Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics
We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hem...
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| Veröffentlicht in: | European journal of pediatrics 2021, Vol.180 (1), p.195-200 |
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| creator | Selim, Ahmed El Wahab, Atef Abd Salem, Hany Yahmadi, Mohammed AL Al Aisary, Salima Malviya, Manoj ALhabsi, Ahmed Elsayed, Yasser |
| description | We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hemodynamics data for 2 complex cases of AVM transferred to Khaula Hospital in Oman for interventional management. We described the value of novel physiological insights gained from comprehensive IEH and provided a systematic approach to the perioperative management. Postoperative targeted neonatal echo (TNE) was used to guide the weaning of the cardiovascular medications within 24 h. Both cases showed significant right ventricle (RV) volume overload before surgery. Narrowing of the pulse pressure (PP) during or after endovascular embolization was used as a marker of compromised systemic blood flow in real time followed by an assessment by TNE to guide the appropriate therapy.
Conclusion
: Integrated evaluation of hemodynamics is helpful to guide perioperative physiologic-based management of AVM.
What is Known:
•
The preoperative management of hemodynamic compromise due to AVM has been described in many articles.
•
Perioperative management of AVM and related hemodynamics is a challenge to the intensive care team.
What is New:
•
Integrated evaluation of hemodynamics is a comprehensive assessment and helpful in understanding the underlying physiologic changes during intervention with AVM.
•
This integrated evaluation can lead to physiologic-based medical recommendation with subsequent improvement. |
| doi_str_mv | 10.1007/s00431-020-03735-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2423514967</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2475036757</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-5ec4b2676b305e8b771da8dae7d624e2b7904c0068104b5df31d12e6f94cf563</originalsourceid><addsrcrecordid>eNp9kc1q3DAUhUVpaCaTvEAXxdBNN06u_sfLMrRNYCBZZC9k63rqYEtTyR6Yefpo4qSFLrISl_OdI-keQj5TuKYA-iYBCE5LYFAC11yWxw9kQQVnJQWtPpIFcAGlolV1Ti5SeoJsqujqEznnTEmlKliQ9gFjF3YY7djtsRist1sc0I9FaAsbx5O6Rx-mlLW-DXHIYPDFduocuqI-FJ0fcZvtecK97adZz-7fOAR38HbomnRJzlrbJ7x6PZfk8eePx_Vtubn_dbf-vikbruVYSmxEzZRWNQeJq1pr6uzKWdROMYGs1hWIBkCtKIhaupZTRxmqthJNKxVfkm9z7C6GPxOm0QxdarDvrcf8BcME45KKSumMfv0PfQpT9PlxmdISuNLyRLGZamJIKWJrdrEbbDwYCuZUgplLMLkE81KCOWbTl9foqR7Q_bW8bT0DfAZSlvwW47-734l9BsxflEg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2475036757</pqid></control><display><type>article</type><title>Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics</title><source>Springer Nature - Complete Springer Journals</source><creator>Selim, Ahmed ; El Wahab, Atef Abd ; Salem, Hany ; Yahmadi, Mohammed AL ; Al Aisary, Salima ; Malviya, Manoj ; ALhabsi, Ahmed ; Elsayed, Yasser</creator><creatorcontrib>Selim, Ahmed ; El Wahab, Atef Abd ; Salem, Hany ; Yahmadi, Mohammed AL ; Al Aisary, Salima ; Malviya, Manoj ; ALhabsi, Ahmed ; Elsayed, Yasser</creatorcontrib><description>We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hemodynamics data for 2 complex cases of AVM transferred to Khaula Hospital in Oman for interventional management. We described the value of novel physiological insights gained from comprehensive IEH and provided a systematic approach to the perioperative management. Postoperative targeted neonatal echo (TNE) was used to guide the weaning of the cardiovascular medications within 24 h. Both cases showed significant right ventricle (RV) volume overload before surgery. Narrowing of the pulse pressure (PP) during or after endovascular embolization was used as a marker of compromised systemic blood flow in real time followed by an assessment by TNE to guide the appropriate therapy.
Conclusion
: Integrated evaluation of hemodynamics is helpful to guide perioperative physiologic-based management of AVM.
What is Known:
•
The preoperative management of hemodynamic compromise due to AVM has been described in many articles.
