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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 24 patients, aged 6 days to 24 months, undergoing the Senning procedure for transposition of the great arteries, 2 patients died perioperatively (8% operative mortality): 1 patient, a neonate, from sepsis and 1 patient, born prematurely and with multiple anomalies, from congestive heart failure. One patient died late postoperatively from noncardiac causes. The 21 survivors are clinically well, and in 20 complete hemodynamic and electrophysiologic data were obtained by cardiac catheterization a mean of 13 months after repair. All patients have normal systemic arterial oxygen saturation. Left ventricular function and pulmonary artery pressures are normal in all. None had pulmonary venous obstruction. Narrowing at the junction of the superior vena cava and systemic venous atrium with mean pressure differences of 5 mm Hg or more was found in 4 of the 20 patients, but was clinically manifest in only 1 patient. No abnormality of atrioventricular conduction was seen in response to programmed electrical stimulation. Sinus node dysfunction was present in 6 patients, with abnormalities of both automaticity and sinoatrial conduction. Among these 6 patients were the 5 who were younger than 5 months at operation. The Senning procedure generally results in excellent hemodynamic and electrophysiologic status in patients who undergo operation after the newborn period. Identification of sinus node dysfunction, seen in patients in whom the procedure is performed in the first few months of life, is of concern and identifies a need for close follow-up of sinus node function in this cohort of patients.
Am J Cardiol 1986 Jul 01
PMID:Hemodynamic and electrophysiologic results of the Senning procedure for transposition of the great arteries. 372 14

To compare the percutaneous and surgical techniques of intraaortic balloon pump insertion, 101 patients referred for this procedure were randomly assigned to either percutaneous or surgical insertion. Insertion using the designated technique was successful in 45 (88%) of 51 patients with percutaneous insertion and 48 (96%) of 50 patients with surgical insertion (difference not statistically significant). The time from the beginning of the insertion procedure to the initiation of counterpulsation was 13 +/- 8 minutes for the percutaneous technique versus 31 +/- 16 minutes for the surgical technique (p less than 0.001). In the percutaneous group, 10 patients required Fogarty thrombectomy after balloon pump removal, and 1 patient developed severe leg ischemia requiring immediate termination of balloon pump support. In the surgical group, one patient developed leg ischemia requiring surgical intervention, three patients developed sepsis with bacteremia (including one patient who required vein patch repair of the femoral artery), one patient developed a wound infection requiring debridement and one patient had a cerebral embolus. Aortic dissection, aortoiliac perforation or amputation did not occur in either group. Major vascular complications occurred in 11 patients (22%) with percutaneous insertion versus 2 patients (4%) with surgical insertion (p less than 0.05). It is concluded that although the percutaneous technique for intraaortic balloon pump insertion is faster than the surgical technique and is technically easy, it is associated with a higher incidence of vascular complications.
J Am Coll Cardiol 1987 Mar
PMID:Intraaortic balloon pump insertion: a randomized study comparing percutaneous and surgical techniques. 381 98

Intracardiac masses are rare in infants and children. Early detection is essential to their successful management. We present seven patients in whom echocardiography established the diagnosis and was crucial in the management. Three of the masses were primary cardiac tumors and four were thrombi. Patient 1: an infant with a calcified left ventricular fibroma. Patient 2: a neonate who presented with cyanosis due to obstruction of the right ventricular inflow tract by a fibroblastic tumor. Patient 3: an infant with a right atrial myxoma presenting as sepsis. Patient 4: a child who had a pulmonary embolus after a pulmonary valvotomy and was found to have a right ventricular thrombus. Patient 5: a child with a right atrial thrombus following a Fontan procedure for univentricular atrioventricular connection. Patient 6: a child with a left ventricular thrombus due to a dilated cardiomyopathy in association with epidermolysis bullosa. Patient 7: An infant with bilateral lobar emphysema, an aorticopulmonary window with left ventricular fibroelastosis, who developed a left ventricular thrombus.
Pediatr Cardiol 1986
PMID:Echocardiography of intracardiac filling defects in infants and children. 382 62

