Hyperarousal is a hallmark of posttraumatic stress disorder (PTSD). PTSD has been associated with increased blood pressure (BP) and heart rate (HR) in veteran populations. We retrospectively identified male patients consulted to outpatient psychiatry at the Iowa City Veterans Affairs Healthcare System. Patients were divided into PTSD (n = 88) ...

Over a million children are subjected to some form trauma in the United States every year. Early trauma has been shown to have deleterious effects on cardiovascular health in adulthood. However, the presence of strong social relationships as an adult can buffer an individual against many of the harmful effects ...

BACKGROUND. : Positive pressure ventilation (PPV) is provided by manual ventilation devices such as self-inflating bags (SIB), flow inflating bags and T-piece resuscitators. The objective of this study is to compare the effect of type of manual ventilation device on overall response to resuscitation among preterm neonates born < 35 ...

INTRODUCTION: Discrepant data exist regarding the incidence and severity of clinical problems related to intra-hospital transport of brain-injured patients and no consensus exists whether modern-day intra-hospital transport represents a safe or potentially problematic environment for neurointensive care unit (NICU) patients. METHODS: We examined the incidence of clinical complications and physiological ...

ABSTRACT: Despite the high incidence and prognostic relevance of hemorrhagic shock, abdominal and blunt chest trauma in multiply injured patients, there are no animal models combining these injuries. Therefore, we established a new porcine multiple trauma model consisting of blunt chest trauma, penetrating abdominal trauma (two incisions in the right ...

Airway pressure release ventilation (APRV) is used both as a rescue therapy for patients with acute lung injury and as a primary mode of ventilation. Unlike assist-control volume (ACV) ventilation that uses spontaneous breathing trials, APRV weaning consists of gradual decreases in supporting pressure. We hypothesized that the APRV weaning ...

The respiratory pump can be optimized to enhance circulation in patients with hypotension by having patients spontaneously breathe through a low level of inspiratory resistance. This can be achieved with an impedance threshold device (ITD) designed to provide 7 cm H2O resistance during spontaneous inspiration with minimal resistance during expiration. ...

Objective To explore the efficacy of homemade hemostatics of injected gelatin matrix (HIGM) for immediately treating blunt hepatic trauma in canine model without additional pressure. Methods A total of 27 commercial hybrid dogs underwent celiotomy to establish hepatic trauma model after general anesthesia. The dogs were prospectively randomized into 3 ...

New-onset arterial hypertension is a well-recognised complication of kidney trauma. Cases have been described in young healthy athletes with hypertension arising years after sports-related trauma. The pathophysiology of this disease is thought to arise from intrarenal arterial stenosis resulting from rapid deceleration during the initial injury. This leads to arterial ...

Transportation of laboratory rodents unavoidably causes stress. Nevertheless, very little is known about the effects of transportation and how long it takes for the animal to recuperate. In the present study, we investigated physiological and behavioral parameters before and after transportation in both transported and nontransported animals. We took blood ...

The purpose of this study was to assess the relationship between blood pressure (BP) levels and physical activity (PA) domains accounting for overweight/obesity. Adolescents aged 10 to 17 years old were recruited (n = 1021). International Obesity Task Force (IOTF) criteria were used to define overweight and obesity. High BP was defined ...

Essential hypertension is highly prevalent in the elderly population, exceeding 70% in people older than 60 yr of age, and remains a leading risk factor for heart disease, stroke, and chronic renal disease. Elucidation of genetic determinants is critical but remains a challenge due to its complex, multifactorial pathogenesis. We ...

Exposure of myocardium to a mechanical impact may produce premature ventricular contractions (PVCs). High-intensity focused ultrasound was reported to generate PVCs, while microbubbles at the target increased absorption, thus, promoting energy localization and decreased PVC threshold. The objective was to investigate the benefit of a two-stage ultrasonic transmission: (1) asymmetric ...

Femoral venous access is frequently used in critically ill patients. Because raised intra-abdominal pressure (IAP) is also frequently found in this group of patients, we examined the impact of IAP and positive end-expiratory pressure (PEEP) on femoral venous pressure (FVP) and femoral venous oxygen saturation (Sfvo2) in an animal model. ...

The growth and enlargement of jaw cysts are associated with raised intracystic pressure and bone resorption surrounding the cysts. The major bone-resorbing cells are the osteoclasts. They are acting under the influence of local bone-resorbing factors: prostaglandins, proteinases and cytokines. It was found that positive pressure enhanced the expression of ...

When the Macondo well was shut in on July 15, 2010, the shut-in pressure recovered to a level that indicated the possibility of oil leakage out of the well casing into the surrounding formation. Such a leak could initiate a hydraulic fracture that might eventually breach the seafloor, resulting in ...

