Expulsive maneuvers (EMs) caused by simultaneous contraction of diaphragm and abdominal muscles shift substantial quantities of blood from the splanchnic circulation to the extremities. This suggests that the diaphragm assisted by abdominal muscles might accomplish ventilation and circulation simultaneously by repeated EMs. We tested this hypothesis in normal subjects by ...

Health care workers in a rural community hospital were queried about factors associated with blood pressure (BP) accuracy. Results suggest remedial education regarding cuff size, patient position, arm position, and location for accurate BP measurement is needed.

Hypertrophic obstructive cardiomyopathy (HOCM) involves marked hypertrophy of cardiac muscle, resulting in myocardial ischemia and arrhythmia because of left ventricular diastolic dysfunction. In perioperative management of HOCM, hemodynamic stabilization is required, by prevention of arrhythmia and tachycardia and maintenance of preload and afterload. Here, we describe anesthesia management during cesarean ...

BACKGROUND: Spinal cord injury (SCI) produces acute hemodynamic alterations through disruption of sympathetic output of the autonomic nervous system and places individuals with SCI at high risk of secondary ischemic insult to the spinal cord as well as to other organs. The purpose of this study was to examine hemodynamics ...

The purpose of this study was to assess the effectiveness of ischemic pressure on myofascial trigger point (MTrP) sensitivity. Randomized, controlled study with the researcher assessing MTrP sensitivity blinded to the intervention. Twenty-eight people with two MTrPs in the upper back musculature. The sensitivity of two MTrPs in the upper ...

The hematocrit (Hct) of awake hamsters was lowered to 90% of baseline by isovolemic hemodilution using hamster plasma to determine the acute effect of small changes in Hct and blood viscosity on systemic hemodynamics. Mean arterial blood pressure increased, reaching a maximum of about 10% above baseline (8.6 +/- 5.5 ...

OBJECTIVE: To evaluate the effect of medetomidine-butorphanol sedation on serum cardiac troponin I (cTnI) concentration, a marker of myocardial ischemia and injury, in healthy dogs undergoing pre-surgical radiographs for orthopedic procedures. STUDY DESIGN: Prospective clinical study. ANIMALS: Twenty client-owned dogs with no history of cardiac disease. METHODS: Dogs were evaluated ...

BACKGROUND: Resistance training has been introduced into rehabilitation to improve the efficiency of the 1980s traditional training. Among the modalities, the choice of recovery period length or repetition speed is hardly explained in term of functional benefit but not in terms of cardiovascular (CV) response. To our knowledge, no investigation ...

PURPOSE OF REVIEW: To discuss the role of microcirculatory abnormalities in critically ill patients and the link between systemic hemodynamics and microvascular perfusion. RECENT FINDINGS: Microcirculatory alterations have been repeatedly observed in patients with severe sepsis, but recent findings show that these also occur in patients with severe heart failure ...

BACKGROUND AND OBJECTIVE: We studied the evolution of software in the accuracy of the FloTrac/Vigileo system to measure cardiac output less invasively from arterial pressure waveform analysis without calibration, in comparison with pulmonary artery catheter-derived thermodilution measurements, in patients with septic shock and presumed alterations in vascular tone. METHODS: Nine ...

Altitude exposure is associated with major changes in cardiovascular function. The initial cardiovascular response to altitude is characterized by an increase in cardiac output with tachycardia, no change in stroke volume, whereas blood pressure may temporarily be slightly increased. After a few days of acclimatization, cardiac output returns to normal, ...

BACKGROUND AND OBJECTIVE: Mild therapeutic hypothermia (MTH) is used after out-of-hospital cardiac arrest (OHCA) to minimize cerebral damage. Induced hypothermia may further interfere with cardiac function and influence haemodynamics after OHCA. METHODS: This was a prospective study of haemodynamic variables in 50 consecutive patients with OHCA treated with MTH. Patients ...

