Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cardiac Output, High”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1983

Does increased pulmonary blood flow redistribute towards edematous lung units?

Unilobar pulmonary edema secondary to increased capillary permeability was produced utilizing oleic acid infusion into the left lower lobe pulmonary artery of seven dogs. This model was used to determine whether random changes in cardiac output produced by opening and closing arteriovenous fistulae were associated with changes in fractional perfusion to the edematous lobe (as determined by differentially labeled radiomicrospheres) thus explaining changes in intrapulmonary shunt. With an increase in cardiac output from a mean (+/- SD) of 1.6 +/- 0.5 liters/min to 2.6 +/- 0.8 liters/min (P less than 0.01), mean (+/- SD) injured lobar shunt as measured from O2 contents of lower lobar pulmonary venous blood and mixed venous blood increased from 54.4 +/- 3.0% to 74.4 +/- 22.1% while total intrapulmonary shunt increased from 12.0 +/- 4.0% to 16.0 +/- 3.7% (P less than 0.01). This increase in intrapulmonary shunt was, however, not associated with preferential perfusion of the edematous lobe, the mean (+/- SD) of the perfusion to the edematous lobe expressed as a percentage of the cardiac output being 16.6 +/- 1.6% at the low cardiac output and 16.9 +/- 1.4% at the high cardiac output. It is concluded that redistribution of blood flow towards the edematous lobe does not occur with increases in cardiac output and therefore does not account for the increased intrapulmonary shunt.

Animals↗
PubMed1998

Arteriovenous shunting in patients with multiple myeloma and high-output failure.

UNLABELLED: High-output cardiac failure is one of the cardiovascular problems associated with multiple myeloma and frequently seen in patients with extensive bone lesions. The purpose of this study was to search arteriovenous shunting in patients with multiple myeloma and cardiac failure. METHODS: After the exclusion of other causes of congestive heart failure, 11 patients whose cardiac indices were higher than or equal to 4 liter/min/m2 were selected for the study (7 women, 4 men; mean age 59.64 +/- 8.92 yr). All patients had Stage II-III disease and femoral involvement in radiological examination. Arteriovenous shunting was determined by means of intra-arterial injection technique of 99mTc-macroaggregated albumin (MAA) particles. A quantitative analysis of all scans was performed, and the results were correlated with cardiac index. RESULTS: Mean cardiac index was 4.33 +/- 0.36 liter/min/m2 in the study group. In all cases, arteriovenous shunting was detected (18.70% +/- 17.29%), and inhomogenous, increased radioactivity accumulation was revealed in the femoral region (lesion-to-background ratio 2.71 +/- 2.08). This zone corresponded to the area of infiltration in a radiograph. A significant correlation was found between shunting values and cardiac indices (r = 0.7899, p = 0.004, Spearman). Although all patients had varying degrees of anemia, we did not find such a relationship between the degree of anemia and cardiac index. CONCLUSION: Arteriovenous shunting within involved skeleton contributes significantly to the development of high-output cardiac failure in multiple myeloma.

Cardiac Output↗
PubMed1998

E. Coli bacteremia-induced changes in the skeletal muscle microcirculation vary with anesthetics.

AIM: To test if anesthetic procedures change the hemodynamic pattern in animals with experimental septic shock. METHODS: The effect of two anesthetics on systemic hemodynamic and skeletal muscle microcirculatory responses in high cardiac output live E. coli bacteremia was studied in rats and compared to the effect of two other anesthetic procedures in previously published studies. RESULTS: Baseline blood pressures and cardiac outputs were similar in rats with decerebrate, ketamine/xylazine, pentobarbital or urethane/chloralose anesthesia. There was a relative baseline tachycardia in decerebrate rats. Ketamine/xylazine anesthetized rats had reduced blood pressure, cardiac output, and heart rate. In decerebrate, pentobarbital, and urethane/chloralose anesthesia, cardiac output increased initially during bacteremia but did not remain elevated in pentobarbital anesthesia. Blood pressure and heart rate remained constant in pentobarbital, decerebrate, and urethane/chloralose anesth esia. During bacteremia, cardiac output, blood pressure, and vascular resistance did not change with ketamine/xylazine, but the heart rate increased. Baseline diameters of cremaster muscle large (A1) arterioles were higher in decerebrate anesthesia. A1 arterioles constricted during high cardiac output bacteremia in decerebrate rats, and pentobarbital or urethane/chloralose-anesthetized rats. A4 arterioles in bacteremia dilated in decerebrate and pentobarbital anesthesia, but did not change under urethane/chloralose and ketamine/xylazine anesthesia. CONCLUSION: Anesthetics influence baseline systemic variables and the response of systemic hemodynamics of rats to E. coli bacteremia. During bacteremia, anesthetics primarily affect the reactivity of skeletal muscle small arterioles. Ketamine/xylazine anesthesia has the most pronounced effect on systemic and microcirculatory variables and seems to be an inappropriate choice in sepsis experiments in rats.