Controversy exists in the literature concerning the effects of insulin and glucagon on cardiac muscle contractility, in particular during anoxia, ischemia or sepsis. The purpose of the present study was to determine the effects of insulin and glucagon on the systolic function of the normal and the dysfunctioning septic rat myocardium in the Langendorff preparation. In the normal isolated rat heart, neither insulin nor glucagon exhibited any lasting inotropic effect on systolic function or coronary flow. Sepsis (cecal ligation and puncture) resulted in a dramatic reduction of systolic function to 44% of control animals. All insulin-containing formulations tested improved systolic function in septic hearts by a mean of 85% compared to Krebs and glucose only. However, this improvement did not reach statistical significance compared to the use of Krebs and glucose only. Glucagon at 100 micrograms/l was doing as well as Krebs and glucose alone while at 1 mg/l glucagon was only able to maintain pre-perfusion contractility. Our results suggest that neither insulin nor glucagon seem to possess special inotropic properties for the isolated perfused normal or septic rat heart.
Basic Res Cardiol
PMID:The effect of insulin and glucagon on systolic properties of the normal and septic isolated rat heart. 390 99

A 54 year old man, hospitalised for thoraco-abdominal pain resulting from a septicemia which gives positive hemocultures for streptococcus D Bovis, is diagnosed to have a splenic abscess which will require splenectomy. At the same time, an endocarditis develops and gets worse, with auriculo-ventricular blockade and, especially, major aortic insufficiency, which is the cause of death by a brutal and massive pulmonary oedema. In the progression of an endocarditis, the occurrence of a splenic abscess, primary localisation of the initial septicemia or the secondary of an arterial septic embolism, is a rare contingency compared to the frequency of splenomegaly or splenic infarction: less than 2 percent of the cases in the literature. This very atypical and exceptional case serves as a reminder, on the one hand, of the diagnostic inadequacy of echocardiography which cannot visualise vegetation in the course of progressive endocarditis, and, on the other, of the prognostic importance of auriculoventricular blockade in septal and aortic endocardial lesions.
Ann Cardiol Angeiol (Paris) 1985 Nov
PMID:[Splenic abscess disclosing endocarditis]. 393 91

A 7-month-old infant presented with suspected sepsis. On the third day of illness signs of cardiac tamponade developed. Tamponade was relieved by pericardiocentesis, and countercurrent immunoelectrophoresis (CIE) analysis of the fluid was positive for meningococcus group B. Antibiotic treatment was changed to penicillin G. After echocardiography demonstrated reaccumulation of fluid, a modified #16 gauge angiocatheter was placed percutaneously in the pericardial space. When drainage slowed it was repositioned using two-dimensional echocardiography. After 24 h the catheter was removed and no further accumulation occurred. The antibiotics were continued an additional 10 days and the infant recovered uneventfully. Modification of the catheter and echographic repositioning may decrease the need for surgical drainage in such patients.
Clin Cardiol 1985 Oct
PMID:Purulent meningococcal pericarditis: chronic percutaneous drainage with a modified catheter aided by echocardiography. 405 34

Ear acupuncture followed by sepsis caused subacute bacterial endocarditis in a patient with rheumatic valve disease.
Int J Cardiol 1985 Jan
PMID:Subacute bacterial endocarditis following ear acupuncture. 405 36