To determine whether central venous pressure and fluid balance after resuscitation for septic shock are associated with mortality. We conducted a retrospective review of the use of intravenous fluids during the first 4 days of care. Multicenter randomized controlled trial. The Vasopressin in Septic Shock Trial (VASST) study enrolled 778 ...

Oscillometric devices are being widely used for ambulatory, home and office blood pressure (BP) measurement, and several of them have been validated using established protocols. This cross-sectional study assessed the impact on antihypertensive treatment decisions of replacing the mercury sphygmomanometer by a validated oscillometric device. Consecutive subjects attending a hypertension ...

High mortality in the 2001 US and recent European anthrax outbreaks suggests that better understanding of the effects of the toxins produced by this bacterium is needed to improve treatment. Here, 24-h edema (ETx) and lethal (LeTx) toxin infusions were investigated for 96 hin sedated canines receiving mechanical ventilation. The ...

A 42-year-old woman with a body mass index of 36 presented with visual obscurations and headaches. She had a visual acuity of 6/5 bilaterally, a constricted right visual field and bilateral papilloedema. Idiopathic intracranial hypertension (IIH) was suspected but brain magnetic resonance imaging and venography demonstrated multiple enhancing lesions in ...

Pressure differences play an important role in the hemodynamics of both arterial and venous circulation. Venous ambulatory pressure gradient of about 35 mm Hg arises during the activity of the calf muscle venous pump between the veins in the thigh and the lower leg; this is the initiator launching venous ...

To determine if the monitor cursor-line feature on bedside monitors is accurate for measuring central venous and pulmonary artery pressures in cardiac surgery patients. Central venous and pulmonary artery pressures were measured via 3 methods (end-expiratory graphic recording, monitor cursor-line display, and monitor digital display) in a convenience sample of ...

Venous hypertension is associated with microvascular inflammation, restructuring, and apoptosis, but the cellular and molecular mechanisms underlying these events remain uncertain. In the present study, we tested the hypothesis that elevated venous pressure and reduction of shear stress induce elevated enzymatic activity. This activity in turn may affect endothelial surface ...

Hemodynamic effects of compression devices in patients with venous insufficiency are still under dispute. The aim of this paper was to describe a method which is able to give quantitative results concerning an improvement of the venous pumping function by using compression devices in patients with venous insufficiency. The ejection ...

The aim of this study was to demonstrate the usefulness of Duplex in measuring venous reflux and changes in reflux caused by leg compression. Twelve patients with severe incompetence of the great saphenous vein (GSV) were investigated. A special Duplex probe was fixed by tapes on the mid-thigh portion of ...

Limb venous compliance decreases with advancing age, even in healthy humans. To test the hypothesis that adrenergic mechanisms contribute to age-associated reductions in limb venous compliance, we measured calf venous compliance before and during acute systemic α- and β-adrenergic blockade in eight young (27 ± 1 yr old, mean ± ...

We compared saturations from a paediatric central venous oximetry catheter with co-oximetry values with changes in drug infusions, intravascular blood volume and hypoxia in an animal model. Piglets (large white) were anaesthetised, intubated and mechanically ventilated. PediaSat oximetry catheters were placed in the superior vena cava via jugular vein cut-down ...

Bedside ultrasound examination could be used to assess jugular venous pressure (JVP), and thus central venous pressure (CVP), more reliably than clinical examination. The study was a prospective, blinded evaluation comparing physical examination of external jugular venous pressure (JVPEXT), internal jugular venous pressure (JVPINT), and ultrasound collapse pressure (UCP) with ...

Greater venous compliance is associated with attenuation of the tolerance response to orthostatic stress and reduced incidence of venous diseases. Resistance training induces tolerance to orthostatic challenge and the growth of capillaries, which may lead to negative and positive effects on venous compliance, respectively. It has not been confirmed, however, ...

Tissue Doppler imaging (TDI) measurements have been demonstrated to correlate with central venous pressure (CVP) in adults. We hypothesize that TDI measurements also correlate with CVP in children after cardiac surgery. Patients younger than 10 years with invasive CVP monitoring after cardiac surgery were studied. Annular tissue and atrioventricular inflow ...

Venoarterial ECMO has been utilized in trauma patients to improve oxygenation, particularly in the setting of pulmonary contusions and ARDS. We hypothesized that venoarterial ECMO could reduce the central venous pressure in the trauma scenario, thus, alleviating major venous hemorrhage. Ten swine were cannulated for venoarterial ECMO. Central venous pressure, ...

PURPOSE OF REVIEW: The physiology of the venous part of the human circulation seems to be a forgotten component of the circulation in critical care medicine. One of the main reasons, probably, is that measures of right atrial pressure (Pra) do not seem to be directly linked to blood flow. ...