Anesthetics↗
PubMed2002

Lack of agreement between thermodilution and fick cardiac output in critically ill patients.

STUDY OBJECTIVE: s: Individual comparison of cardiac output via intermittent thermodilution and Fick technique over a wide range of cardiac outputs. DESIGN: Prospective clinical investigation. SETTING: Multidisciplinary ICUs of two teaching hospitals in Vancouver, British Columbia. PARTICIPANTS: Eighteen critically ill patients who had pulmonary and systemic arterial catheters and in whom active support was being withdrawn. INTERVENTIONS: Measurement of thermodilution cardiac output and calculation of Fick cardiac output while support was withdrawn. Active support was withdrawn in a three-step process: removal of vasopressors followed by decrease in fraction of inspired oxygen to 0.21, and finally removal of mechanical ventilation. MEASUREMENTS AND RESULTS: Simultaneous Fick and thermodilution cardiac outputs were obtained over a wide range. Fick calculated cardiac outputs were obtained using the Fick equation with oxygen uptake (O(2)) being measured with indirect calorimetry. O(2) determinations were made using five measurements over 5 min, with the mean being used for subsequent analysis. Thermodilution cardiac outputs were determined by the mean of five measurements, with the first being discarded. Coefficient of variation was calculated for the O(2) and thermodilution cardiac outputs. One hundred thirty-six simultaneous cardiac outputs were obtained in 18 patients with a mean APACHE (acute physiology and chronic health evaluation) II score of 25.5. The range of cardiac outputs was 1.39 to 16.95 L/min. Linear regression analysis found a good correlation of the data sets, with an R of 0.85. Bias and precision calculations found a bias of - 0.17 L/min with the upper and lower limits of agreement being 2.96 L/min and - 3.30 L/min, respectively. In patients with high cardiac outputs (> 7 L/min), the bias was - 1.90 with the limits of agreement being 1.87 L/min and - 5.67 L/min. The coefficient of variation for O(2) was 4.6% and for thermodilution cardiac output was 7.75%. CONCLUSIONS: There was good consistency of each of the measurements with a low coefficient of variation. The bias for the whole group was small, but the limits of agreement extended into a clinically relevant area, resulting in a lack of agreement. In patients with high cardiac outputs, the Fick tended to consistently produce higher cardiac outputs compared to thermodilution, suggesting a systematic error.

Adult↗
PubMed2003

[High-output congestive cardiac decompensation caused by an atrio-venous fistula resulting from lumbar disk surgery].

Although uncommon, arterio-venous fistula is a serious complication of lumbar disk surgery. Unless congestive heart failure develops, it often remains undetected. The present case report refers to a 30-year-old male who was referred to our division with a diagnosis of high-output congestive heart failure. It is important that surgeons, cardiologists and radiologists be aware of this potentially fatal complication.

Adult↗
PubMedDate not supplied

Severe acidosis and hyperdynamic circulation in a 39-year-old alcoholic.

A case of acute fulminant cardiovascular beriberi, or "shoshin beriberi," is presented. Beriberi is classified as "dry" (neurologic) or "wet" (cardiovascular) and may be mixed. "Wet" beriberi refers to a spectrum of clinical manifestations ranging from a hyperdynamic state with high output cardiac failure to fulminant failure with collapsed peripheral circulation, lactic acidosis, and shock. Beriberi is probably much more common than previously recognized. Beriberi is caused by thiamine deficiency and should be suspected in alcoholics who present with unexplained lactic acidosis, a hyperdynamic state, high output cardiac failure, or cardiogenic shock without electrocardiographic (EKG) evidence of myocardial necrosis. Shoshin beriberi is rapidly fatal without immediate treatment with thiamine.

