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Pulse pressure variation

Angela Briganti, Flavia Evangelista, Paola Centonze, Annaliso Rizzo, Francesco Bentivegna, Antonio Crovace, Francesco Staffieri
BACKGROUND: Haemodynamic variations normally occur in anaesthetized animals, in relation to the animal status, administered drugs, sympathetic and parasympathetic tone, fluid therapy and surgical stimulus. The possibility to measure some cardiovascular parameters, such as cardiac output (CO), during anaesthesia would be beneficial for both the anaesthesia management and its outcome. New techniques for the monitoring of CO are aimed at finding methods which are non invasive, accurate and with good trending ability, which can be used in a clinical setting...
March 6, 2018: BMC Veterinary Research
Katarzyna Kaczmarska, Magdalena Kasprowicz, Antoni Grzanka, Wojciech Zabołotny, Peter Smielewski, Despina Afroditi Lalou, Georgios Varsos, Marek Czosnyka, Zofia Czosnyka
OBJECTIVES: The objectives were to compare three methods of estimating critical closing pressure (CrCP) in a scenario of a controlled increase in intracranial pressure (ICP) induced during an infusion test in patients with suspected normal pressure hydrocephalus (NPH). METHODS: We retrospectively analyzed data from 37 NPH patients who underwent infusion tests. Computer recordings of directly measured intracranial pressure (ICP), arterial blood pressure (ABP) and transcranial Doppler cerebral blood flow velocity (CBFV) were used...
2018: Acta Neurochirurgica. Supplement
Min Hur, Seokha Yoo, Jung-Yoon Choi, Sun-Kyung Park, Dhong Eun Jung, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: Dynamic change in central venous pressure (CVP) was associated with fluid responsiveness. External jugular venous pressure (EJVP) may reliably estimate CVP and have the advantages of being less invasive. We investigated whether increase in EJVP induced by positive end-expiratory pressure (PEEP) could be a reliable predictor of fluid responsiveness in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). METHODS: Fifty patients who underwent RALP with steep Trendelenburg position were enrolled...
February 27, 2018: Journal of Anesthesia
Matthew J Burns, Jeremy D Seed, Anthony V Incognito, Connor J Doherty, Karambir Notay, Philip J Millar
Prior studies demonstrating clinical significance of noninvasive estimates of central blood pressure (BP) and pulse wave reflection have relied primarily on discrete resting measures. The aim of this study was to compare central BP and pulse wave reflection measures sampled during a single resting laboratory visit against those obtained under ambulatory conditions. The secondary aim was to investigate the reproducibility of ambulatory central BP and pulse wave reflection measurements. Forty healthy participants (21 males; 24 ± 3 years) completed three measurements of brachial artery pulse wave analysis (Oscar 2 with SphygmoCor Inside) in the laboratory followed by 24 hours of ambulatory monitoring...
February 10, 2018: Journal of the American Society of Hypertension: JASH
Judi A Lapsley Miller, Charlotte M Reed, Sarah R Robinson, Zachary D Perez
OBJECTIVES: Clinical pure-tone audiometry is conducted using stimuli delivered through supra-aural headphones or insert earphones. The stimuli are calibrated in an acoustic (average ear) coupler. Deviations in individual-ear acoustics from the coupler acoustics affect test validity, and variations in probe insertion and headphone placement affect both test validity and test-retest reliability. Using an insert earphone designed for otoacoustic emission testing, which contains a microphone and loudspeaker, an individualized in-the-ear calibration can be calculated from the ear-canal sound pressure measured at the microphone...
February 21, 2018: Ear and Hearing
Satoko Nozato, Koichi Yamamoto, Yoichi Nozato, Masao Takeda, Kazuhiro Hongyo, Miyuki Takeya, Hiroshi Akasaka, Yoichi Takami, Yasushi Takeya, Ken Sugimoto, Norihisa Ito, Hiromi Rakugi
Recent studies suggest that L-type calcium channel blockers (CCBs) contribute to reducing blood pressure (BP) variability. We investigated whether inhibition of the N-type calcium channel has an additional effect on BP variability by comparing the effect of L-type and L/N-type CCBs on home BP variability in elderly hypertensive patients. Twenty-six hypertensive patients (≥65 years) were subjected to repeated changes with the administration of amlodipine (L-type CCB) and cilnidipine (L/N-type CCB) every 2 months...