AIM: To study hemodynamic and blood oxygenation changes in patients undergoing carotid endarterectomy (CEA) under general (GA) or locoregional (LRA) anesthesia. METHODS: Prospective non-randomized study including 50 patients undergoing CEA (31 men, mean age 72 (range 50-84) years-old under GA (N.=23) or LRA (N.=27). Systemic blood pressure, ECG, venous oxygen ...

A too high resting pressure of compression devices is poorly tolerated and may cause skin defects, especially in patients with concomitant arterial occlusive disease. To investigate whether low compression pressure will improve venous pumping function in patients with venous incompetence. Venous pumping function was assessed in 20 patients with severe ...

After univentricular Fontan conversion, systemic venous pressure serves as the sole driving force for transpulmonary blood flow. Consequently, systemic venous return is markedly altered and ventricular filling is subnormal. The mechanisms and time course of systemic adaptation to Fontan conversion are incompletely understood. We hypothesized that acute elevation in systemic ...

Nutcracker syndrome occurs when the left renal vein (LRV) is compressed between the superior mesenteric artery and the aorta, and this syndrome is often characterized by venous hypertension and related pathologies. However, invasive studies such as phlebography and measuring the reno-caval pressure gradient should be performed to identify venous hypertension. ...

The historical development of the use of pressure sensors as protective system against blood loss to the environment is reviewed. In spite of early warnings about the deficiency of such sensors, the venous pressure sensor is still formally accepted as protective system against blood loss to the environment in case ...

Although significant steps have been taken to monitor complex hemodynamics in neonatal and pediatric intensive care units, cardiovascular function in neonates is still evaluated by measuring blood pressure, heart rate, diuresis, central venous pressure (if a central venous catheter was placed), capillary refill time and oxygen saturation measurement in the ...

The case of a 38-year old man with recurrent adenocarcinoma of the right lung and infiltration of the thoracic wall, who underwent a right pneumonectomy with thoracic wall resection, is described. Dissection of the right pulmonary hilous was extremely difficult due to the previous operations. The superior vena cava (SVC) ...

Iatrogenic injury is a difficult situation for a surgeon. Being successful in saving a patient at risk is the major concern in this situation. Once an iatrogenic injury to the superior vena cava (SVC) is found, increasing the intrathoracic pressure is theoretically able to overcome the venous pressure and to ...

PURPOSE: Passive leg raising (PLR) is a maneuver performed to test the cardiac Frank-Starling mechanism. We assessed the influence of PLR-induced changes in preload on the performance of PLR-induced change in pulse pressure (Delta(PLR)PP) and cardiac output (Delta(PLR)CO) for fluid responsiveness prediction. METHODS: Sedated, nonarrhythmic patients with persistent shock were ...

Venous tortuosity is associated with multiple disease states and is often thought to be a consequence of venous hypertension and chronic venous disease. However, the underlying mechanisms of vein tortuosity are unclear. We hypothesized that increased pressure causes vein buckling that leads to a tortuous appearance. The specific aim of ...

It has been demonstrated that internal jugular vein (IJV) compression aggravates headache intensity in patients of migraine. We hypothesized that patients with migraine may have veins that are less distensible; consequently, these veins are more likely to develop and transmit venous hypertension caused by the increased venous blood volume during ...

Early goal directed therapy improves survival in patients with septic shock. Central venous pressure (CVP) monitoring is essential to guide adequate resuscitation. Use of peripherally inserted central catheters (PICC) is increasing, but little data exists comparing a PICC to a conventional CVP catheter. We studied the accuracy of a novel ...

The valvular segment is a distinct venous structure, which, from a morphological point of view, is comprised of the following components: the valvular insertion, the valvular gorge entrance orifice, the valvular defile, the valvular gorge exit orifice, the valvular sinus. Endoscopic and echo Doppler examinations are used to identify the ...

During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential ...

Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. ...

PURPOSE OF REVIEW: The focus of intraoperative monitoring is moving away from invasive monitoring. This has been attributed to procedure time, cost, and the known risks, which include carotid artery puncture, arrhythmia, pneumothorax, and infection. Until recently, the venous system's contribution to the circulatory system has been incorrectly identified as ...

The Fontan circulation is critically dependent on elevated venous pressures to sustain effective venous return. We hypothesized that chronically increased systemic venous pressures lead to adaptive changes in regional and peripheral vessels to maintain cardiac output, especially when patients are upright. Nine post-Fontan procedure patients (aged 13 to 24 years) ...

OBJECTIVE: To correlate physical examination findings, central venous pressure, fluid output, and central venous oxygen saturation with pulmonary artery catheter parameters. DESIGN: Retrospective study. SETTING: Data from the multicenter Fluid and Catheter Treatment Trial of the National Institutes of Health Acute Respiratory Distress Syndrome Network. PATIENTS: Five hundred thirteen patients ...