1,721,039 research outputs found
Ten situations where inferior vena cava ultrasound may fail to accurately predict fluid responsiveness: a physiologically based point of view
No full textTen situations where inferior vena cava ultrasound may fail to accurately predict fluid responsiveness: a physiologically based point of view
No full textLung ultrasound and B-lines quantification inaccuracy: B sure to have the right solution
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Resolution of cardiogenic shock using echocardiography-guided pacing optimization in intensive care: A case series
No full textObjective: Inotropic and vasopressor drugs are routinely used in critically ill patients to maintain adequate blood pressure and cardiac output in patients with cardiogenic shock although potentially at the expense of increasing myocardial oxygen demand. Pacing optimization has been demonstrated as effective in reducing catecholamine requirements in patients with chronic heart failure by improving cardiac efficiency; however, there are no reports relating to the effectiveness of pacemaker optimization on cardiac output in critically ill patients with cardiogenic shock in the intensive care. Data Sources: Retrospective data analysis. Study Selection: Twenty-bed adult tertiary cardiothoracic ICU, university hospital. Data Extraction: Eight sequential patients receiving dual chamber pacemaker with DDD modality with cardiogenic shock and hemodynamic instability refractory to catecholamines underwent echocardiography-guided pacemaker optimization of cardiac output. An iterative method with Doppler echocardiography was used to assess changes in cardiac output, left ventricular filling time, ejection time, total isovolumic time, mitral regurgitation, ejection fraction, and blood pressure at different increments of heart rate, and atrioventricular and interventricular delay. All results are shown as median (minimum/maximum level) or mean ± sd. Data Synthesis: Using echocardiography-guided pacemaker optimization on cardiac output, the cardiac output increased from 3.2 (2.3/3.8) to 5.7 L/min (4.85/7.1) and cardiac index from 1.64 (1.1/1.9) to 2.68 L/min/m 2 (2.1/3.2) and the total isovolumic time reduced from 22.8 to normal values (<14). In association, the glomerular filtration rate increased significantly except in one patient with stage IV chronic kidney disease. All inotropes and vasopressors were discontinued within 12 hours of pacemaker optimization on cardiac output, and all patients were discharged from the ICU within 1 week. Conclusions: Echocardiography-guided pacemaker optimization of cardiac output is a feasible bedside therapeutic option, which should be considered when standard medical treatments are insufficient for the treatment of cardiogenic shock refractory to inotropic support, thereby minimizing the detrimental effect of catecholamines
Multimodality imaging in cardiogenic shock: state-of-the art
No full textPurpose of reviewThere is emerging evidence on the role of the multimodality imaging in the setting of cardiogenic shock. The utility of different imaging modalities, along with their pitfalls and limitations, and their integration in a multiparametric approach are discussed in the current review.Recent findingsThe evaluation of congestion and perfusion in patients with shock has allowed a better understanding of the underlying physiopathological mechanisms. Integration of echocardiography, using more physiological parameters, with lung ultrasound, as well as the Doppler evaluation of abdominal blood flow dynamics, has led to a better stratification in patinas with hemodynamic instability.SummaryAlthough validation of the integrated approaches and single parameters are needed, the physiopathological-driven approach using ultrasound in patients with cardiogenic shock on top of the clinical and biochemical evaluation, may aid to a quicker and more detailed evaluation of patient's phenotype
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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