Cardiac function after intermittent antegrade warm blood cardioplegia: contribution of the double-indicator dilution technique

2000 ◽  
Vol 26 (6) ◽  
pp. 686-692
Author(s):  
L. Jacquet ◽  
P. Honore ◽  
R. Beale ◽  
D. Valadi ◽  
R. Dion ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Indicator Dilution ◽  
Dilution Technique ◽  
Blood Cardioplegia ◽  
Indicator Dilution Technique ◽  
Warm Blood ◽  
Double Indicator Dilution ◽  
Warm Blood Cardioplegia

Lung mechanics in hypervolemic pulmonary edema

1975 ◽  
Vol 38 (4) ◽  
pp. 681-687 ◽  
Author(s):  
W. H. Noble ◽  
J. C. Kay ◽  
J. Obdrzalek
Keyword(s):  
Pulmonary Edema ◽  
Lung Compliance ◽  
Indicator Dilution ◽  
Lung Mechanics ◽  
Dilution Technique ◽  
Lung Water ◽  
Electron Microscopic ◽  
Indicator Dilution Technique ◽  
Double Indicator Dilution ◽  
Alveolar Edema

Extravascular thermal volume of the lung (ETVL) is a double indicator dilution technique of use in measuring pulmonary edema. ETVL and lung mechanics measurements were followed to find a less invasive monitor of pulmonary edema than the double indicator dilution technique. Pulmonary edema was induced by overloading the dogs' circulation with dextran. Phases of overload were defined on the basis of a previous electron microscopic study (Noble et al., Can. Anesthetists Soc. J. 21:275, 1974) of lung biopsies relating anatomic changes to physiologic measurements of ETVL and central blood volume (CBV). Congestion occurred when CBV was elevated and ETVL was not, interstitial edema when ETVL was elevated but smaller than 60% above control and alveolar edema when ETVL greater than 85% above control. Once the dogs were in alveolar edema, they were mechanically ventilated with 4, 8, 12, and 16 cmH2O end-tidal pressure (CPPV). Mean functional residual capacity (FRC) for all 15 dogs did not change up to the time CPPV was applied. Pulmonary resistance did not rise until alveolar edema was present. Once in pulmonary edema, lung compliance always fell as lung water increased. In individual dogs, the compliance fall was directly proportional to the rising lung water. However, the variations in slope and beginning point among dogs made it difficult to predict the amount of lung water from dynamic compliance values. PaO2 fell markedly in alveolar edema as a result of a widened A-a gradient. CPPV did not decrease lung water but did increase FRC and PaO2.

Terminal Warm Blood Cardioplegia Improves Cardiac Function Through Microtubule Repolymerization

1998 ◽  
Vol 65 (6) ◽  
pp. 1580-1587 ◽  
Author(s):  
Hironori Tenpaku ◽  
Koji Onoda ◽  
Kyoko Imanaka-Yoshida ◽  
Toshimichi Yoshida ◽  
Takatsugu Shimono ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Blood Cardioplegia ◽  
Warm Blood ◽  
Warm Blood Cardioplegia

Bedside Assessment of Cerebral Blood Flow by Double-indicator Dilution Technique

2000 ◽  
Vol 92 (2) ◽  
pp. 367-367 ◽  
Author(s):  
Götz J. K. Wietasch ◽  
Frank Mielck ◽  
Martin Scholz ◽  
Tilman von Spiegel ◽  
Heidrun Stephan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Clinical Setting ◽  
Coronary Bypass ◽  
Central Venous Line ◽  
Indicator Dilution ◽  
Alternative Methods ◽  
Dilution Technique ◽  
Indicator Dilution Technique ◽  
Double Indicator Dilution

Background Currently, quantitative measurement of global cerebral blood flow (CBF) at bedside is not widely performed. The aim of the present study was to evaluate a newly developed method for bedside measurement of CBF based on thermodilution in a clinical setting. Methods The investigation was performed in 14 anesthetized patients before coronary bypass surgery. CBF was altered by hypocapnia, normocapnia, and hypercapnia. CBF was measured simultaneously by the Kety-Schmidt inert-gas technique with argon and a newly developed transcerebral double-indicator dilution technique (TCID). For TCID, bolus injections of ice-cold indocyanine green were performed via a central venous line, and the resulting thermo-dye dilution curves were recorded simultaneously in the aorta and the jugular bulb using combined fiberoptic thermistor catheters. CBF was calculated from the mean transit times of the indicators through the brain. Results Both methods of measurement of CBF indicate a decrease during hypocapnia and an increase during hypercapnia, whereas cerebral metabolic rate remained unchanged. Bias between CBF(TCID) and CBFargon was -7.1+/-2.2 (SEM) ml x min(-1) x 100 g(-1); precision (+/- 2 x SD of differences) between methods was 26.6 ml x min(-1) x 100 g(-1). Conclusions In the clinical setting, TCID was feasible and less time-consuming than alternative methods. The authors conclude that TCID is an alternative method to measure global CBF at bedside and offers a new opportunity to monitor cerebral perfusion of patients.

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