Hemostatic procedures and control of blood pressure concomitant with rapid transfusion of blood products aimed at recovery of coagulability are necessary for intractable bleeding during cardiac surgery. However, when the bleeding is massive and hemostasis is prolonged for several hours, operative maneuvers such as manual compression of the heart can ...

BACKGROUND: Dexmedetomidine has opposing effects on the cardiovascular system. Action in the central nervous system produces sympatholysis and a reduction in blood pressure, while peripherally it causes vasoconstriction leading to an increase in blood pressure. The purpose of our study is to define the concentration-response profile for these hemodynamic effects ...

The measurement of cardiac output in critically ill patients is complicated by rapid pathophysiological changes. The aim of this study was to compare the recently developed Arterial Pressure Cardiac Output algorithm (APCO) with transpulmonary thermodilution (TDCO). Clinical and hemodynamic parameters were tested for their impact on the measurements. Twenty septic ...

The present article explores some of the newer noninvasive techniques for monitoring cardiac output in the pediatric population. These new techniques can be utilized in both a wide variety of patient sizes and the unique pathology of congenital cardiopathy. These techniques may assist in optimizing therapy in the intensive care ...

Chronic pressure overload to the heart leads to cardiac hypertrophy and failure through processes that involve reorganization of subcellular compartments and alteration of established signaling mechanisms. To identify proteins contributing to this process, we examined changes in nuclear-associated myofilament proteins as the murine heart undergoes progressive hypertrophy following pressure overload. ...

The cardiovascular effects of interleukin 2 (IL2), were investigated in animals pretreated with indomethacin. Bolus intravenous administration of IL2 alone caused a significant reduction in cardiac output over time. Pretreatment with indomethacin significantly accentuated the reduction in cardiac output produced by IL2. The administration of IL2 or indomethacin alone or ...

The effects of blood solubility, cardiac output and ventilation on the rise of the alveolar towards the inspired concentration, the F(A)/F(I) curve, of an inhaled anaesthetic are often thought to reflect how these factors affect wash-in of the central nervous system compartment and, therefore, speed of induction because F(A) is ...

Cardiac output (CO) and stroke volume (SV) are the key hemodynamic parameters to be monitored and assessed in ambulatory and critically ill patients. The purpose of this study was to introduce and validate a new algorithm to continuously estimate, within a proportionality constant, CO and SV by means of mathematical ...

Pulse pressure analysis algorithms are commonly used to measure cardiac output and to allow for the rational titration of therapy in critically ill patients. The ability of these algorithms to accurately track changes in stroke volume (and cardiac output) is thus very important. Most of the currently available algorithms can ...

We sought to examine the cardiac consequences of early administration of norepinephrine in severely hypotensive sepsis patients hospitalized in a medical intensive care unit of a university hospital. We included 105 septic-shock patients who already had received volume resuscitation. All received norepinephrine early because of life-threatening hypotension and the need ...

We recently proposed a technique to estimate relative cardiac output (CO) change by unique long time interval analysis (LTIA) of a radial arterial blood pressure waveform. Here, we evaluated the technique in 169 critically ill patients, while comparing it to previous "pulse contour analysis" techniques, using the public MIMIC II ...

In our extended Guyton's model, the ability of heart to pump blood is characterized by a cardiac output curve and the ability of vasculature to pool blood by a venous return surface. These intersect in a three-dimensional coordinate system at the operating right atrial pressure, left atrial pressure, and cardiac ...

The accuracy of the arterial pressure-based cardiac output FloTrac-Vigileo system remains unacceptably low during haemodynamic instability. Data show that the measurement of cardiac output (CO) is strongly influenced by changes in factors that affect arterial blood pressure (ABP) - for example, vascular tone and compliance and the arterial site - ...

Fibroblasts, which are the most numerous cell type in the heart, interact with cardiomyocytes in vitro and affect their function; however, they are considered to play a secondary role in cardiac hypertrophy and failure. Here we have shown that cardiac fibroblasts are essential for the protective and hypertrophic myocardial responses ...