February 15, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
Frederick Adam Zeiler, Joseph Donnelly, Basil Nourallah, Eric Peter Thelin, Leanne Calviello, Peter Smieleweski, Marek Czosnyka, Ari Ercole, David Menon
Impaired cerebrovascular reactivity has been associated with outcome following traumatic brain injury (TBI), but it is unknown how it is affected by trauma severity. Thus, we aimed to explore the relationship between intra-cranial (IC) and extra-cranial (EC) injury burden and cerebrovascular reactivity in TBI patients. We retrospectively included critically ill TBI patients. IC injury burden included detailed lesion and computerized tomography (CT) scoring (ie. Marshall, Rotterdam, Helsinki and Stockholm Scores) on admission...
February 12, 2018: Journal of Neurotrauma
Renato Carneiro de Freitas Chaves, Thiago Domingos Corrêa, Ary Serpa Neto, Bruno de Arruda Bravim, Ricardo Luiz Cordioli, Fabio Tanzillo Moreira, Karina Tavares Timenetsky, Murillo Santucci Cesar de Assunção
Patients who increase stoke volume or cardiac index more than 10 or 15% after a fluid challenge are usually considered fluid responders. Assessment of fluid responsiveness prior to volume expansion is critical to avoid fluid overload, which has been associated with poor outcomes. Maneuvers to assess fluid responsiveness are well established in mechanically ventilated patients; however, few studies evaluated maneuvers to predict fluid responsiveness in spontaneously breathing patients. Our objective was to perform a systematic review of literature addressing the available methods to assess fluid responsiveness in spontaneously breathing patients...
February 9, 2018: Annals of Intensive Care
Hamid Alemi, Pegah Khaloo, Mohammad Ali Mansournia, Soghra Rabizadeh, Salome Sadat Salehi, Hossein Mirmiranpour, Neda Meftah, Alireza Esteghamati, Manouchehr Nakhjavani
Type 2 diabetes is associated with higher pulse pressure. In this study, we assessed and compared effects of classic diabetes treatments on pulse pressure (PP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) in patients with type 2 diabetes.In a retrospective cohort study, 718 non-hypertensive patients with type 2 diabetes were selected and divided into 4 groups including metformin, insulin, glibenclamide+metformin, and metformin+insulin. They were followed for 4 consecutive visits lasting about 45...
February 2018: Medicine (Baltimore)
Tapan Sood, Somnath Roy, Manabendra Pathak
The present work reports numerical simulations of blood flow patterns and wall shear stress (WSS) distributions in stenotic arteries, modelled as straight tubes. Inflow waveforms have been generated for different pulse rates considering constant volumetric flow during each pulsation cycle and a two-element windkessel model has been used to specify the outlet pressure. It is noticed that the non-Newtonian shear thinning rheology of blood produces more accurate and realistic predictions of the flow field as compared to the Newtonian assumption...
January 30, 2018: Mathematical Biosciences
Wei-Ye Chen, Li Li, Hui-Yuan Wang, Nan Jiang
OBJECTIVE: To assess the safety and efficacy of transcutaneous electrical acupoint stimulation (TEAS) for depression in late pregnancy and impacts on inflammatory cytokines. METHODS: A total of 150 pregnant women with depression in late pregnancy were randomized into a high intensity group (n=52), a low intensity group (n=49) and a control group (n=49). TEAS was applied at bilateral Neiguan (PC 6) and Shenmen (HT 7) for 6 weeks. The intensities of TEAS in the high intensity group, the low intensity group and the control group were 10, 5 and 0 mA, respectively...
January 25, 2018: Zhen Ci Yan Jiu, Acupuncture Research
Raphaël Giraud, Paul S Abraham, Pauline Brindel, Nils Siegenthaler, Karim Bendjelid
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. Cardiac output (CO) and dynamic parameters [stroke volume variation (SVV) and pulse pressure variation (PPV)] measured by transpulmonary thermodilution and pulse contour analysis (PiCCO™) as well as classical hemodynamic parameters were recorded at baseline and after FC...
January 29, 2018: Journal of Clinical Monitoring and Computing
Erhard E Pfündel, Gwendal Latouche, Armin Meister, Zoran G Cerovic
Low light (LL) and high light (HL)-acclimated plants of A. thaliana were exposed to blue (BB) or red (RR) light or to a mixture of blue and red light (BR) of incrementally increasing intensities. The light response of photosystem II was measured by pulse amplitude-modulated chlorophyll fluorescence and that of photosystem I by near infrared difference spectroscopy. The LL but not HL leaves exhibited blue light-specific responses which were assigned to relocation of chloroplasts from the dark to the light-avoidance arrangement...
