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Results for “Cardiac Output, High”

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At least 19 recordsLinked to original sources
PubMed1985

A model of ovine endotoxemia characterized by an increased cardiac output.

High cardiac output sepsis is a major clinical problem. We have designed a sheep endotoxin model to simulate this condition and have evaluated how closely it approximates the clinical situation. The animals were prepared for chronic study by the implantation of cardiopulmonary catheters. One week later, endotoxin (0.75 microgram/kg/30 min) was administered following baseline measurements, and the animals were studied for an additional 15 hr. From 6-15 hr after the administration of endotoxin, there was a statistically significant twofold increase in cardiac output. Simultaneously, the total peripheral vascular resistance and mean arterial pressure was reduced. Eicosanoid measurements made at this time indicated that the vasodilator prostanoid, prostacyclin, was not elevated. A high cardiac output (hyperdynamic) model of sepsis has thus been established by the 30 min infusion of a small quantity of endotoxin. Prostacyclin is not a mediator of this response.

Animals↗
PubMed2004

Arteriovenous fistula-associated high-output cardiac failure: a review of mechanisms.

High-output cardiac failure can be a rare complication of high-output arteriovenous fistula. The authors present a case in which a hemodialysis patient with a high-flow arteriovenous fistula has cardiac failure that improves with fistula closure. The hemodynamic effects of a fistula are reviewed, and the hemodialysis literature regarding high-output cardiac failure is summarized. To gain insight into the problem of high-output cardiac failure, research efforts should focus on the prospective monitoring of high-access flows.

Aged↗
PubMed2001

High Output Cardiac Failure.

Congestive heart failure describes a syndrome with complex and variable symptoms and signs, including dyspnea, increased fatigability, tachypnea, tachycardia, pulmonary rales, and peripheral edema. Although this syndrome usually is associated with low cardiac output, it may occur in a number of so-called high output states, when the cardiac output is normal or greater than normal. A high output state may occur in chronic severe anemia, large arteriovenous fistula or multiple small arteriovenous shunts as in Paget's bone disease, some forms of severe hepatic or renal disorders, and acutely in septic shock. The syndrome of systemic congestion in a high output state is traditionally referred to as high output heart failure. However, the term is a misnomer because the heart in these conditions is normal, capable of generating very high cardiac output. The underlying problem in high output failure is a decrease in the systemic vascular resistance that threatens the arterial blood pressure and causes activation of neurohormones, resulting in an increase in salt and water retention by the kidney. Many of the high output states are curable conditions, and because they are associated with decreased peripheral vascular resistance, the use of vasodilator therapy for treatment of congestion may aggravate the problem. There are other clinically important issues in high output failure that have received little attention in the current medical literature. This article reviews the available data on high output cardiac failure with particular emphasis on the underlying mechanisms and treatment.

Journal Article↗
PubMed1994

Banding a hemodialysis arteriovenous fistula to decrease blood flow and resolve high output cardiac failure: report of a case.

We report herein the successful surgical treatment of a patient with high-output cardiac failure which developed from a high-flow hemodialysis arteriovenous fistula of the Brescia-Cimino type. Banding correction of the venous limb of the fistula with a woven Dacron prosthesis resulted in marked improvement of the cardiac failure. An ultrasonic study showed the fistula flow of 3.2 l/min to be as high as 40% of the resting cardiac output, or 8.0 l/min, before banding, while an intraoperative electromagnetic study was useful for controlling the degree of banding and showing the decrease of fistula flow from 3.7 l/min to 1.4 l/min.

Aortic Aneurysm, Abdominal↗
PubMedDate not supplied

Effects of iced and room temperature injectate on cardiac output measurements in critically ill patients with low and high cardiac outputs.

