226 SECTION IV Pediatric Critical Care Cardiovascular Key References Aird WC Endothelial cell heterogeneity Crit Care Med 2003;31(suppl 4) S221 S230 Asahara T, Masuda H, Takahashi T, et al Bone marrow[.]
226 S E C T I O N I V Pediatric Critical Care: Cardiovascular Key References Aird WC Endothelial cell heterogeneity Crit Care Med 2003;31(suppl 4):S221-S230 Asahara T, Masuda H, Takahashi T, et al Bone marrow origin of endothelial progenitor cells responsible for postnatal vasculogenesis in physiological and pathological neovascularization Circ Res 1999;85: 221-228 Asahara T, Murohara T, Sullivan A, et al Isolation of putative progenitor endothelial cells for angiogenesis Science 1997;275:964-967 Chistiakov DA, Orekhov AN, Bobryshev YV Endothelial barrier and its abnormalities in cardiovascular disease Front Physiol 2015;6:365 Dejana E Endothelial adherens junctions: implications in the control of vascular permeability and angiogenesis J Clin Invest 1996;98: 1949-1953 Kalka C, Masuda H, Takahashi T, et al Transplantation of ex vivo expanded endothelial progenitor cells for therapeutic neovascularization Proc Natl Acad Sci U S A 2000;97:3422-3427 Kumar S, West DC, Ager A Heterogeneity in endothelial cells from large vessels and microvessels Differentiation 1987;36:57-70 McCarthy SA, Kuzu I, Gatter KC, Bicknell R Heterogeneity of the endothelial cell and its role in organ preference of tumour metastasis Trends Pharmacol Sci 1991;12:462-467 Reitsma S, Slaaf DW, Vink H, van Zandvoort MA, oude Egbrink MG The endothelial glycocalyx: composition, functions, and visualization Pflugers Arch 2007;454:345-359 Rubanyi GM The role of endothelium in cardiovascular homeostasis and diseases J Cardiovasc Pharmacol 1993;22(suppl 4):S1-S14 Sukriti S, Tauseef M, Yazbeck P, Mehta D Mechanisms regulating endothelial permeability Pulm Circ 2014;4:535-551 The full reference list for this chapter is available at ExpertConsult.com e1 References Rubanyi GM The role of endothelium in cardiovascular homeostasis and diseases J Cardiovasc Pharmacol 1993;22(suppl 4):S1-S14 Aird WC Endothelial cell heterogeneity Crit Care Med 2003;31(suppl 4): S221-S230 Kumar S, West DC, Ager A Heterogeneity in endothelial cells from large vessels and microvessels Differentiation 1987;36:57-70 Dejana E Endothelial adherens junctions: implications in the control of vascular permeability and angiogenesis J Clin Invest 1996;98:1949-1953 Butcher EC, Picker LJ Lymphocyte homing and homeostasis Science 1996;272:60-66 Zhu DZ, Cheng CF, Pauli BU Mediation of lung metastasis of murine melanomas by a lung-specific endothelial cell adhesion molecule Proc Natl Acad Sci U S A 1991;88:9568-9572 McCarthy SA, Kuzu I, Gatter KC, Bicknell R Heterogeneity of the endothelial cell and its role in organ preference of tumour metastasis Trends Pharmacol Sci 1991;12:462-467 Asahara T, Murohara T, Sullivan A, et al Isolation of putative progenitor endothelial cells for angiogenesis Science 1997;275:964-967 Kalka C, Masuda H, Takahashi T, et al Transplantation of ex vivo expanded endothelial progenitor cells for therapeutic neovascularization Proc Natl Acad Sci U S A 2000;97:3422-3427 10 Asahara T, Masuda H, Takahashi T, et al Bone marrow origin of endothelial progenitor cells responsible for postnatal vasculogenesis in physiological and pathological neovascularization Circ Res 1999; 85:221-228 11 Asahara T, Takahashi T, Masuda H, et al VEGF contributes to postnatal neovascularization by mobilizing bone marrow-derived endothelial progenitor cells EMBO J 1999;18:3964-3972 12 Schachinger V, Erbs S, Elsässer A, et al Intracoronary bone marrowderived progenitor cells in acute myocardial infarction N Engl J Med 2006;355:1210-1221 13 Taniguchi E, Kin M, Torimura T, et al Endothelial progenitor cell transplantation improves the survival following liver injury in mice Gastroenterology 2006;130:521-531 14 Wang XX, Zhang FR, Shang YP, et al Transplantation of autologous endothelial progenitor cells may be beneficial in patients with idiopathic pulmonary arterial hypertension: a pilot randomized controlled trial J Am Coll Cardiol 2007;49:1566-1571 15 Bombeli T, Mueller M, Haeberli A Anticoagulant properties of 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with sepsis and multiple organ failure syndrome (MOFS) Histol Histopathol 1998;13:121-128 e2 52 Li H, Forstermann U Nitric oxide in the pathogenesis of vascular disease J Pathol 2000;190:244-254 53 Moake JL Haemolytic-uraemic syndrome: basic science Lancet 1994;343:393-397 54 Mitra D, Jaffe EA, Weksler B, Hajjar KA, Soderland C, Laurence J Thrombotic thrombocytopenic purpura and sporadic hemolyticuremic syndrome plasmas induce apoptosis in restricted lineages of human microvascular endothelial cells Blood 1997;89:1224-1234 55 Savage CO The evolving pathogenesis of systemic vasculitis Clin Med (Lond) 2002;2:458-464 56 Xing K, Murthy S, Liles WC, Singh JM Clinical utility of biomarkers of endothelial activation in sepsis—a systematic review Crit Care 2012;16:R7 57 Masaki T The discovery, the present state, and the future prospects of endothelin J Cardiovasc Pharmacol 1989;13(suppl 5):S1-S4 58 Yanagisawa M, Kurihara H, Kimura S, Goto K, Masaki T A novel peptide vasoconstrictor, endothelin, is produced by vascular endothelium and modulates smooth muscle Ca21 channels J Hypertens Suppl 1988;6:S188-S191 59 Rafat N, Hanusch C, Brinkkoetter PT, et al Increased circulating endothelial progenitor cells in septic patients: correlation with survival Crit Care Med 2007;35:1677-1684 60 Darwish NI, Liles WC Emerging therapeutic strategies to prevent infection-related microvascular endothelial activation and dysfunction Virulence 2013;4:572-582 61 Soriano AO, Jy W, Chirinos JA, et al Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis Crit Care Med 2005;33:2540-2546 62 Liu L, Wei H, Chen F, Wang J, Dong JF, Zhang J Endothelial