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mean arterial pressure

J Michael Dickson, Xu Wang, Alexander E St John, Esther B Lim, Susan A Stern, Nathan J White
Introduction: Traumatic brain injury (TBI) and hemorrhagic shock (HS) are the leading causes of traumatic death worldwide and particularly on the battlefield. They are especially challenging when present simultaneously (polytrauma), and clear blood pressure end points during fluid resuscitation are not well described for this situation. The goal of this study is to evaluate for any benefit of increasing blood pressure using a vasopressor on brain blood flow during initial fluid resuscitation in a swine polytrauma model...
March 14, 2018: Military Medicine
Fernando Martínez, Núria Alegret, Federico Carol, M Jesús Laso, Juanjo Zancajo, Esteban García, Vanesa Ros
OBJECTIVES: The main objective of this study was to identify demographic, clinical, analytical factors or injuries associated with 30-day mortality in patients with pelvic fractures. MATERIAL AND METHODS: Prospective observational study of patients with multiple injuries including pelvic fractures between January 2009 and January 2017. We recorded demographic, clinical, and laboratory data on arrival at the emergency department; type of pelvic fracture; treatments; associated lesions; and 30-day mortality...
2018: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
Afroditi Despina Lalou, Marek Czosnyka, Joseph Donnelly, John D Pickard, FMedSci, Eva Nabbanja, Nicole C Keong, Matthew Garnett, Zofia H Czosnyka
OBJECTIVE Normal pressure hydrocephalus is not simply the result of a disturbance in CSF circulation, but often includes cardiovascular comorbidity and abnormalities within the cerebral mantle. In this study, the authors have examined the relationship between the global autoregulation pressure reactivity index (PRx), the profile of disturbed CSF circulation and pressure-volume compensation, and their possible effects on outcome after surgery. METHODS The authors studied a cohort of 131 patients in whom a clinical suspicion of normal pressure hydrocephalus was investigated...
March 16, 2018: Journal of Neurosurgery
Eloisa Basile, Giulio Russo, Antonio M Leone
It is essential to understand the pathophysiology of cardiogenic shock and the possible deterioration of contractile function during high-risk PCI in order to select those patients who could benefit from mechanical support thus choosing the most suitable device in every situation. Percutaneous Ventricular Assist Devices (pVAD) provide hemodynamic support by improving cardiac output and mean arterial pressure, but their specific features result in different hemodynamic effects and degrees of myocardial ischemic protection and LV unloading...
March 15, 2018: Minerva Cardioangiologica
Mark Waldron, Luke Waldron, Craig Lawlor, Adrian Gray, Jamie Highton
PURPOSE: We investigated the effects of an acute 24-h nitrate-rich beetroot juice supplement (BR) on the energy cost, exercise efficiency and blood pressure responses to intermittent walking at different gradients. METHODS: In a double-blind, cross-over design, eight participants were provided with a total of 350 ml of nitrate-rich (~ 20.5 mmol nitrate) BR or placebo (PLA) across 24 h before completing intermittent walking at 3 km/h on treadmill at gradients of 1, 5, 10, 15 and 20%...
March 15, 2018: European Journal of Applied Physiology
Mehmet Akif Cakar, Ersun Tatli, Alptug Tokatli, Harun Kilic, Huseyin Gunduz, Ramazan Akdemir
INTRODUCTION: Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. METHODS: Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included...
March 16, 2018: Singapore Medical Journal
Rebecca R Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T Gladwin, Marc A Simon
Importance: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. Objective: To identify the hemodynamic characteristics and outcomes of PH-HFpEF. Design, Setting, and Participants: Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed...
March 14, 2018: JAMA Cardiology
Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
Jun Sugawara, Tsubasa Tomoto, Hirofumi Tanaka
As an initial step to better define heart-brachial pulse wave velocity (hbPWV), a novel measure of proximal aortic stiffness, we proposed and validated a simple formula to estimate the arterial path length (Lhb) for hbPWV. In 190 patients aged 19-79 years, the reference Lhb was measured by a three-dimensional MRI. Using multiple regression analysis and fivefold cross-validation, estimation formulae were created using age, sex, and height. hbPWV was calculated as Lhb divided by the time interval from the second heart sound to the dicrotic notch on the brachial pressure wave...