In management of canine cardiac disorders, cardiac drugs are commonly administered with food, although the cardiovascular effects of feeding and frequency of feeding are unknown. This study investigated the cardiovascular effect of feeding and frequency of feeding using a telemetry monitoring system in unanesthetized and unrestrained dogs. Systolic and diastolic ...

OBJECTIVE: The authors investigated the accuracy and precision of the pressure recording analytic method (PRAM) in cardiac index measurement compared with thermodilution in unstable patients, a setting in which minimally invasive monitoring devices often fail. DESIGN: Criterion standard. SETTING: Intensive care unit. PATIENTS: Thirty-two consecutive patients with low cardiac output ...

Haemodynamic monitoring may potentially lead to improved quality of care in haemodynamic compromised patients. However, the usefulness of invasive techniques using the pulmonary artery catheter is questioned. Noninvasive techniques which provide data on haemodynamics might provide a good alternative. New techniques have been developed in recent years to monitor cardiac ...

To investigate whether the established reductions in heart rate and cardiac output with hyperoxia in humans are primary effects or secondary to increases in systemic vascular resistance, we paced the hearts of nine patients with permanent pacemakers at a fixed rate when breathing either medical air (inspired O(2) fraction 0.21) ...

NT-proXNP, a new natriuretic peptide analyte, incorporates information about the concentrations of both N-terminal pro-atrial and pro-brain natriuretic peptides (NT-proANP, NT-proBNP). We aimed to investigate whether NT-proXNP is a reliable indicator of the cardiac index (CI) and the hemodynamic state in neonates and infants undergoing an open heart surgery. We ...

Biventricular pacing (BiVP) can optimize cardiac output (CO) in patients after cardiac surgery, so devices that calculate continuous CO from arterial pressure may be a useful tool. We investigated PulseCO for measuring CO during optimization by comparison with aortic flow probe measurement. Seven patients in the Biventricular Pacing After Cardiac ...

OBJECTIVE: To assess the agreement between cardiac output (CO) measured by use of arterial pressure waveform analysis (PulseCO) and lithium dilution (LiDCO) in conscious dogs with systemic inflammatory response syndrome (SIRS). ANIMALS: 14 dogs with naturally occurring SIRS. PROCEDURES: Pulse power analysis was performed on critically ill patients with a ...

BACKGROUND: Mathematical coupling may explain in part why cardiac filling volumes obtained by transpulmonary thermodilution may better predict and monitor responses of cardiac output to fluid loading than pressures obtained by pulmonary artery catheters (PACs). METHODS: Eleven consecutive patients with hypovolaemia after coronary surgery and a PAC, allowing central venous ...

BACKGROUND: For decades the pulmonary artery catheter has been the mainstay of cardiac output monitoring in critically ill patients, and pressure-based indices of ventricular filling have been used to gauge fluid requirements with acknowledged limitations. In recent years, alternative technologies have become available which are minimally invasive, allow beat-to-beat cardiac ...

BACKGROUND: Delayed sternal closure is used to prevent low cardiac output syndrome in selected newborns shortly after cardiac surgery for congenital cardiac defects. Sternal closure itself often causes haemodynamic and ventilatory instability that cannot be entirely assessed by standard monitoring means. Therefore, we used transpulmonary thermodilution technique for an exact ...

INTRODUCTION: Determination of hemodynamic status is central to arrhythmia management in the inpatient setting. In contrast, therapy decisions in implantable cardioverter defibrillators (ICDs) are based exclusively on the arrhythmia's electrical signature. Hemodynamic sensing in ICDs would allow tailoring of therapy according to perfusion status. Subcutaneous photoplethysmography (PPG) is an attractive ...

OBJECTIVE: To compare cardiac output (CO) measured by use of lithium dilution (LiDCO) and ultrasound velocity dilution (UDCO) in conditions of high, intermediate, and low CO in anesthetized foals. DESIGN: Original prospective study. SETTING: University teaching hospital. ANIMALS: Six foals 1-3 days of age (38-45 kg). INTERVENTIONS: Neonatal foals were ...

