI), with respect to cardiac index (CIpa), obtained from Pulmonary Artery catheter (PAC) during lung transplantation. The reproducibility and precision of all transPulmonary single indicator dilution technique (CIart) and CIpa measurements were also evaluated.
