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https://www.readbyqxmd.com/read/29781840/cardiovascular-autonomic-profile-in-women-with-constitutional-hypotension
#1
Giris Jacob, Franca Barbic, Meytal Glago, Franca Dipaola, Alberto Porta, Raffaello Furlan
BACKGROUND: Constitutional hypotension (CHT) is defined as a SBP below 105 mmHg. As autonomic-related symptoms are frequently reported in CHT, these symptoms suggest that the cardiovascular autonomic control is perturbed in individuals with CHT. METHODS: We investigated the autonomic cardiovascular control of 15 women with CHT and 12 women with NBP (SBP >110 mmHg). We monitored BP and ECG for autonomic function test. Supine and head up tilt (HUT) spectral analysis of RR interval and BP variability, baroreflex sensitivity and plasma levels of plasma renin activity and aldosterone were determined...
May 16, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29735525/orthostatic-hypotension-and-risk-of-clinical-and-subclinical-cardiovascular-disease-in-middle-aged-adults
#2
Stephen P Juraschek, Natalie Daya, Lawrence J Appel, Edgar R Miller, John William McEvoy, Kunihiro Matsushita, Christie M Ballantyne, Elizabeth Selvin
BACKGROUND: Although orthostatic hypotension (OH) is a well-recognized manifestation of neuropathy and hypovolemia, its contribution to cardiovascular disease (CVD) risk is controversial. METHODS AND RESULTS: Participants with OH, defined as a decrease in blood pressure (systolic ≥20 mm Hg or diastolic ≥10 mm Hg) from the supine to standing position, were identified during the first visit of the ARIC (Atherosclerosis Risk in Communities) Study (1987-1989) within 2 minutes of standing...
May 7, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29732372/the-role-of-failing-autonomic-nervous-system-on-life-threatening-idiopathic-systemic-capillary-leak-syndrome
#3
Riccardo Colombo, Maddalena Alessandra Wu, Emanuele Catena, Andrea Perotti, Tommaso Fossali, Federico Cioffi, Roberto Rech, Antonio Castelli, Marco Cicardi
Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disease that involves the endothelium and microcirculation, leading to an abrupt shift of fluids and proteins from the intravascular to the interstitial compartment. The consequence of the capillary leakage is a life-threatening hypovolemic shock that can lead to lethal multiple organ dysfunction. The autonomic nervous system (ANS) is central in regulating the cardiovascular response to hypovolemia, but ANS modulation in ISCLS has not yet been investigated...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29726418/improving-fluid-management-in-critical-care-towards-the-icu-of-the-future
#4
Katharina Bergmoser, Lucas Pflanzl-Knizacek, Matthias Hafner, Gernot Schilcher, Christian Baumgartner
BACKGROUND: The calculation of daily fluid balances is essential in perioperative and postoperative fluid management in order to prevent severe hypervolemia or hypovolemia in critically ill patients. In this context, modern health information technology has the potential to reduce the workload for health care professionals by not only automating data collection but also providing appropriate decision support. OBJECTIVES: Within this work, current problems and barriers regarding fluid balancing in cardiac intensive care patients are outlined and improvement activities are specified...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29716625/6-hydroxyethyl-starch-hes-130-0-4-diminishes-glycocalyx-degradation-and-decreases-vascular-permeability-during-systemic-and-pulmonary-inflammation-in-mice
#5
Andreas Margraf, Jan M Herter, Katharina Kühne, Anika Stadtmann, Thomas Ermert, Manuel Wenk, Melanie Meersch, Hugo Van Aken, Alexander Zarbock, Jan Rossaint
BACKGROUND: Increased vascular permeability is a pathophysiological hallmark of sepsis and results in increased transcapillary leakage of plasma fluid, hypovolemia, and interstitial edema formation. 6% hydroxyethyl starch (HES 130/0.4) is commonly used to treat hypovolemia to maintain adequate organ perfusion and oxygen delivery. The present study was designed to investigate the effects of 6% HES 130/0.4 on glycocalyx integrity and vascular permeability in lipopolysaccharide (LPS)-induced pulmonary inflammation and systemic inflammation in mice...
May 1, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29710689/pulmonary-hemodynamic-effects-and-pulmonary-arterial-compliance-during-hypovolemic-shock-and-reinfusion-with-human-relaxin-2-serelaxin-treatment-in-a-sheep-model
#6
René Schiffner, Thomas Lehmann, Sabine J Bischoff, Timo Zippelius, Marius Nistor, Martin Schmidt
BACKGROUND: Previous studies on the recombinant form of human relaxin-2 (serelaxin) have shown a decrease of pulmonary hemodynamics after serelaxin injection. Currently, the effect of serelaxin treatment during hypovolemia in a large animal model remains mostly unknown. METHODS: 12 sheep were randomly assigned to a sham or serelaxin (30μg/kg serelaxin) group and underwent right heart catheterization. 50% of the estimated total blood volume were removed to induce hypovolemia, and subsequently retransfused 20 min later (reinfusion)...