Acidosis↗
PubMed1984

Pathophysiologic mechanisms in essential hypertension: a clue to the therapeutic approach.

Essential hypertension is not a homogeneous disorder. Distinct differences with regard to systemic hemodynamics, cardiac adaptation, and volumetric and humoral factors have been identified in various patient groups. Simple clinical clues allow us to identify three main underlying pathophysiologic mechanisms. The young, lean, white patient is characterized by an elevated cardiac output, normal total peripheral resistance, and increased activity of the sympathetic nervous system. The elderly hypertensive patient is characterized by a low cardiac output, left ventricular hypertrophy, high total peripheral resistance, contracted intravascular volume, low plasma renin activity, and target organ disease. The obese patient with essential hypertension presents with a high cardiac output, expanded intravascular volume, and a normal total peripheral resistance. Each of these three models represents one extreme of a wide, overlapping continuum. Identifying the underlying pathophysiologic mechanisms and matching them with the specific pharmacological properties of an appropriate antihypertensive agent should ensure greater patient acceptance and fewer adverse effects.

Adult↗
PubMed1996

Successful treatment of recurrent non-immune hydrops secondary to fetal hyperthyroidism.

BACKGROUND: Non-immune fetal hydrops is a heterogeneous disorder with a mortality rate of 50-98%. Resolution of non-immune fetal hydrops is rare but has been reported to occur spontaneously or after targeted therapeutic measures. CASE: A euthyroid gravida with Graves disease presented with a history of three prior perinatal deaths between 26 and 28 weeks' gestation, all associated with fetal hydrops. In the current pregnancy, the fetus developed hydrops at 24 weeks' gestation. Fetal hyperthyroidism, with high-output cardiac failure, was diagnosed with fetal blood sampling. After maternal therapy with propylthiouracil, resolution of the non-immune hydrops were documented and a healthy neonate subsequently delivered to term. The neonate developed transient hyperthyroidism after delivery, which required treatment for 10 weeks. CONCLUSION: Non-immune hydrops occurring as a result of fetal hyperthyroidism with high output cardiac failure is treatable with propylthiouracil.

Adult↗
PubMed2002

Prenatal diagnosis and management of fetuses with liver hemangiomata.

OBJECTIVES: To study the relationship between prenatal appearance and perinatal outcome of fetuses with hepatic hemangiomata with special emphasis on criteria that may help to improve perinatal management. METHODS: In a tertiary referral center six fetuses with hepatic hemangiomata were evaluated by gray-scale, color, and pulsed wave Doppler ultrasound between 1994 and 2000. Fetal blood sampling was performed in four cases. All data (computerized files and video tapes) were analyzed retrospectively. RESULTS: Two fetuses showed very similar sonographic findings. They had an isolated large ('giant') round hepatic hemangioma (diameter 43 and 68 mm, respectively) supplied by one hepatic artery and drained by one hepatic vein, both of them showing high velocity and low pulsatility blood flow. Fetal blood count and coagulation parameters were normal in one case, whereas the other fetus showed a Kasabach-Merritt sequence with severe thrombocytopenia (10 platelets/nL) and mild disseminated intravascular coagulation. Intrauterine platelet transfusion was performed immediately prior to planned Cesarean delivery. Rapid platelet consumption continued postnatally, requiring several thrombocyte transfusions. Platelet counts stabilized only after tumor resection on the second day of life. One fetus with diffuse neonatal hemangiomatosis developed high-output cardiac failure with hydrops in addition to Kasabach-Merritt sequence (15 platelets/nL), and died following premature delivery. Three fetuses, however, showing an isolated small hyperechogenic hepatic hemangioma (5, 5, and 6 mm in diameter, respectively) did not develop any perinatal complications. CONCLUSION: Large fetal liver hemangiomata and diffuse hemangiomatosis may cause severe perinatal complications, particularly high-output cardiac failure and/or Kasabach-Merritt sequence with severe consumption of platelets and clotting factors and hemolytic anemia. Fetal blood sampling enables the prenatal detection of these potential complications, allowing critical modification of perinatal management such as intrauterine platelet transfusion, especially directly before delivery. In contrast, isolated small hyperreflexic hepatic hemangiomata do not appear to be associated with any of these fetal and postnatal sequelae.