•
Perioperative management of AVM and related hemodynamics is a challenge to the intensive care team.
What is New:
•
Integrated evaluation of hemodynamics is a comprehensive assessment and helpful in understanding the underlying physiologic changes during intervention with AVM.
•
This integrated evaluation can lead to physiologic-based medical recommendation with subsequent improvement.</description><identifier>ISSN: 0340-6199</identifier><identifier>EISSN: 1432-1076</identifier><identifier>DOI: 10.1007/s00431-020-03735-z</identifier><identifier>PMID: 32656690</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood flow ; Cardiovascular system ; Corporate histories ; Disease management ; Embolization ; Hemodynamics ; Infants ; Medicine ; Medicine & Public Health ; Neonates ; Newborn babies ; Original Article ; Pediatrics ; Surgery ; Ventricle ; Weaning</subject><ispartof>European journal of pediatrics, 2021, Vol.180 (1), p.195-200</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-5ec4b2676b305e8b771da8dae7d624e2b7904c0068104b5df31d12e6f94cf563</citedby><cites>FETCH-LOGICAL-c375t-5ec4b2676b305e8b771da8dae7d624e2b7904c0068104b5df31d12e6f94cf563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00431-020-03735-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00431-020-03735-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32656690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selim, Ahmed</creatorcontrib><creatorcontrib>El Wahab, Atef Abd</creatorcontrib><creatorcontrib>Salem, Hany</creatorcontrib><creatorcontrib>Yahmadi, Mohammed AL</creatorcontrib><creatorcontrib>Al Aisary, Salima</creatorcontrib><creatorcontrib>Malviya, Manoj</creatorcontrib><creatorcontrib>ALhabsi, Ahmed</creatorcontrib><creatorcontrib>Elsayed, Yasser</creatorcontrib><title>Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics</title><title>European journal of pediatrics</title><addtitle>Eur J Pediatr</addtitle><addtitle>Eur J Pediatr</addtitle><description>We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hemodynamics data for 2 complex cases of AVM transferred to Khaula Hospital in Oman for interventional management. We described the value of novel physiological insights gained from comprehensive IEH and provided a systematic approach to the perioperative management. Postoperative targeted neonatal echo (TNE) was used to guide the weaning of the cardiovascular medications within 24 h. Both cases showed significant right ventricle (RV) volume overload before surgery. Narrowing of the pulse pressure (PP) during or after endovascular embolization was used as a marker of compromised systemic blood flow in real time followed by an assessment by TNE to guide the appropriate therapy.
Conclusion
: Integrated evaluation of hemodynamics is helpful to guide perioperative physiologic-based management of AVM.
What is Known:
•
The preoperative management of hemodynamic compromise due to AVM has been described in many articles.
•
Perioperative management of AVM and related hemodynamics is a challenge to the intensive care team.
What is New:
•
Integrated evaluation of hemodynamics is a comprehensive assessment and helpful in understanding the underlying physiologic changes during intervention with AVM.
•
This integrated evaluation can lead to physiologic-based medical recommendation with subsequent improvement.</description><subject>Blood flow</subject><subject>Cardiovascular system</subject><subject>Corporate histories</subject><subject>Disease management</subject><subject>Embolization</subject><subject>Hemodynamics</subject><subject>Infants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Surgery</subject><subject>Ventricle</subject><subject>Weaning</subject><issn>0340-6199</issn><issn>1432-1076</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kc1q3DAUhUVpaCaTvEAXxdBNN06u_sfLMrRNYCBZZC9k63rqYEtTyR6Yefpo4qSFLrISl_OdI-keQj5TuKYA-iYBCE5LYFAC11yWxw9kQQVnJQWtPpIFcAGlolV1Ti5SeoJsqujqEznnTEmlKliQ9gFjF3YY7djtsRist1sc0I9FaAsbx5O6Rx-mlLW-DXHIYPDFduocuqI-FJ0fcZvtecK97adZz-7fOAR38HbomnRJzlrbJ7x6PZfk8eePx_Vtubn_dbf-vikbruVYSmxEzZRWNQeJq1pr6uzKWdROMYGs1hWIBkCtKIhaupZTRxmqthJNKxVfkm9z7C6GPxOm0QxdarDvrcf8BcME45KKSumMfv0PfQpT9PlxmdISuNLyRLGZamJIKWJrdrEbbDwYCuZUgplLMLkE81KCOWbTl9foqR7Q_bW8bT0DfAZSlvwW47-734l9BsxflEg</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Selim, Ahmed</creator><creator>El