scholarly journals Pulse Pressure Variation-Guided Fluid Therapy during Supratentorial Brain Tumour Excision: A Randomized Controlled Trial

2019 ◽  
Vol 7 (15) ◽  
pp. 2474-2479
Author(s):  
Ahmed Hasanin ◽  
Tarek Zanata ◽  
Safinaz Osman ◽  
Yasser Abdelwahab ◽  
Rania Samer ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Fluid Therapy ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Serum Lactate ◽  
Pressure Variation ◽  
Control Group ◽  
Intraoperative Fluids

BACKGROUND: Goal-directed fluid therapy (GDFT) improved patient outcomes in various surgical procedures; however, its role during mass brain resection was not well investigated. AIM: In this study, we evaluated a simple protocol based on intermittent evaluation of pulse pressure variation for guiding fluid therapy during brain tumour resection. METHODS: Sixty-one adult patients scheduled for supratentorial brain mass excision were randomized into either GDFT group (received intraoperative fluids guided by pulse pressure variation) and control group (received standard care). Both groups were compared according to the following: brain relaxation scale (BRS), mean arterial pressure, heart rate, urine output, intraoperative fluid intake, postoperative serum lactate, and length of hospital stay. RESULTS: Demographic data, cardiovascular data (mean arterial pressure and heart rate), and BRS were comparable between both groups. GDFT group received more intraoperative fluids {3155 (452) mL vs 2790 (443) mL, P = 0.002}, had higher urine output {2019 (449) mL vs 1410 (382) mL, P < 0.001}, and had lower serum lactate {0.9 (1) mmol versus 2.5 (1.1) mmol, P = 0.03} compared to control group. CONCLUSION: In conclusion, PPV-guided fluid therapy during supratentorial mass excision, increased intraoperative fluids, and improved peripheral perfusion without increasing brain swelling.

Online Monitoring of Pulse Pressure Variation to Guide Fluid Therapy After Cardiac Surgery

2008 ◽  
Vol 106 (4) ◽  
pp. 1201-1206 ◽  
Author(s):  
Jose Otavio Auler ◽  
Filomena Galas ◽  
Ludhmila Hajjar ◽  
Luciana Santos ◽  
Thiago Carvalho ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Fluid Therapy ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Online Monitoring ◽  
Pressure Variation

Effects of V1- and V2-vasopressin (AVP) antagonists on the pressor, AVP and atrial natriuretic peptide responses to a hypertonic saline infusion in conscious anephric rats

1995 ◽  
Vol 133 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Kozo Ota ◽  
Tokihisa Kimura ◽  
Minoru Inoue ◽  
Takeharu Funyu ◽  
Masaru Shoji ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Atrial Natriuretic Peptide ◽  
Receptor Antagonist ◽  
Hypertonic Saline ◽  
Natriuretic Peptide ◽  
Plasma Volume ◽  
Control Group ◽  
Antagonist Group

Ota K, Kimura T, Inoue M, Funyu T, Shoji M, Sato K, Ohta M, Yamamoto T, Abe K, Effects of V1- and V2-vasopressin (AVP) antagonists on the pressor, AVP and atrial natriuretic peptide responses to a hypertonic saline infusion in conscious anephric rats. Eur J Endocrinol 1995;133:127–32. ISSN 0804–4643 To examine the role of vasopressin (AVP) receptors in the regulation of the hemodynamics and release of atrial natriuretic peptide (ANP), and the participation of renal nerve inputs in the osmotic AVP release, hypertonic saline (HS) was infused into conscious, bilaterally nephrectomized rats with nonpeptide, selective antagonists for the V1-receptor or V2-receptor of AVP. In the control group, HS alone increased mean arterial pressure, plasma ANP and AVP, plasma volume and plasma osmolality, and decreased the heart rate. In the V1-receptor antagonist group, an increase in the mean arterial pressure and a decrease in heart rate were completely abolished and an increase in plasma ANP was attenuated. In the V2-receptor antagonist group, increases in mean arterial pressure and plasma ANP and a decrease in heart rate were attenuated. However, the ratio of the changes in heart rate to the changes in mean arterial pressure in the V2-receptor antagonist group is significantly higher than that in the control group. In both experimental groups, increases in plasma AVP, plasma volume and plasma osmolality were not different from those in the control group. These results suggest that a HS-induced increase in mean arterial pressure is mediated by the pressor effect of AVP, mainly through V1-receptors, and that the depressor effect of AVP through V2-receptors may not influence tonically HS-induced hypertension. Moreover, HS-induced increase in plasma ANP is mediated mainly by increases in plasma volume and blood pressure, but may not be affected by a direct action of AVP to the heart. Renal afferent nerve inputs may not have effects on the regulation of osmotic AVP release. Kozo Ota, Second Department of Internal Medicine, Tohoku University School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-77, Japan