Adult↗
PubMed1989

Fetal hydrops and death from sacrococcygeal teratoma: rationale for fetal surgery.

Most sacrococcygeal teratomas diagnosed before birth can be managed by planned delivery and postnatal surgery. However, large tumors early in gestation may result in placentomegaly, hydrops, and fetal death and a preeclampsia-like syndrome in the mother. This chain of events may result from high output cardiac failure in the fetus caused by arteriovenous shunting through the tumor. We recently encountered this situation in a fetus at 21 weeks' gestation and performed fetal surgery in an attempt to reverse the process. Excision of the teratoma resulted in reversal of hydrops, diminution of descending aortic flow on Doppler echocardiography, and decrease in placental thickness. Despite these changes, uterine irritability after hysterotomy resulted in labor and delivery of a nonviable premature infant. This case demonstrates that when fetal sacrococcygeal teratoma becomes very large early in gestation, high output cardiac failure can endanger both fetus and mother. In the future, use of Doppler echocardiography may allow appropriate selection of high-risk fetuses. Intervention to prevent arteriovenous shunting through the tumor may offer these fetuses an improved chance for survival.

Adult↗
PubMedDate not supplied

In utero repair of rectal atresia after complete resection of a sacrococcygeal teratoma.

PURPOSE: A case of a fetus with a prenatally diagnosed sacrococcygeal teratoma that produced high-output cardiac failure, hydrops, rectal atresia, and urinary tract obstruction is presented. The unique prenatal surgical management along with the embryogenesis of tumor-related rectal atresia is discussed. CASE REPORT: A large fetal sacrococcygeal teratoma with a significant intrapelvic component was detected at routine ultrasound in a 35-year-old gravida 3 para 2. Fetal hydrops developed rapidly due to high-output cardiac failure from the vascular 'steal' by the growing tumor. The urinary tract was obstructed due to the intrapelvic tumors mass. At 27 weeks' gestation, the female fetus underwent hysterotomy, resection of the entire mass and urinary diversion via bilateral flank ureterostomies. The rectum was found to be completely atretic due to apparent encasement by the tumor. Pull-through anorectoplasty was carried out concurrently. At 30 weeks' gestation, the mother developed preterm labor and a 1.8-kg was delivered by cesarean section. The baby did very well for 3 days but had a cardiac arrest and died due to an atrial perforation by a transfemoral venous catheter. CONCLUSIONS: To our knowledge this is the first report of a complete prenatal resection of a sacrococcygeal teratoma with concomitant pull-through anorectoplasty for rectal atresia.

Adult↗
PubMed1998

Persistently low cardiac output predicts high mortality in newborns with cardiogenic shock.

BACKGROUND: Cardiogenic shock is an acute "unstable" state of circulatory dysfunction. OBJECTIVE: To evaluate the haemodynamic aspects of 45 newborn infants affected by cardiogenic shock, in relation to etiologies and the mortality rate. DESIGN: Retrospective, correlation study of etiologies, mortality rate and haemodynamic measurements by Doppler ultrasound parameters. PATIENTS: 45 newborn infants with cardiogenic shock, Gestational Age (GA) 37 (34-41), Birth Weight (BW) 2750 (1600-3600) g and and a control group of 20 neonates [GA 38 (34-40) wks, BW 2960 (1750-3800) g]. MEASUREMENTS: Left ventricular Cardiac Output (CO) was measured by a duplex scanner with pulsed Doppler and color flow mapping echocardiography in the first 48 hours of life. RESULTS: In healthy newborns CO was 240 mL/min/kg (210-280), in newborns with cardiogenic shock CO was 170 mL/min/kg (f130-200), p < 0.01. The Stroke Volume was 1.80 mL/kg (1.70-1.90) in the control group and 1.20 (1.15-1.80) in the shocked group (p < 0.05); Heart Rate was 146 beats/min (130-160) and 160 beats/mm (140-194), (p < 0.01) respectively. Twenty-nine infants with cardiogenic shock had CO < or = 150 mL/min/kg and 5 of them (17.2%) died; 16 neonates had CO > 150 mL/min/kg and only one (6.2%) died (p < .01). Twenty-six of 36 newborns with perinatal asphyxia had CO < or = mL/min/kg and 5 of them died, while only one of 10 infants with CO > 150 mL/min/kg died. CONCLUSIONS: Our results show that persistently low CO (< or = mL/min/kg) during the first 48 hours life, in newborns with cardiogenic shock due to perinatal asphyxia is associated with a significantly higher mortality.