OBJECTIVE: To determine the effect of injectate temperature (iced or room temperature) on cardiac output values in critically ill adults with low and high cardiac outputs. DESIGN: Quasi-experimental. SETTINGS: Two multidisciplinary intensive care units in two large, metropolitan, private, nonprofit hospitals in Texas. SUBJECTS: A convenience sample of 21 critically ill men and women who averaged 61 years of age (range 31 to 82 years) and whose most recent cardiac output measured with room temperature injectate was low (< or = 3.5 L/min) or high (> or = 8.0 L/min). INTERVENTION: Iced injectate and room temperature injectate (randomly ordered) were used to measure cardiac output in each subject. OUTCOME MEASURES: Cardiac output value with iced injectate versus cardiac output value with room temperature injectate. RESULTS: We found significant differences between cardiac output measurements with room temperature and those with iced injectate in eleven critically ill patients with low cardiac outputs (< or = 3.5 L/min) and in ten critically ill patients with high cardiac outputs (> or = 8.0 L/min). In the low cardiac output group, cardiac outputs using room temperature injectate averaged 0.37 L/min (range 0.1 to 1.10 L/min) higher than cardiac outputs using iced injectate (p = 0.001). In the high cardiac output group, measurements with room temperature injectate averaged 1.17 L/min L/min (range 0.3 to 3.0 L/min) higher than cardiac outputs with iced injectate (p = 0.005). Percent differences between room temperature and iced injectate values averaged 13% (range 3% to 27%) in patients with low cardiac outputs and 11% (range 3% to 29%) in patients with high cardiac outputs. Seven (77%) of the patients in the low cardiac output group and four (40%) of the patients in the high cardiac group had a 10% or greater difference--which many clinicians describe as a clinically significant difference--between room temperature and iced injectate cardiac output values. CONCLUSION: Although research is clearly needed to substantiate these findings, we suggest that nurses use iced injectate in patients with low and high cardiac outputs (< or = 3.5 L/min or > or = 8.0 L/min) to ensure accurate measurement of cardiac output.

Adult↗
PubMed1990

Unilateral megalencephaly associated with neonatal high output cardiac failure.

High-flow cerebral arteriovenous fistulae are well known to present in the neonatal period with macrocephaly, cranial bruits and high-output cardiac failure. This report describes a newborn infant with such a clinical presentation, who had unilateral megalencephaly without macroscopic arteriovenous shunts. Ultrasound Doppler examination of the carotid and cerebral vessels showed diastolic flow, or a decreased pulsatility index, consistent with decreased intracranial vascular resistance. The ipsilateral cerebral arteries and veins were markedly enlarged at angiography and at post-mortem examination, but there was no arteriovenous malformation. The infant expired from high-output cardiac failure and hypoglycemia. It is postulated that the high-output cardiac failure was due to increased blood flow through the enlarged, dysplastic cerebral hemisphere.

Brain↗
PubMed1991

High cardiac output as a paraneoplastic syndrome.

A high cardiac output (17 1 min-1) was recorded in a young man suffering from lymphoplasmatocytotic lymphoma. The evolution of the blood disease was characterized by two relapses, during which clinical signs of heart failure were prominent but resolved with efficient blood chemotherapy. The known aetiologies of high cardiac output were excluded. The complete normalization of the cardiac parameters with blood remission suggests that the high cardiac output represented an unusual paraneoplastic syndrome, the pathogenesis of which still remains unknown, although several hypotheses were tested.

Adult↗
PubMed1999

Successful transcutaneous arterial embolization of a giant hemangioma associated with high-output cardiac failure and Kasabach-Merritt syndrome in a neonate: a case report.

We describe the case of a patient with a neonatal giant cutaneous hemangioma with high-output cardiac failure and Kasabach-Merritt syndrome and successfully treated with transcutaneous arterial embolization aimed at controlling severe congestive heart failure and consumption coagulopathy. A patient was admitted to the neonatal care unit on the first day of age because of a large hemangioma on his right lateral chest wall and respiratory distress, associated with cardiac failure resulting from arteriovenous shunting. On the second day of age the platelet count decreased to 5.7 x 10(4)/microliter and fibrinogen level was 85 mg/dl. The values of prothrombin time and activated partial thromboplastin time were prolonged. Intravenous predonisone therapy was started immediately, but bleeding tendency was getting worse and the evidence of congestive heart failure persisted. On the third day the patient then underwent embolization of feeding arteries with microcoils. The cardiac failure and thrombocytopenic coagulopathy had improved significantly without complications. We conclude that transcutaneous arterial embolization is an effective and safe treatment in this neonate and should be considered for the treatment of control high-output cardiac failure and coagulopathy in infants with hemangioma and Kasabach-Merritt syndrome.