March 14, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Thenappan Thenappan, Mark L Ormiston, John J Ryan, Stephen L Archer
Pulmonary hypertension is defined as a resting mean pulmonary artery pressure of 25 mm Hg or above. This review deals with pulmonary arterial hypertension (PAH), a type of pulmonary hypertension that primarily affects the pulmonary vasculature. In PAH, the pulmonary vasculature is dynamically obstructed by vasoconstriction, structurally obstructed by adverse vascular remodeling, and pathologically non-compliant as a result of vascular fibrosis and stiffening. Many cell types are abnormal in PAH, including vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) and inflammatory cells...
March 14, 2018: BMJ: British Medical Journal
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
Clara Gregori-Pla, Gianluca Cotta, Igor Blanco, Peyman Zirak, Martina Giovannella, Anna Mola, Ana Fortuna, Turgut Durduran, Mercedes Mayos
MOTIVATION: Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA...
2018: PloS One
Antonio G Cabrera, Kathleen K Kibler, R Blaine Easley, Michelle Goldsworthy, Lara S Shekerdemian, Dean B Andropoulos, Jeffrey Heinle, Erin A Gottlieb, Eric Vu, Ken M Brady
BACKGROUND: Elevated arterial blood pressure (ABP) is common after superior bidirectional cavo-pulmonary anastomosis (BCPA). The effects of elevated ABP after BCPA on cerebrovascular hemodynamics are unknown. We sought to determine the relationship between elevated ABP and cerebrovascular autoregulation after BCPA. METHODS: Prospective, observational study on infants with single-ventricle physiology after BCPA surgery. Continuous recordings of mean ABP, mean cavo-pulmonary pressure (PAP), near-infrared spectroscopy measures of cerebral oximetry (rSO2), and relative cerebral blood volume index (BVI) were obtained from admission to extubation...
March 14, 2018: Pediatric Research
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Telmo Pereira, João Maldonado
INTRODUCTION: The aim of this study was to assess the interobserver and intraobserver reproducibility, as well as the temporal variability of the new Complior Analyse assessing central arterial hemodynamic parameters through carotid pulse wave analysis (PWA). PATIENTS AND METHODS: Eighty-seven (60% men) participants, with a mean age of 34.26±16.58 years, were enrolled in a cross-sectional study. All patients were subjected to sequential measures of carotid PWA by two experienced operators...
March 13, 2018: Blood Pressure Monitoring
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Ayse Selcan Koc, Ferıde Fatma Gorgulu, Yurdaer Donmez, Yahya Kemal Icen
PURPOSE: There are limited data about increased aortic intima-media thickness (A-IMT) in the presence of subclinical target organ damage in hypertensive (HT) patients. In this study, we aimed to determine the frequency of increased A-IMT, the parameters determining increased A-IMT, and the relationship between increased A-IMT and other vascular IMT measurements. MATERIALS AND METHODS: We prospectively included 265 patients (mean age 54.1 ± 10.6 years, male/female 91/174) with essential HT...
March 13, 2018: Journal of Medical Ultrasonics
Sujith S Pereira, Stephen T Kempley, David F Wertheim, Ajay K Sinha, Joan K Morris, Divyen K Shah
Background: Cerebral electrical activity in extremely preterm infants is affected by various factors including blood gas and circulatory parameters. Objective: To investigate whether continuously measured invasive mean arterial blood pressure (BP) is associated with electroencephalographic (EEG) discontinuity in extremely preterm infants. Study design: This prospective observational study examined 51 newborn infants born <29 weeks gestation in the first 3 days after birth...
2018: Frontiers in Neurology
Leandro G Franco, Carlos Henrique M Wilges, Daniel P Junior, Sofia A Cerejo, Lilian T Nishimura, Isabela P Bittar
OBJECTIVE: To evaluate the effects of ketamine continuous rate infusions (CRI) at two dose rates on cardiovascular function and serum creatine kinase MB isoenzyme (CK-MB) and troponin I in healthy conscious dogs. STUDY DESIGN: Experimental, prospective, crossover, randomized, blinded study. ANIMALS: Eight adult mixed-breed dogs, aged 6±1 years and weighing 19±8.6 kg (mean±standard deviation). METHODS: Dogs were administered an intravenous bolus of ketamine (0...
December 18, 2017: Veterinary Anaesthesia and Analgesia
Neil D Patel, Patrick M Sullivan, Cheryl M Takao, Sarah Badran, Joseph Ahdoot, Frank F Ing
BACKGROUND: One indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state. OBJECTIVES: We aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients...
March 14, 2018: Cardiology in the Young
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