April 14, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29704693/cardiac-arrest-during-spine-surgery-in-the-prone-position-case-report-and-review-of-the-literature
#7
REVIEW
Victor E Staartjes, Shiva A Schillevoort, Patricia G Blum, J Peter van Tintelen, Wouter E Kok, Marc L Schröder
OBJECTIVE: Intraoperative cardiac arrest (CA) is usually attributable to pre-existing disease, or to intraoperative complications. In rare cases, intraoperative stress can demask certain genetic diseases, such as Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). It is essential that neurosurgeons are aware of the etiologies, risk factors, and initial management of CA during surgery in the prone position. METHODS: We present a case of CA directly after spinal fusion for lumbar spondylolisthesis, and review the literature on cardiac arrests during spinal neurosurgery in the prone position...
April 26, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29696346/orthostatic-intolerance-and-postural-tachycardia-syndrome-new-insights-into-pathophysiology-and-treatment
#8
REVIEW
Mohammed Ruzieh, Blair P Grubb
Orthostatic intolerance is characterized by symptoms of light-headedness or syncope that is provoked upon standing or in an upright posture. It is most commonly caused by postural orthostatic tachycardia syndrome (POTS) or orthostatic hypotension (OH). Its pathophysiology is complex and commonly involves abnormal autonomic nervous system regulation, autoimmunity, a hyperadrenergic state, and hypovolemia. This article reviews the pathophysiology underlying orthostatic intolerance, as well as the current treatment available...
April 25, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29696295/expert-statement-for-the-management-of-hypovolemia-in-sepsis
#9
REVIEW
Anders Perner, Maurizio Cecconi, Maria Cronhjort, Michael Darmon, Stephan M Jakob, Ville Pettilä, Iwan C C van der Horst
Hypovolemia is frequent in patients with sepsis and may contribute to worse outcome. The management of these patients is impeded by the low quality of the evidence for many of the specific components of the care. In this paper, we discuss recent advances and controversies in this field and give expert statements for the management of hypovolemia in patients with sepsis including triggers and targets for fluid therapy and volumes and types of fluid to be given. Finally, we point to unanswered questions and suggest a roadmap for future research...
April 25, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29687945/severe-lactic-acidosis-and-hypoglycemia-due-to-acute-metformin-intoxication-in-a-dog
#10
Yu Ueda, Christine Wong, Angela Borchers
OBJECTIVE: To report a case of severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog. CASE SUMMARY: A female neutered Rat Terrier was presented for an acute onset of seizure-like episodes, weakness, and vomiting approximately 14 hours after ingestion of 198 mg/kg of metformin. The dog was found to be laterally recumbent, paddling, and unresponsive shortly before presentation. On physical exam, the dog was in hypovolemic shock and hypothermic...
April 24, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29686625/modeling-arterial-pulse-pressure-from-heart-rate-during-sympathetic-activation-by-progressive-central-hypovolemia
#11
Björn J P van Der Ster, Nicolaas H Sperna Weiland, Berend E Westerhof, Wim J Stok, Johannes J van Lieshout
Heart rate (HR) has an impact on the central blood pressure (BP) wave shape and is related to pulse wave velocity and therefore to timing and duration of systole and diastole. This study tested the hypothesis that in healthy subjects both in rest and during sympathetic stimulation the relation between HR and pulse pressure (PP) is described by a linear effect model. Forty-four healthy volunteers were subjected to sympathetic stimulation by continuous lower body negative pressure (LBNP) until the onset of pre-syncopal symptoms...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29682354/pathology-and-treatment-of-traumatic-cervical-spine-syndrome-whiplash-injury
#12
REVIEW
Nobuhiro Tanaka, Kivanc Atesok, Kazuyoshi Nakanishi, Naosuke Kamei, Toshio Nakamae, Shinji Kotaka, Nobuo Adachi
Traumatic cervical syndrome comprises the various symptoms that occur as a result of external force such as that of a traffic accident. In 1995, the Quebec Task Force on whiplash-associated disorders (WAD) formulated the Quebec classification, with accompanying clinical practice guidelines. These guidelines were in accordance with the stated clinical isolated or combined symptoms of the syndrome: neck pain, headaches, dizziness, numbness of head or face, eye pain, vision loss, double vision, tinnitus, hearing loss, nausea, and numbness and/or weakness of extremities...