Wahab, Atef Abd</creator><creator>Salem, Hany</creator><creator>Yahmadi, Mohammed AL</creator><creator>Al Aisary, Salima</creator><creator>Malviya, Manoj</creator><creator>ALhabsi, Ahmed</creator><creator>Elsayed, Yasser</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2021</creationdate><title>Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics</title><author>Selim, Ahmed ; El Wahab, Atef Abd ; Salem, Hany ; Yahmadi, Mohammed AL ; Al Aisary, Salima ; Malviya, Manoj ; ALhabsi, Ahmed ; Elsayed, Yasser</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-5ec4b2676b305e8b771da8dae7d624e2b7904c0068104b5df31d12e6f94cf563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Blood flow</topic><topic>Cardiovascular system</topic><topic>Corporate histories</topic><topic>Disease management</topic><topic>Embolization</topic><topic>Hemodynamics</topic><topic>Infants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Surgery</topic><topic>Ventricle</topic><topic>Weaning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Selim, Ahmed</creatorcontrib><creatorcontrib>El Wahab, Atef Abd</creatorcontrib><creatorcontrib>Salem, Hany</creatorcontrib><creatorcontrib>Yahmadi, Mohammed AL</creatorcontrib><creatorcontrib>Al Aisary, Salima</creatorcontrib><creatorcontrib>Malviya, Manoj</creatorcontrib><creatorcontrib>ALhabsi, Ahmed</creatorcontrib><creatorcontrib>Elsayed, Yasser</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Selim, Ahmed</au><au>El Wahab, Atef Abd</au><au>Salem, Hany</au><au>Yahmadi, Mohammed AL</au><au>Al Aisary, Salima</au><au>Malviya, Manoj</au><au>ALhabsi, Ahmed</au><au>Elsayed, Yasser</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics</atitle><jtitle>European journal of pediatrics</jtitle><stitle>Eur J Pediatr</stitle><addtitle>Eur J Pediatr</addtitle><date>2021</date><risdate>2021</risdate><volume>180</volume><issue>1</issue><spage>195</spage><epage>200</epage><pages>195-200</pages><issn>0340-6199</issn><eissn>1432-1076</eissn><abstract>We aimed to demonstrate the value of monitoring infants with arteriovenous malformation (AVM) during endovascular embolization with integrated evaluation of hemodynamics (IEH) and guiding decisions according to the underlying pathophysiology. This is a retrospective analysis of the perioperative hemodynamics data for 2 complex cases of AVM transferred to Khaula Hospital in Oman for interventional management. We described the value of novel physiological insights gained from comprehensive IEH and provided a systematic approach to the perioperative management. Postoperative targeted neonatal echo (TNE) was used to guide the weaning of the cardiovascular medications within 24 h. Both cases showed significant right ventricle (RV) volume overload before surgery. Narrowing of the pulse pressure (PP) during or after endovascular embolization was used as a marker of compromised systemic blood flow in real time followed by an assessment by TNE to guide the appropriate therapy.
Conclusion
: Integrated evaluation of hemodynamics is helpful to guide perioperative physiologic-based management of AVM.
What is Known:
•
The preoperative management of hemodynamic compromise due to AVM has been described in many articles.
•
Perioperative management of AVM and related hemodynamics is a challenge to the intensive care team.
What is New:
•
Integrated evaluation of hemodynamics is a comprehensive assessment and helpful in understanding the underlying physiologic changes during intervention with AVM.
•
This integrated evaluation can lead to physiologic-based medical recommendation with subsequent improvement.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32656690</pmid><doi>10.1007/s00431-020-03735-z</doi><tpages>6</tpages></addata></record> |
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| ispartof | European journal of pediatrics, 2021, Vol.180 (1), p.195-200 |
| issn | 0340-6199 1432-1076 |
| language | eng |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Blood flow Cardiovascular system Corporate histories Disease management Embolization Hemodynamics Infants Medicine Medicine & Public Health Neonates Newborn babies Original Article Pediatrics Surgery Ventricle Weaning |
| title | Perioperative management of arteriovenous malformation guided by integrated evaluation of hemodynamics |
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