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Query: UMLS:C0028961 (oliguria)
 1,847 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To characterize the relation between clinical and hemodynamic state in acute myocardial infarction, 200 patients with acute infarction were evaluated with clinical and hemodynamic criteria. Patients were classified clinically on the basis of peripheral hypoperfusion (hypotension, tachycardia, confusion, cyanosis, oliguria) and pulmonary congestion (rales, abnormal chest roentgenogram). Four clinical subsets were defined that correlated with cardiac index (Cl, liters/min per m2) and pulmonary capillary pressure (PCP, mm Hg): (see article). Parallel hemodynamic subsets were developed independently on the basis of depressed cardiac index (2.2 liters/min per m2 or less) and elevated pulmonary capillary pressure (greater than 18 mm Hg). The rate of accuracy of clinical examination in predicting hemodynamic abnormalities was 83 percent. Mortality rates were similar in the clinical and hemodynamic subset calssifications, averaging 2.2 percent in subset I, 10.1 percent in subset II, 22.4 percent in subset III and 55.5 percent in subset IV. Drug interventions in the course of hospitalization resulted in a 38 percent increase in depressed cardiac index and 34 percent decrease in elevated pulmonary capillary pressure. Resolution of clinical abnormalities paralleled this hemodynamic improvement in 70 percent of patients. These data suggest that clinical performance and both clinical and hemodynamic subsets are directly relevant to establishing prognosis and the selection of therapy in patients with acute myocardial infarction.
Am J Cardiol 1977 Feb
PMID:Correlative classification of clinical and hemodynamic function after acute myocardial infarction. 83 73

Involvement of the RV in AMI is not as rare as previously thought and may lead to a particular clinical and hemodynamic syndrome with raised RV filling pressures, hypotension and oliguria. Major extension to the RV from inferior LV infarctions can be recognized by ST segment elevations iead CR4R or V4R. The significance of anterior RV extension and of RV papillary muscle infarction is still largerly unknown. It has been suggested from autopsy studies that the prognosis of patients with RV involvement might be poor healed extensive RV infarction is rarely seen. Indeed, ST segment elevation in lead CR4R indicating RV involvement has been found to carry a poor short-term prognosis. An increased awareness of the possibility of impaired RV function and of the special therapeutic considerations in some of these patients may increase survival.
Eur J Cardiol 1976 Dec
PMID:Right ventricular involvement in acute myocardial infarction. 100 36

Hemofiltration was performed in 15 patients with refractory congestive heart failure. All of these patients had oliguria, although intensive treatment with diuretics, digitalis, vasodilators, and catecholamines was prescribed. Hemofiltration was performed under hemodynamic monitoring in 14 patients. The water removal by hemofiltration decreased pulmonary arterial pressure, pulmonary capillary wedge pressure and right atrial pressure. Despite these hemodynamic improvements, nine patients (60%) died within one month after the start of hemofiltration; the causes were fatal arrhythmia in three, renal failure in two, sepsis in one and irreversible cardiogenic shock in three. Oliguria for over 15 h or a serum creatinine concentration of more than 4.0 mg/dl at the start of hemofiltration related to poor prognosis. In view of these results, hemofiltration for refractory heart failure should be started earlier and performed carefully in order to avoid arrhythmia, cardiogenic shock, and other complications.
Clin Cardiol 1992 Jul
PMID:Hemofiltration as treatment for patients with refractory heart failure. 149 76

Contrast nephropathy can be defined as an acute impairment of renal function that follows exposure to radiocontrast materials and for which alternative explanations for renal impairment have been eliminated. Based on reported studies, the incidence of contrast associated nephropathy (CAN) varies from 0 to 22%. This wide variation can be traced to differences in study design and the criteria used to designate significant renal impairment. Irrespective of the exact incidence, 2 defined risk factors have been identified: preexisting renal disease and diabetes mellitus. Whereas preexisting renal insufficiency is the single most influential risk factor for CAN, when diabetes coexists the incidence approaches 100%. The clinical presentation of CAN is distinct, having a temporal relation between the performance of the contrast study in the high-risk patient and the onset of an increase in serum creatinine levels within the next 24 hours. Serum creatinine values greater than 50% of baseline or rising 1 mg/dl or more is diagnostic. The peak serum creatinine level occurs within 3 to 5 days of the contrast study and oliguria is associated in approximately 30% of the cases. Monitoring serum creatinine is the most useful clinical procedure in high-risk patients after angiography. At least 5 potential pathophysiologic mechanisms of CAN have been proposed: interference with renal perfusion, altered glomerular perm-selectivity, direct tubular injury, intraluminal obstruction, and immunologic mechanisms. Support for each mechanism, either singularly or in combination, can be found in published reports; however, none has achieved universal acceptance. The single most important clinical axiom regarding the prevention and management of CAN is, "Always use the least invasive diagnostic procedure available."(ABSTRACT TRUNCATED AT 250 WORDS)
Am J Cardiol 1989 Sep 05
PMID:Contrast-associated nephropathy. 267 65