Cardiac Output, High↗
PubMed2000

Automated cardiac output measurements by ultrasound are inaccurate at high cardiac outputs.

OBJECTIVE: The sonographic technique of automated cardiac output measurement (ACM) is a promising new method to measure cardiac output and could be of use in a high-risk obstetric unit in the treatment of pre-eclamptic patients. The aim was to determine the accuracy of the ACM method. DESIGN: Comparative study of the sonographic technique of ACM versus cardiac output measured by thermodilution (TD). METHODS: The study included 39 intensive care patients, 21 men, 13 non-pregnant women and five severely pre-eclamptic pregnant patients, with a wide range of cardiac outputs, in whom TD catheters had been inserted for clinical reasons. Two separate experienced observers, blinded to the results obtained with the other method, performed four successive measurements in each patient with either the ACM or TD technique. The averaged cardiac output value per patient and method was used for comparison. RESULTS: Cardiac output was successfully measured with ACM and TD in 85 and 100% of patients, respectively. Mean cardiac output measured by ACM (6.77 +/- 1.90 L/min) was significantly lower than that measured by TD (9.12 +/- 3.06 L/min). Although cardiac output values obtained with ACM were significantly correlated with those measured by TD, the ACM values were consistently lower than TD values in the higher cardiac output range; the relationship was represented by ACM = 0.35 TD + 3.55 L/min (r = 0.57, P < 0.001). The (ACM - TD) difference increased significantly with cardiac output, through a difference in stroke volume, not in heart rate. CONCLUSION: The ACM is not an accurate tool to measure cardiac output in patients with a high cardiac output, including treated pre-eclamptic women.

Adult↗
PubMed1987

[Early changes in the circulation of the humeral artery in borderline arterial hypertension].

The brachial artery diameter and blood flow rate were measured by pulsed Doppler velocimetry in 9 healthy subjects and 24 patients of the same age group with borderline hypertension. To evaluate the results, the patients were divided into two groups according to their cardiac output: high cardiac output group (i.e. patients whose cardiac output was superior to the mean +/- 2 S.D. value in the control population), and normal cardiac output group (i.e. cardiac output lower than that value). Patients in both groups were of the same age and had the same level of blood pressure. The brachial artery diameter and blood flow rate values were the same in the normal cardiac output group and in the control population. However, these values were significantly higher in patients with high cardiac output than in controls (P less than 0.05 and P less than 0.001) and in patients with normal cardiac output (P less than 0.01). These results suggest that the haemodynamic profile in the brachial artery is not the same in all patients with borderline hypertension: there was a tendency to vasoconstriction in patients with normal cardiac output, whereas the brachial artery was clearly dilated in patients with high cardiac output.

Adult↗
PubMedDate not supplied

Successful intervention for high-output cardiac failure caused by massive renal arteriovenous fistula-a case report.

Renal arteriovenous fistula is a rare clinical entity that may produce high-output cardiac failure. This report describes the case of an 81-year-old woman in whom recurrent episodes of congestive heart failure developed over a relatively short time. A massive renal arteriovenous fistula was visualized by CT scan and arteriography. Successful embolization was performed under hemodynamic monitoring with complete resolution of the patient's symptoms.

Aged↗
PubMed2006

Successful anesthetic management of a child with an extensive facial hemangioma and high output cardiac failure for placement of a central venous catheter.

A two-and-a-half-year-old female with an extensive facial and lingual hemangioma, associated high output cardiac failure, and a history of difficult intubation presented for central venous catheter (CVC) placement for vincristine chemotherapy. Anesthetic management of this complex case is presented and the complicating medical conditions are discussed.

