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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Related Experiment Video

Updated: Sep 4, 2025

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Peripheral tissue hypoperfusion predicts post intubation hemodynamic instability.

Vincent Dubée1,2, Geoffroy Hariri2,3,4, Jérémie Joffre2,3

  • 1Service de Maladies Infectieuses et Tropicales, CHU Angers, Angers, France.

Annals of Intensive Care
|July 17, 2022
PubMed
Summary
This summary is machine-generated.

Peripheral microvascular dysfunction, indicated by a high mottling score, can predict post-intubation hemodynamic instability in critically ill patients. Early identification aids in managing ventilation risks.

Keywords:
HemodynamicIntubationMottlingOutcomeTissue perfusion

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Area of Science:

  • Critical Care Medicine
  • Hemodynamics
  • Microvascular Physiology

Background:

  • Tracheal intubation and mechanical ventilation initiation carry risks of arterial hypotension in ICUs.
  • The link between pre-existing microvascular alterations and post-intubation hemodynamic instability (PIHI) is not well understood.

Purpose of the Study:

  • To investigate the relationship between pre-intubation peripheral microvascular dysfunction and PIHI.
  • To identify predictors of PIHI in critically ill patients.

Main Methods:

  • Prospective observational study in a medical ICU.
  • Monitored global hemodynamic and tissue perfusion parameters before and after tracheal intubation.
  • PIHI defined as any hemodynamic event requiring intervention.

Main Results:

  • 42% of 120 patients developed PIHI.
  • Baseline mottling score (≥3), sepsis, and elevated lactate were associated with PIHI.
  • Mottling score was the best predictor of PIHI (AUC: 0.72).

Conclusions:

  • Tissue hypoperfusion parameters, particularly the mottling score, can predict PIHI in critically ill patients.
  • Mottling score aids in identifying patients at risk for hemodynamic instability post-intubation.