Cardiac Output, Low↗
PubMed2001

Congestive heart failure caused by aortocaval fistula after nephrectomy.

We treated a 66-year-old man and a 69-year-old woman with high output cardiac failure due to aortocaval fistula. They underwent nephrectomy 40 and 36 years ago, respectively. They suffered from heart failure for a very long time. However, the etiology was not elucidated until recently. The aortogram revealed massive shunt from the aorta to the inferior vena cava via the right renal artery. Three-dimensional computerized tomography clearly delineated the aortocaval fistula. Surgical closure of the fistula promptly improved heart failure. We stress the importance of history taking concerning nephrectomy and the importance of abdominal auscultation in high output cardiac failure.

Aged↗
PubMed1995

Klippel-Trenaunay syndrome: clinical features, complications and management in children.

Clinical features and management of 47 children with Klippel-Trenaunay syndrome treated since 1970 were reviewed. Haemangiomas and soft tissue and/or skeletal hypertrophy were present in all 47 patients; venous varicosities developed in 37 (79 per cent). There was no clinical evidence of macrofistulous arteriovenous communications in any patient. Thromboembolic episodes occurred in five children (11 per cent) and 25 (53 per cent) experienced thrombophlebitis. The Kasabach-Merritt syndrome was observed in 21 (45 per cent) and six (13 per cent) presented with high-output cardiac failure. Other manifestations included haematuria in five (11 per cent), rectal or colonic haemorrhage in six (13 per cent), and vaginal, vulval or penile bleeding in six (13 per cent) children with visceral and pelvic haemangiomas. In 26 patients (55 per cent) symptomatic treatment only was required. Surgery was undertaken in selected cases for complications of the haemangioma, for cosmetic reasons and for chronic venous insufficiency. Only one of four children who underwent resection of varicose veins improved. There was no death, but significant morbidity was associated with the treatment of Kasabach-Merritt syndrome and high-output cardiac failure.

Adolescent↗
PubMed1994

[The heart in systolic hypertension].

Among the various forms of systolic hypertension, the primary hyperkinetic heart syndrome (overactivity of the cardiac beta-receptors) and the systolic hypertension in the elderly are the more interesting ones. The former, although involving subjects in the second or third decade of life, is a separate entity from the hyperdynamic phase of primary hypertension. Beta-adrenergic blockade, even at very long-term, is able to normalize all the major features of the syndrome (systolic hypertension, high cardiac output and systolic ejection rate, and variability of the repolarization phase of the electrocardiogram related to changes in the cardiac adrenergic tone). Beta-blockade is not curative and the syndrome reappears as soon as treatment is interrupted. It is a sort of clinical experimental model allowing the following deductions: high cardiac output is able to cause systolic hypertension; its persistence does not promote the development of an elevated systemic vascular resistance; although exposed to some of the stimuli that promote cardiac hypertrophy, such as increased stress of the ventricular wall, very prolonged adrenergic stimulation, activation of the renin system, the syndrome does not evolve towards ventricular hypertrophy. Regarding isolated systolic hypertension in the elderly, the so called de novo and "burned out" hypertension, are currently indicated as the two forms that characterize patients in the seventh and eighth decades of life. Both are interpreted as due to a loss of capacitance of the arterial system. It follows that the great vessels do not propel blood during diastole, thus increasing the hemodynamic burden on the left ventricle, prolonging diastole and delaying relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart↗
PubMed1990

Permeability pulmonary edema following lung resection.