Anesthetics, Inhalation↗
PubMed1993

Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure.

Congenital intracranial teratomas are rare and usually fatal. We present prenatal diagnosis of such a case associated with scalp, facial, and body skin edema, hepatomegaly, extramedullary hematopoiesis, polyhydramnios, and a hydropic placenta. These manifestations of high-output cardiac failure were thought to be the result of the large cardiac output required by massive intracranial tumor arteriovenous shunting.

Adult↗
PubMed1988

Transition from high cardiac output to elevated vascular resistance in hypertension.

The early phase of hypertension (borderline hypertension) is characterized by a hyperkinetic circulation caused by excessive sympathetic drive and decreased parasympathetic inhibition to the heart. In later phases the cardiac output becomes normal, but the hypertension is still neurogenic, as demonstrated by the fact that continued pharmacologic parasympathetic, beta- and alpha-adrenergic inhibition normalizes the blood pressure. In both of these phases of the process, plasma norepinephrine values are elevated. These patients also show characteristic behavioral patterns; they are outward oriented, submissive, but experience unexpressed anger and frequently harbor hostile feelings. In late phases of hypertension the cardiac output is normal and the total peripheral resistance is elevated. This hemodynamic transition can be explained by a secondary response to elevated blood pressure. The heart becomes less responsive as a result of altered receptor responsiveness and decreased cardiac compliance, whereas the responsiveness of arterioles increases because of vascular hypertrophy, which leads to changes in the wall-to-lumen ratio. However, one observation eludes explanation: the absence of plasma norepinephrine elevation in later phases of hypertension. We propose a new conceptual framework to explain the disappearance of elevated plasma norepinephrine in the course of hypertension. The concept is based on a wide range of observations with the use of various receptor-blocking agents during neurogenic pressor responses. Invariably, the blood pressure response is preserved, but the hemodynamic pattern can be altered from a high cardiac output to high total peripheral resistance or vice versa.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1993

High-output cardiac failure: an unusual manifestation of intravenous leiomyomatosis.

Intravenous leiomyomatosis is a rare uterine neoplasm characterized by nodular or wormlike masses of histologically benign smooth muscle growing within myometrial veins and extending variable distances into the veins of contiguous organs and major pelvic veins. In some cases, there has been extension into the gonadal or iliac veins to the vena cava and right atrium, causing symptoms of congestive heart failure and an eventual fatal outcome. We present a report of the first case in which high-output cardiac failure was caused by the development of arteriovenous shunting within the intravenous component of the tumor that involved the pelvic organs and retroperitoneal and gonadal veins but not the vena cava. Treatment by total abdominal hysterectomy, bilateral oopherectomy, and tumor mass excision from the retroperitoneum was successful.

Adult↗
PubMed1997

[High cardiac output in myeloma patients. Its prevalence and clinical characteristics. The Castile-León Cooperative Group for the Study of Monoclonal Gammapathies].

BACKGROUND: The study determines the prevalence of high cardiac output status in patients with multiple myeloma (MM) and its relationship with the more significant clinical and biological characteristics of the disease. PATIENTS AND METHODS: Cardiac output was determined in 28 patients with multiple myeloma by pulsed Doppler echocardiography. Patients with any other identifiable cause of high cardiac output were excluded. Mean age was 70 +/- 8 SD years (53-84). A stepwise regression with the cardiac output as dependent variable and age, performance status (ECOG), clinical stage (Durie and Salmon), scale of bone lesions, serum calcium, serum creatine, bone involvement (percentage), and M protein quantity as independent variables showed the following results. RESULTS: A high cardiac output state, defined as a cardiac index higher than 4.6 l/min/m2 was present in five patients (17.8%), four of them with severe bone involvement. Two patients developed heart failure. The stepwise regression revealed the scale of bone lesions was the unique variable associated with the risk of developing a high cardiac output status. CONCLUSIONS: A high cardiac output status may be fairly common in patients with multiple myeloma. The syndrome is associated with severe bone involvement, being the scale of bone lesions the only risk factor for this complication.

Aged↗