progenitor cells correlate with clinical outcome of traumatic brain injury Crit Care Med 2011;39:1760-1765 e3 Abstract: Because of their location, endothelial cells have the ability to interact with blood components, such as flow, soluble factors, and other cells Endothelial cells integrate these signals into a cohesive regulation of vascular responses The endothelium controls the vascular tone of the underlying smooth muscle cells through the production of vasodilator and vasoconstrictor mediators Endothelial cell activation in response to inflammation changes endothelial cellular physiology and alters vascular function Key words: Endothelial cells, smooth muscle cells, vascular tone, coagulation, vasodilators, vasoconstrictors, leukocytes, vascular permeability, inflammation 10 26 Chapter Title Principles of Invasive Cardiovascular Monitoring CHAPTER AUTHOR MATTHEW R TIMLIN AND KENNETH A SCHENKMAN PEARLS • • To gain basic knowledge of the development of the eye To develop essential understanding how abnormalities at P Evarious A R L Sstages of development can arrest or hamper normal formation of the ocular structures and visual pathways • Hemodynamic monitoring refers to measurement of the functional characteristics of the heart and circulatory system that affect the perfusion of tissues with oxygenated blood • Hemodynamic monitoring can be performed invasively or noninvasively and can be used for diagnosis, surveillance, or titration of therapy • The central venous waveform is composed of three waves (a, c, and v) and two wave descents (x and y) • Role of Invasive Hemodynamic Monitoring and pulmonary artery catheters (PACs) Invasive hemodynamic monitoring can provide the skilled intensivist with a plethora of valuable information but should still be integrated with all patient data rather than viewed in isolation Successful use of invasive hemodynamic measurements necessitates skills to obtain these measures safely with attention to the risks imposed on the patient As with any technology, the use of invasive hemodynamic monitoring is in evolution, and it is incumbent on the clinician to be familiar with developments as they arise This chapter aims to be a practical guide to the use of hemodynamic monitoring in the PICU It reviews general principles of measurement and discusses the three main types of invasive hemodynamic monitoring: CVC, arterial catheter, and PAC It addresses the indications and controversies, interpretation of waveforms, and potential complications and also reviews cardiac output (CO) monitoring and calculation of oxygen consumption and delivery New techniques coupling invasive monitoring with noninvasive devices are also discussed The specific techniques for gaining access to make these measurements are detailed in Chapter 14, which covers invasive procedures • • Since William Harvey’s observation in the early 1600s that the heart pumps blood in a continuous circuit, the function of the circulatory system has been the subject of intense scrutiny Hemodynamic monitoring refers to measurement of the functional characteristics of the heart and circulatory system that affect the perfusion of tissues with oxygenated blood in order to maintain homeostasis and to remove byproducts of metabolism Several different types of invasive hemodynamic monitoring can be used concurrently to guide management The goal of hemodynamic monitoring is to provide accurate diagnoses and to guide additional interventions to deliver improved care to the critically ill patient In his 1733 report “Statical essays: containing haemastaticks; or, an account of some hydraulick and hydrostatical experiments made on the blood and blood-vessels of animals,” Hales1 described early experiments in horses in which he used tubular devices inserted directly into arteries to measure intravascular pressures Fig 26.1 depicts Hales and an assistant in the process of these early experiments This figure also illustrates a simple method for inferring arterial versus venous placement of a vascular catheter, which can also give a quick bedside estimate of central venous pressure Frequently in the pediatric intensive care unit (PICU), noninvasive assessments of hemodynamics are supplemented by invasive hemodynamic measures that require entrance into the intravascular space Such invasive hemodynamic measurements include placement of central venous catheters (CVCs), arterial catheters, • • To acquire adequate information about normal anatomy of the eye and related structures and develop a strong foundation for the understanding of common ocular problems and their consequences The arterial waveform has three components: rapid upstroke, dicrotic notch, and runoff Pulse pressure variation has excellent specificity as an indicator of fluid responsiveness in many critically ill patients Cardiac output can be calculated using the Fick method or measured directly via thermodilution A pulmonary artery catheter can be used to measure cardiac output and indices of oxygen delivery and extraction Indications for Invasive Hemodynamic Measurements The three main indications for invasive hemodynamic monitoring are diagnosis, surveillance, and titration of therapy Diagnosis may include the differentiation of septic shock (through assessment of 227 ... PA, Mathie RT Ischemia-Reperfusion Injury London: Blackwell Science; 1999 48 Neary P, Redmond HP Ischemia-reperfusion injury and the systemic inflammatory response syndrome In: Grace PA, Mathie... Transplantation of autologous endothelial progenitor cells may be beneficial in patients with idiopathic pulmonary arterial hypertension: a pilot randomized controlled trial J Am Coll Cardiol 2007;49:1566-1571... evolution, and it is incumbent on the clinician to be familiar with developments as they arise This chapter aims to be a practical guide to the use of hemodynamic monitoring in the PICU It reviews