The etiology of edema associated with pulmonary resection was investigated in five patients during the immediate postoperative period. Three patients received pneumonectomy while two patients had one lobe resected. All patients suffered from severe respiratory distress and had x-ray evidence of diffuse interstitial pulmonary edema within 12 hours of surgery. Hemodynamic data were obtained with radial and pulmonary artery catheters. Edema fluid was obtained along with blood samples for simultaneous determination of protein and albumin content. All patients studied had normal or high cardiac output, normal cardiac filling pressures, and edema fluid protein to serum protein ratio of 0.6 or greater suggestive of permeability changes contributing to edema fluid accumulation. Calculated shunt fraction exceeded 25 percent in all patients. Pulmonary edema has been noted in patients following pulmonary resection in the early postoperative period. In patients reviewed here, two factors appeared to be significant. First is an increase in pulmonary capillary pressure associated with passage of a normal to high cardiac output in a reduced volume pulmonary vascular bed. The second factor, as demonstrated by protein content in the edema fluid, is injury to the alveolar capillary membrane.

Blood Proteins↗
PubMed1999

Cardiovascular abnormalities in transgenic mice with reduced brown fat: an animal model of human obesity.

BACKGROUND: A new model of murine obesity has recently been developed through transgenic ablation of brown adipose tissue that manifests typical metabolic complications of obesity, including insulin resistance and non-insulin-dependent diabetes mellitus. The cardiovascular phenotype has not been defined. METHODS AND RESULTS: Transthoracic echocardiography, aortic catheterization, isolated whole-heart studies, and morphometric histology defined cardiac structure and function in 30 transgenic mice with reduced brown fat and 30 matched wild-type controls. Obesity was indicated by a 77% increase in body weight and was accompanied by elevated systemic pressures (mean aortic blood pressure 85+/-1 versus 66+/-2 mm Hg; P<0.01), left ventricular dilation and hypertrophy (mass/body weight 4.0+/-0.2 versus 2.7+/-0.3 mg/g; P<0.01), and high cardiac output (cardiac index 3.2+/-0.4 versus 2.4+/-0.1 mL x kg(-1) x min(-1); P<0.01). Baseline functional parameters assessed in vitro were not different, but after imposition of zero-flow ischemia, significant relaxation impairment developed in obese mice. Although morphometrically determined myocyte diameters were similar, the percentage of interstitial fibrosis was significantly increased in transgenic mice compared with wild-type controls (7.5+/-2% versus 4. 2+/-0.2%; P<0.01). CONCLUSIONS: Transgenic ablation of brown adipose tissue is associated not only with obesity but also with systemic hypertension, left ventricular hypertrophy with eccentric remodeling and fibrosis, and high cardiac output, a unique constellation of findings strikingly similar to that seen in human obesity. Mice with reduced brown fat may serve as a new model for the cardiovascular morbid complications associated with obesity in humans.

Adipose Tissue, Brown↗
PubMed1997

19 mm sized bileaflet valve prostheses' flow field investigated by bidimensional laser Doppler anemometry (part I: velocity profiles).

The investigation of the flow field downstream of a cardiac valve prosthesis is a well established task. In particular turbulence generation is of interest if damage to blood constituents is to be assessed. Several prosthetic valve flow studies are available in literature but they generally concern large-sized prostheses. The FDA draft guidance requires the study of the maximum Reynolds number conditions for a cardiac valve model to assess the worst case in turbulence by choosing both the minimum valve diameter and a high cardiac output value as protocol set up. Within the framework of a national research project regarding the characterization of cardiovascular endoprostheses, the Laboratory of Biomedical Engineering is currently conducting an in-depth study of turbulence generated downstream of bileaflet cardiac valves. Four models of 19 mm sized bileaflet valve prostheses, namely St Jude Medical HP Edwards Tekna, Sorin Bicarbon, and CarboMedics, were studied in aortic position. The prostheses were selected for the nominal annulus diameter reported by the manufacturers without any assessment of the valve sizing method. The hemodynamic function was investigated using a bidimensional LDA system. Results concern velocity profiles during the peak flow systolic phase, at high cardiac output regime, highlighting the different flow field features downstream of the four small-sized cardiac valves.

Aortic Valve↗