2018: Advances in Orthopedics
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#13
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#14
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29668322/time-course-of-compensatory-physiological-responses-to-central-hypovolemia-in-high-and-low-tolerant-human-subjects
#15
Lusha Xiang, Carmen Hinojosa-Laborde, Kathy L Ryan, Caroline A Rickards, Victor A Convertino
Lower body negative pressure (LBNP) simulates hemorrhage in humans. Most subjects (67%) exhibited high tolerance (HT) to hypovolemia, while the remainder (33%) has low tolerance (LT). To investigate the mechanisms for decompensation to hypovolemia in HT and LT subjects, we characterized the time course of total peripheral resistance (TPR), heart rate (HR) and muscle sympathetic nerve activity (MSNA) during LBNP to tolerance determined by the onset of decompensation (presyncope, PS). We hypothesized that 1) maximum (max) TPR, HR, and MSNA would coincide, and 2) PS results from simultaneous decreases in TPR, HR and MSNA in LT and HT, but occur earlier in LT versus HT subjects...
April 18, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29644314/complete-femoral-artery-transection-following-handlebar-trauma
#16
Gergana Todorova Taneva Zaryanova, Ana Begoña Arribas Díaz, Ciro Baeza Bermejillo, César Aparicio Martínez, Alejandro González García
Complete transection of the common femoral artery is more frequent after penetrating injuries than after blunt trauma, with most of the cases occurring in combination with fractures. Contusion from a bicycle handlebar is a rare form of injury to the femoral vessels. Hereby, we present a case of complete common femoral artery transection caused by a direct bicycle handlebar trauma. The patient suffered severe hypovolemia during his transfer to the Emergency room. He required an emergency intervention and a bypass reconstruction...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29617159/the-effect-of-acute-hypovolemia-on-the-eye
#17
Hatice Bilge Araz-Ersan, Nihat Sayin, Sadık Etka Bayramoğlu, Dilara Pirhan, Kamuran Sanli, Necip Kara
INTRODUCTION: To investigate the effects of acute hypovolemia induced by blood donation on the eye. Methods or Study Design: This prospective, observational study included a single eye from each of 48 healthy men between 20 and 40 years of age who had donated 500 ml of blood and 28 eyes of 28 healthy, age- and gender-matched control subjects. The ocular parameters including ocular perfusion pressure (OPP), intraocular pressure (IOP), axial length (AL), central corneal thickness (CCT), choroidal and retinal thicknesses, and retinal nerve fiber layer (RNFL) were measured before blood donation and at 10 min and 1, 2, 3, and 4 h after blood donation...
April 4, 2018: Current Eye Research
https://www.readbyqxmd.com/read/29616230/anesthesia-associated-relative-hypovolemia-mechanisms-monitoring-and-treatment-considerations
#18
Jessica Noel-Morgan, William W Muir
Although the utility and benefits of anesthesia and analgesia are irrefutable, their practice is not void of risks. Almost all drugs that produce anesthesia endanger cardiovascular stability by producing dose-dependent impairment of cardiac function, vascular reactivity, and compensatory autoregulatory responses. Whereas anesthesia-related depression of cardiac performance and arterial vasodilation are well recognized adverse effects contributing to anesthetic risk, far less emphasis has been placed on effects impacting venous physiology and venous return...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29606259/-vancomycin-nephrotoxicity-frequency-and-mechanistic-aspects
#19
Yosu Luque, Laurent Mesnard
Vancomycin, discovered in 1953 and widely used today, has a nephrotoxic potential that has long been debated. The frequency of renal involvement is variable and can range from 5% to 30% depending concomitant risk factors: overdose, chronic kidney disease, obesity, hypovolemia, and use of other nephrotoxic drugs as aminoglycosides. Its association with piperacillin-tazobactam also appears to increase the risk of nephrotoxicity. This hypothesis should be confirmed experimentally. Vancomycin-induced oxidative stress in tubular cells and intraluminal cast formation are the two physiopathological mechanisms explaining its nephrotoxicity...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29596477/using-support-vector-machines-on-photoplethysmographic-signals-to-discriminate-between-hypovolemia-and-euvolemia
#20
Natasa Reljin, Gary Zimmer, Yelena Malyuta, Kirk Shelley, Yitzhak Mendelson, David J Blehar, Chad E Darling, Ki H Chon
Identifying trauma patients at risk of imminent hemorrhagic shock is a challenging task in intraoperative and battlefield settings given the variability of traditional vital signs, such as heart rate and blood pressure, and their inability to detect blood loss at an early stage. To this end, we acquired N = 58 photoplethysmographic (PPG) recordings from both trauma patients with suspected hemorrhage admitted to the hospital, and healthy volunteers subjected to blood withdrawal of 0.9 L. We propose four features to characterize each recording: goodness of fit (r2), the slope of the trend line, percentage change, and the absolute change between amplitude estimates in the heart rate frequency range at the first and last time points...
2018: PloS One
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