Evaluating the Effects of Time From Brain Death and Type of Inotrope Usage on Result of Heart Transplant: Results of 1-Year Follow-Up.

OBJECTIVES: Heart transplant is the most effective treatment in patients with advanced heart failure who are refractory to medical treatment. The brain death interval and type of inotrope We assessed the effects of these parameters on heart transplant outcomes. MATERIALS AND METHODS: In this follow-up study, we followed heart transplant recipients for 1 year to study patient survival, ejection fraction, adverse events, and organ rejection. We evaluated follow-up results on time from brainstem death test to the cross-clamp placement, as well as the type of inotrope used. RESULTS: Our study enrolled 54 heart transplant candidates. The inotrope dose was 3.66 ± 0.99 µg/kg/min, and the most used inotrope, with 28 cases (51.9%), was related to dopamine. Six cases (11.1%) of death and 1 case of infection after transplant were observed in recipients. The average ejection fraction of transplanted hearts before transplant, instantly at time of transplant, and 1 month, 6 months, and 1 year after transplant was 54.9 ± 0.68, 52.9 ± 10.4, 51.9 ± 10.7, 50.1 ± 10.9, and 46.8 ± 17, respectively; this decreasing trend over time was significant (P =.001). Furthermore, ejection fraction changes following transplant did not differ significantly in transplanted hearts regarding brain death interval and type of inotrope used. CONCLUSIONS: Our study revealed that cardiac output of a transplanted heart may decrease over time and the time elapsed from brain death, and both dopamine and norepinephrine could have negligible effects on cardiac function.

A distributed scheme to manage the dynamic coexistence of IEEE 802.15.4-based health-monitoring WBANs.

The overlap of transmission ranges between wireless networks as a result of mobility is referred to as dynamic coexistence. The interference caused by coexistence may significantly affect the performance of wireless body area networks (WBANs) where reliability is particularly critical for health monitoring applications. In this paper, we analytically study the effects of dynamic coexistence on the operation of IEEE 802.15.4-based health monitoring WBANs. The current IEEE 802.15.4 standard lacks mechanisms for effectively managing the coexistence of mobile WBANs. Considering the specific characteristics and requirements of health monitoring WBANs, we propose the dynamic coexistence management (DCM) mechanism to make IEEE 802.15.4-based WBANs able to detect and mitigate the harmful effects of coexistence. We assess the effectiveness of this scheme using extensive OPNET simulations. Our results indicate that DCM improves the successful transmission rates of dynamically coexisting WBANs by 20%-25% for typical medical monitoring applications.

Performance analysis of coexisting IEEE 802.15.4-based health monitoring WBANs.

Wireless Body Area Networks (WBANs) for health monitoring systems are required to meet stringent performance demands regarding the tradeoff between reliability, latency, and power efficiency. WBANs feature limited range and bandwidth and they are prone to interference. Considering the life-critical nature of some WBAN systems, we present an in-depth investigation of the situations where the dynamic coexistence of multiple WBANs may severely affect their performances. In this paper, we analytically study the effect of coexistence on the operation of WBANs. We present a mathematical analysis to precisely obtain the probabilities of successful communication and validate this analysis through simulation. Our simulation analysis indicates that in the default mode of operation, coexistence of three WBANs can lead to the loss of 20-85% of data transmissions for typical sensor configurations.