The results of a prospective study of ventricular electrical instability after myocardial infarction (MI) are presented. Ventricular electrical stability was assessed using a standardized protocol of programmed stimulation in 165 hemodynamically stable patients 6 to 28 days after acute MI. Ventricular electrical instability was defined as induction at programmed stimulation of ventricular fibrillation (VF) or ventricular tachycardia (VT) lasting at least 10 seconds. Of 165 MI survivors, 38 (23%) had ventricular electrical instability. No significant differences were noted between stable and unstable patients in terms of coronary prognostic index, elevation of serum creatine phosphokinase, coronary anatomy, site of MI, or frequency of VT within 48 hours of MI. The mean follow-up period was 8 months (range 0 to 12). There were 7 deaths in stable patients (5 from cardiogenic shock, 1 from septicemia, and 1 unwitnessed) and 10 deaths in unstable patients (8 instantaneous, 1 from cardiogenic shock, and 1 unwitnessed) during the subsequent year. In addition, 2 of 127 stable patients and 4 of 38 unstable patients had spontaneous VT from which they were satisfactorily resuscitated. Thus, the sensitivity of ventricular electrical instability as a predictor of instantaneous death or spontaneous VT was 86% and the specificity 83%. The predictive accuracy of the absence of ventricular electrical instability as an indicator for the absence of instantaneous death or spontaneous VT was 98%. The predictive accuracy of the presence of ventricular electrical instability as a predictor of instantaneous death or spontaneous VT was 32%. Thus, patients with ventricular electrical instability after MI have a high risk of instantaneous death within 1 year; patients without ventricular electrical instability after MI have a low risk of instantaneous death within 1 year; prospective studies of antiarrhythmic therapy and measures to prevent reinfarction and optimize left ventricular performance are required to determine whether instantaneous death can be prevented in unstable patients; and therapy to prevent reinfarction and optimize left ventricular performance may offer the best chance to improve prognosis in stable patients.
Am J Cardiol 1983 Jan 01
PMID:Ventricular electrical instability: a predictor of death after myocardial infarction. 612 96

Congenital stenosis of the pulmonary veins is a rare but frequently lethal congenital cardiac abnormality. Eight patients with this malformation were diagnosed, evaluated and treated. All eight patients had associated congenital cardiac defects. Two of the eight died, one of sepsis and one after operative pulmonary venoplasty. In three patients who underwent transvenous balloon catheter dilation of the stenosis the procedure provided immediate but transient relief of the stenosis. The prognosis for symptomatic infants with pulmonary vein stenosis is poor and its treatment an enigma.
Am J Cardiol 1982 May
PMID:Congenital stenosis of individual pulmonary veins: clinical spectrum and unsuccessful treatment by transvenous balloon dilation. 621 Oct 76

To evaluate the significance of ventricular tachycardia (VT) in idiopathic dilated cardiomyopathy (IDC), 35 consecutive patients seen between 1976 and 1980 were studied. The criteria for diagnosis of IDC were based on clinical, laboratory, and cardiac catheterization findings. All patients had right and left heart catheterization, left ventriculography, and coronary cineangiography. Long-term ambulatory electrocardiograms (Holter) were obtained in all patients at the time of diagnosis. There were 24 male and 11 female patients aged 22 to 72 years (mean +/- standard deviation [SD]51 +/- 12). Frequent ventricular premature beats (VPB) (30/h) were observed in 29 patients (83%): complex VPB (Lown grades 3, 4, and 5) in 93% and simple VPB in 7%. Twenty-one patients (60%) had nonsustained VT consisting of 3 to 46 beats (8 +/- 5) with rates from 75 to 210/min. No difference between patients with and those without VT was observed in regard to the presenting symptoms, functional classification, electrocardiographic findings, heart size on chest X-ray, and the hemodynamic measurements including cardiac index, left ventricular end-diastolic pressure, and ejection fraction. Patients with VT were older (p less than 0.05). Follow-up observation from 4 to 74 months (34 +/- 17) showed that 2 patients died suddenly (1 with and 1 without previous VT), a third patient died from intractable congestive heart failure, and the fourth from sepsis. It is concluded that (1) the incidence of ventricular arrhythmias in IDC is high, (2) VT is frequent and tends to occur in the nonsustained form, and (3) there is no correlation between VT and the clinical and hemodynamic findings. VT does not appear to predict prognosis during a relatively short follow-up period in patients with IDC.
Am J Cardiol 1983 Feb
PMID:Significance of ventricular tachycardia in idiopathic dilated cardiomyopathy: observations in 35 patients. 621 46


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