General 1 Flashcards
(49 cards)
Vitamin B-12 aka
cobalamin
what vitamin is Folic Acid
B9
COMPASS study - anacronym means ?
Cardiovascular Outomes for People Using Anticoagulation Strategies
COMPASS study LIMA failure rate
6.4% at one year
COMPASS study Radial artery failure rate
9.9% at one year
COMPASS study - SVG failure rate at one year
10.4%
COMPASS Study - RIMA failure rate at one year
26.4%
COMPASS study - LIMA patency is related to
Target vessel stenosis
COMPASS study - 1 year SVG patency is related to
Target vessel quality and proximal location
composite or sequential had worse patency than direct to the aorta
Definition of vasoplegia
unified definition
if they had following conditions for at least three consecutive hours during the first 48 h after ICU arrival:
*a vasodilation criterion: *
1. MAP ≤50 mmHg or SVR ≤800 dynes·s·cm− 5;
* hemodynamic criterion: *
1. CI ≥ 2.5 l·min− 1·m− 2;
*high vasopressor requirement:**
use of norepinephrine ≥200 ng·kg− 1·min− 1 or equivalent doses of vasopressors (epinephrine ≥200 ng·kg− 1·min− 1; dopamine ≥30 μg·kg− 1·min− 1; phenylephrine ≥2 μg·kg− 1·min− 1, or vasopressin ≥0.08 U·min− 1)
proposed in the ATHOS-3 trial**
The estimated annualized rate of sudden death for asymptomatic patients with severe AS is?
The estimated annualized rate of sudden death for asymptomatic patients with severe AS is 1% per year
operative mortality associated with sAVR in patients aged <70?
Operative mortality associated with sAVR
age < 70: 1%–3%
age > 70: 3%–8%
operative mortality associated with sAVR in patients > 70 years?
operative mortality associated with sAVR in patients
> 70 years: 3%–8%
Indications for sAVR in aysmptomatic AS patients with low surgical risk ?
Vmax presenting a low surgical risk (class IIa recommendation)
≥5 m/s in US guidelines
>5.5 m/s in European guidelines
Finally, the latest European guidelines add:
* markedly elevated brain natriuretic peptide (BNP) levels
* severe pulmonary hypertension at rest (systolic pulmonary artery pressure >60 mm Hg)
Other parameters validated as strong predictors of poor outcome in asymptomatic severe AS?
might represent incentives for AVR referral:
indexed stroke volume by Doppler echocardiography
* <30mL/m2)
LVEF
* between 50% and 55%,
left atrial enlargement
* left atrial volume >95mL or
* indexed left atrial volume >50mL/m2in patients in sinus rhythm).
*
Indicators of very severe aortic stenosis
Peak aortic jet velocity: >5m/s
MTAPG: > 60 mmHg
AVA: 0.6 cm 2
Indexed Aortic valve area :
0.4 cm/m2 (BSA)
0.45 cm/m (height)
Dimensionless index: < 0.2
Dimensionless index for
1. Severe AS
2. Very severe AS
Severe AS: <0.25
Very severe AS: <0.2
Peak aortic velocity for Very severe AS
> 5m/s
MATPG for very severe AS?
> 60 mmHg
Mean AVA for very severe AS ?
< 0.6 cm 2
severe aortic stenosis
Indexed aortic valve area
0.4 cm2/m2
0.45 cm2/m
B vitamin for vasoplegia
hydroxocobalamin
mechanism of action for
hydroxocobalamin
for Vasoplegia
free NO scavenger (similar to methelene blue)
Vasoplegia
Dose for hydroxocobalamin
2 mg/kg bolus
* one of the patients receiving an additional 0.5 mg/kg/hr for 6 hours