January 27, 2018: Photosynthesis Research
Alejandro de la Sierra, Julia Pareja, Sergi Yun, Eva Acosta, Francesco Aiello, Anna Oliveras, Susana Vázquez, Pedro Armario, Pedro Blanch, Cristina Sierra, Francesca Calero, Patricia Fernández-Llama
We aimed to evaluate the association of aortic and brachial short-term blood pressure variability (BPV) with the presence of target organ damage (TOD) in hypertensive patients. One-hundred seventy-eight patients, aged 57 ± 12 years, 33% women were studied. TOD was defined by the presence of left ventricular hypertrophy on echocardiogram, microalbuminuria, reduced glomerular filtration rate, or increased aortic pulse wave velocity. Aortic and brachial BPV was assessed by 24-hour ambulatory BP monitoring (Mobil-O-Graph)...
January 25, 2018: Journal of Clinical Hypertension
Michele Diana, Eric Noll, Andras Legnèr, Seong-Ho Kong, Yu-Yin Liu, Luigi Schiraldi, Francesco Marchegiani, Jordan Bano, Bernard Geny, Anne-Laure Charles, Bernard Dallemagne, Véronique Lindner, Didier Mutter, Pierre Diemunsch, Jacques Marescaux
BACKGROUND: Standard insufflators compensate for intra-abdominal pressure variations with pressure spikes. Our aim was to evaluate the impact of a stable, low-pressure pneumoperitoneum induced by a valve-less insufflator, on working space, hemodynamics, inflammation, and peritoneal physiology, in a model of laparoscopic sigmoid resection. MATERIALS AND METHODS: Twelve pigs (47 ± 3.3 kg) were equipped for invasive hemodynamic monitoring and randomly assigned to Standard (n = 6) vs...
January 12, 2018: Surgical Endoscopy
Anna Oliveras, Pedro Armario, Laia Sans, Albert Clarà, Susana Vázquez, Luis Molina, Júlia Pareja, Alejandro de la Sierra, Julio Pascual
Renal denervation and spironolactone have both been proposed for the treatment of resistant hypertension, but their effects on preclinical target organ damage have not been compared. Twenty-four patients with 24-hour systolic blood pressure ≥140 mm Hg despite receiving three or more full-dose antihypertensive drugs, one a diuretic, were randomized to receive spironolactone or renal denervation. Changes in 24-hour blood pressure, urine albumin excretion, arterial stiffness, carotid intima-media thickness, and left ventricular mass index were evaluated at 6 months...
January 5, 2018: Journal of Clinical Hypertension
Alexander Adair, Igor V Mastikhin, Benedict Newling
The pressure variations experienced by a liquid flowing through a pipe constriction can, in some cases, result in the formation of a bubble cloud (i.e., hydrodynamic cavitation). Due to the nature of the bubble cloud, it is ideally measured through the use of non-optical and non-invasive techniques; therefore, it is well-suited for study by magnetic resonance imaging. This paper demonstrates the use of Conical SPRITE (a 3D, centric-scan, pure phase-encoding pulse sequence) to acquire time-averaged void fraction and velocity information about hydrodynamic cavitation for water flowing through a pipe constriction...
January 2, 2018: Magnetic Resonance Imaging
Antonios A Argyris, Efthimia Nasothimiou, Evaggelia Aissopou, Theodoros G Papaioannou, Yi Zhang, Jacques Blacher, Michel E Safar, Petros P Sfikakis, Athanase D Protogerou
The difference in pulse pressure (PP) between peripheral arteries and the aorta, called pulse pressure amplification (PPamp), is a well-described physiological phenomenon independently associated with cardiovascular events. Recent studies suggest that it exhibits circadian variability. Our aim was to detect the factors associated with the circadian variability of PPamp. In 497 consecutive subjects (aged 54 years, 56.7% male, 79.7% hypertensives), we assessed the circadian pattern of peripheral and central arterial hemodynamics by 24-hour evaluation of brachial and aortic blood pressure (BP), augmentation index (AI), and pulse wave velocity (PWV) using a validated oscillometric device (Mobil-O-Graph)...
December 14, 2017: Journal of the American Society of Hypertension: JASH
Keisuke Okamura, Kazuyuki Shirai, Tetsu Okuda, Hidenori Urata
Background: Azilsartan is an angiotensin II receptor blocker with a potent antihypertensive effect. Methods: In a multicenter, prospective, open-label study, 265 patients with poor blood pressure control despite treatment with other angiotensin II receptor blockers were switched to 20 mg/day of azilsartan (patients on standard dosages) or 40 mg/day of azilsartan (patients on high dosages). Results: Blood pressure was 149/83 mm Hg before switching and was significantly reduced from 1 month after switching until final assessment (132/76 mm Hg, P < 0...
January 2018: Journal of Clinical Medicine Research
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