Uremic patients are prone to heart damage as a consequence of arteriovenous fistula (AVF) presence and hemodialysis treatment. Arteriovenous fistula induces hand ischemic syndrome and cardiac work increase, thus determining cardiac insufficiency in the medium to long term. This work investigates the cardiovascular mechanics evolution induced by the fistula presence. ...

Operations in the pleural cavity are connected with circulatory changes in pulmonary circulation and general changes of hemodynamics. These changes are influenced by the position of patient's body on the operation table and by the introduction of artificial pneumothorax. Thoracoscopy is an advanced surgical approach in thoracic surgery, but its ...

Sepsis elicits severe alterations in cardiac function, impairing cardiac mitochondrial and pressure-generating capacity. Currently, there are no therapies to prevent sepsis-induced cardiac dysfunction. We tested the hypothesis that administration of a mitochondrially targeted antioxidant, 10-(6'-ubiquinonyl)-decyltriphenylphosphonium (MitoQ), would prevent endotoxin-induced reductions in cardiac mitochondrial and contractile function. Studies were performed on ...

BACKGROUND: After surgical repair of congenital heart disease, inotropic support is sometimes necessary to wean from cardiopulmonary bypass. In pediatric cardiac surgery, dobutamine and dopamine are often used as inotropic support. Dopexamine is a synthetic catecholamine, which has positive inotropic and vasodilating properties. Because the hemodynamic effects of catecholamines are ...

Despite the practical importance of polymer melt instabilities, there is still a lack of experiments able to characterize in situ the origin and behavior of these phenomena. In this context, a new set-up consisting of high sensitive pressure transducers located inside a slit-die and an advanced mathematical framework to process ...

Early hemodynamic assessment is of particular importance for adequate cerebral circulation in patients with aneurysmal subarachnoid hemorrhage (SAH), but is often precluded by the invasiveness and complexity of the established cardiac output determination techniques. We examined the utility of an uncalibrated arterial pressure-based cardiac output monitor (FloTrac) for intraoperative and ...

Mannitol is the most commonly used hyperosmotic agent in neurosurgery. Being an agent that increases intravascular volume by withdrawing water from the brain, it may cause significant changes in stroke volume (SV), cardiac output (CO), systemic vascular resistance and blood pressure. In this study, we monitored the hemodynamic changes in ...

We evaluated cardiac output (CO) using three new methods - the auto-calibrated FloTrac-Vigileo (CO(ed)), the non-calibrated Modelflow (CO(mf) ) pulse contour method and the ultra-sound HemoSonic system (CO(hs)) - with thermodilution (CO(td)) as the reference. In 13 postoperative cardiac surgical patients, 104 paired CO values were assessed before, during and ...

With the advent of readily available imaging modalities, the time-honored skills in physical examination of the cardiac patient have eroded and are no longer the hallmark of the expert cardiologist. Although auscultation continues to be the primary focus in the examination, this is a skill in which competency is only ...

BACKGROUND: The most common outcome currently assessed in acute heart failure trials (AHF) is dyspnea improvement. Worsening hear failure (WHF) is a new outcome measure that incorporates failure to improve or recurrent symptoms of AHF requiring rescue intravenous therapy, mechanical circulatory or ventilatory support, or readmission because of AHF, occurring ...

A next generation fiber-optic microsensor based on the extrinsic Fabry-Perot interferometric (EFPI) technique has been developed for pressure measurements. The basic physics governing the operation of these sensors makes them relatively tolerant or immune to the effects of high-temperature, high-EMI, and highly-corrosive environments. This pressure microsensor represents a significant improvement ...

To determine the hemodynamic response to radiofrequency ablation (RFA) of normal adrenal tissue in dogs. Experimental study. Healthy adult mixed-breed dogs (n=6). During general anesthesia a Swan-Ganz thermodilution catheter was flow directed into the pulmonary artery and used to quantify cardiac output. An arterial catheter was used for direct blood ...