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1.
A. Montalto V. Piazza F. Albi R. Gherli C. Contento A. Palermo F. Musumeci 《Transplantation proceedings》2019,51(1):206-209
Background
Pump speed optimization in patients implanted with a ventricular assist device represents a major challenge during the follow-up period. We present our findings on whether combined invasive hemodynamic ramp tests and cardiopulmonary exercise testing (CPX) can help optimize patient management.Methods
Eighteen patients implanted with a HeartMate 3 (HM3) device underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography. Data were recorded at up to 4 speed settings. Speed changes were in steps of 200 revolutions/min (rpm). Evaluation of functional capacity by CPX was conducted according to the modified Bruce protocol.Results
Only 30% of patients had normal PCWPs at their original rpm settings. In going from lowest to highest speeds, cardiac output improved by 0.25 ± 0.35 L/min/step (total change, 1.28 ± 0.3 L/min), and PCWP decreased by 1.9 ± 0.73 mm Hg/step (total change, 6 ± 1.6 mm Hg). CVP and systolic blood pressure did not change significantly with rpm. The rpm assessment was adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in all patients. On CPX, all patients demonstrated good performance (peak VO2, 16.8 ± 3.5 mL/kg/min).Conclusion
Hemodynamic ramp testing provides an objective means of optimizing rpm, and has the potential to provide good exercise tolerance. 相似文献2.
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Effect of nedocromil on bronchospasm induced by inhalation of substance P in asthmatic subjects 总被引:3,自引:0,他引:3
N Crimi F Palermo R Oliveri B Palermo C Vancheri R Polosa A Mistretta 《Clinical allergy》1988,18(4):375-382
Several studies have demonstrated that neuropeptides are present in peptidergic fibres of bronchial tissue. The aim of the present study was to evaluate in vivo the effect of nedocromil sodium (2 x 2 mg) on bronchospasm induced by inhalation of substance P. Six moderate asthmatic patients, mean age 25.17 years, were studied. Airway response was measured as FEV1 and the dose of substance P (using a dose range of 23-736 nmol) producing a 20% decrease in FEV1 (PD20) was calculated from the individual semilogarithmic dose-response curves. Patients were studied on 3 separate days in a randomized, double-blind manner. On the first day a baseline PD20 value was determined. On subsequent days substance P challenge was performed after pretreatment (20 min before challenge) with either placebo or nedocromil sodium. Student's paired t-test and Wilcoxon's test were used for statistical analysis. The results of this study demonstrated that inhalation of substance P causes a dose-dependent bronchoconstriction and that the bronchoconstriction induced by substance P can be prevented by pre-treatment with nedocromil sodium. 相似文献
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L. Molfetta A. Palermo G. De Caro F. Pipino 《Journal of orthopaedics and traumatology》2002,2(2):99-103
Thromboembolism constitutes one of the most dangerous complications during the immediate postoperative period of prosthetic
surgery. Pharmacological prophylaxis and mechanical vascular compression are not always sufficient to protect from this surgical
complication. In patients at greatest risk for thromboembolism, often with a positive history for pulmonary embolism, temporary
vena cava filters may be used to reduce the incidence of vascular and pulmonary complications. However useful, these filters
cannot be routinely used in orthopedic surgery. We present our results with the use of Filcard RFO2 vena cava filters in an
open, randomized study of 30 patients.
Received: 5 November 2001/Accepted: 30 November 2001 相似文献
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