Over the course of the last 5 years, we have instituted peritoneal dialysis on 26 (7.7%) of 338 complex postoperative cardiac bypass cases. The mean age of dialysis patients was 0.64 +/- 0.75 years with a range of 0.1-2.5 years. The indications for the start of dialysis were oliguria (15 cases), fluid overload (three cases), hyperkalemia (one case), and anuria (seven cases). There were no complications as the result of dialysis, although two of the dialysis catheters had to be replaced. Dialysis successfully treated the starting indication in all cases. Dialysis was instituted at 47 +/- 50 (12-240) h after bypass, and lasted 111 +/- 134 (18-552) h; early institution of dialysis had no effect on mortality. Low cardiac output was a significant predictor of death in dialysis patients (p = 0.015). Age was a significant determinant of death (p = 0.0001) and the need for dialysis (p = 0.0043) in the total bypass population; the younger the patient, the greater was the likelihood of death or the need for dialysis. Age, however, was not a predictor of mortality in the peritoneal dialysis group.
Pediatr Cardiol 1989
PMID:Peritoneal dialysis following open heart surgery in children. 279 87

Following open heart surgery using cardiopulmonary bypass, 18 (4%) of 441 operated children required treatment with peritoneal dialysis for acute renal failure or refractory oliguria. Nine recovered renal function (50%) and 5 (28%) survived. Only 2 died from renal causes. Despite both adequate symptomatic treatment of renal failure and few complications of dialysis itself, the prognosis remains poor, even with early treatment, but an aggressive approach is justified because some survivors can be expected.
Int J Cardiol 1985 Mar
PMID:Acute renal failure following cardiopulmonary bypass in children: results of treatment. 398 Jan 27

A case of dobutamine overdose is presented. Due to a prescription mistake a patient with recent myocardial necrosis and acute arterial occlusion received up to 70 mcg/kg/min of dobutamine IV. This resulted in arterial hypotension, diminished vascular resistance, oliguria and signs of cutaneous and mucosal hyperemia. Interruption of the dobutamine infusion and substitution with dopamine normalised all abnormalities. The differences between the hemodynamic profiles of dobutamine and dopamine are discussed.
Acta Cardiol 1984
PMID:Massive dobutamine overdose in a cardiovascular compromised patient. 633 55

The effect of tolazoline was assessed in 29 hypoxic neonates. Tolazoline was given in a bolus starting at 1 mg/kg and repeated or infused for 5-134 hours. A "good clinical response," defined as a rise in PaO2 of more than 20 mm Hg, was obtained in 23 (79%), 20 of this group were weaned from the respirator, and three died. Six infants did not respond initially and four died. Failure to respond to tolazoline or to be weaned from the ventilator was usually associated with severe additional pathology. Urine output (greater than 1 ml/kg/h) was adequate in most neonates during therapy. In those with preexisting oliguria (less than 1 ml/kg/h), output improved during therapy. Blood pressure monitoring showed a fall in blood pressure in 19 patients during tolazoline administration, but true hypotension only occurred in four; in seven there was no fall and in three there was a rise in blood pressure. Echocardiography was performed prior to therapy in 19 patients and repeated in 12 patients after 24 h. Additional "tracking" was performed at 10 min, 1 h, and 4 h in seven patients. Prior to therapy, right ventricular dysfunction was demonstrated by abnormal right ventricular systolic time intervals (RVSTIs) in 17 of the patients tested. A rapid improvement was evident during therapy especially with "tracking." Left ventricular dysfunction, assessed by left ventricular systolic time intervals (LVSTIs), ejection fraction (EF), shortening fraction (SF), and velocity of circumferential fiber shortening (VCF), was also evident prior to therapy and improved, though more gradually than the RVSTIs.(ABSTRACT TRUNCATED AT 250 WORDS)
Pediatr Cardiol
PMID:Clinical and echocardiographic evidence suggesting afterload reduction as a mechanism of action of tolazoline in neonatal hypoxemia. 647 28

Data are reported on 142 infants less than 3 months old who left the operating room alive after an open intracardiac operation during the 13 years from January 1967 to July 1980. The probability of postoperative in-hospital cardiac death for acute postoperative heart failure (the most common mode of death in these infants) was found by multivariate logistic analysis to be significantly related only to the strength of pedal pulses, the pedal skin temperature and the cardiac index in the first 5 postoperative hours. When cardiac index was not analyzed and cold cardioplegic myocardial preservation methods used, only pedal pulses and pedal skin temperature were significant predictors of hospital death. Blood pressure and heart rate were not related to this mode of hospital death. Oliguria occurred in 23 percent of patients; it was related primarily to inadequate cardiac performance and increased the probability of hospital death. Treatment protocols are derived based on these facts.
Am J Cardiol 1981 Sep
PMID:Intracardiac surgery in infants under age 3 months: predictors of postoperative in-hospital cardiac death. 727 Apr 58

A 77-year-old man was referred to our hospital on October 2, 1995 because of fever and left mandibular pain beginning three months before admission. His blood pressure was 90/60 mmHg. A grade III/VI pansystolic murmur was heard over the cardiac apex. The liver was palpable 4 cm below the right costal margin. Lower extremity edema was present bilaterally. White blood cell count was 7,030/mm3 and C-reactive protein was 2.54. Enterococcus faecalis was identified by the blood culture. The diagnosis was infective endocarditis associated with congestive heart failure. He was treated by administration of antibiotics and diuretics. Mitral valve replacement and tricuspid annuloplasty were performed on October 19 because of progressive congestive heart failure with oliguria. The surgical intervention was successful despite the presence of multiple risk factors: high age, emergency, congestive heart failure and active infection. His condition improved dramatically after the operation and he was discharged two months later. Surgical intervention for infective endocarditis was a significant high-risk procedure in this uncontrollable and elderly case. This successful result suggests the indication for the timing of surgery.
J Cardiol 1997
PMID:[An elderly patient with infectious endocarditis complicated with congestive heart failure due to mitral and tricuspid regurgitation]. 921 Nov 14


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