scholarly journals Clinical Effect of Shenfu Injection in Patients with Septic Shock: A Meta-Analysis and Systematic Review

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Zijun Mou ◽  
Zhengtao Lv ◽  
Yi Li ◽  
Meng Wang ◽  
Qun Xu ◽  
...  
Keyword(s):  
Heart Rate ◽  
Septic Shock ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Conventional Therapy ◽  
Meta Analysis ◽  
Serum Lactate ◽  
Controlled Trials ◽  
Shenfu Injection ◽  
Randomized Controlled

Purpose. To conduct a meta-analysis evaluating the efficacy of Shenfu injection for treating patients with septic shock when compared with conventional therapy.Methods. Eight databases including Pubmed, EMBASE, Cochrane Library, ISI Web of Science, CNKI, Wanfang, VIP, and CBM were searched up to October 2014. Randomized controlled trials assessing the efficacy of Shenfu injection were identified. Mean arterial pressure, heart rate, lactate, and mortality were included as outcome measurements.Results. We analyzed data from 12 randomized controlled trials involving 904 participants. Compared with conventional therapy, Shenfu injection could further increase the mean arterial pressure at 1 hour (SMD 0.38; 95% CI, 0.01–0.74) and 6 hours (SMD 0.82; 95% CI, 0.03–1.61). Shenfu injection could further normalize heart rate at 6 hours (SMD −0.90; 95% CI, −1.47–0.33) and clear serum lactate at 6 hours (SMD −0.51; 95% CI, −0.70–0.32) and 24 hours (SMD, 0.52; 95% CI, −0.77–0.26). As the endpoint of mortality was not unified, it was not meta-analyzed.Conclusions. Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality. These results should be confirmed in higher level clinical trials in the future.

Blunted autonomic response to standing up and head-up tilt in individuals with intellectual disabilities

2021 ◽  
Author(s):  
Thessa Irena Maria Hilgenkamp ◽  
Elizabeth C. Lefferts ◽  
Daniel W. White ◽  
Tracy Baynard ◽  
Bo Fernhall
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Intellectual Disabilities ◽  
Autonomic Response ◽  
Control Group ◽  
Standing Up ◽  
Head Up Tilt ◽  
Individuals With Intellectual Disabilities

Previous research suggests individuals with intellectual disabilities (ID) may experience autonomic dysfunction, however this has not been thoroughly investigated. PURPOSE: To compare the autonomic response to standing up (active orthostasis) and head up tilt (passive orthostasis) in individuals with ID to a control group without ID. METHODS: Eighteen individuals with and 18 individuals without ID were instrumented with an ECG-lead and finger-photoplethysmography for continuous heart rate and blood pressure recordings. The active and passive orthostasis protocol consisted of 10 minutes supine rest, 10 minutes standing, 10 minutes supine recovery, 5 minutes head-up tilt at 70 degrees, followed by 10 minutes supine recovery. The last five minutes of each position was used to calculate hemodynamic and autonomic function (time- and frequency-domain heart rate and blood pressure variability measures and baroreflex sensitivity). RESULTS Individuals with ID had higher heart rate during baseline and recovery (p<0.05), and an attenuated hemodynamic (stroke volume, heart rate) and heart rate variability response to active and passive orthostasis (interaction effect p<0.05) compared to individuals without ID. Mean arterial pressure (MAP) was higher in individuals with ID at all timepoints. CONCLUSION Individuals with ID demonstrated altered hemodynamic and autonomic regulation compared to a sex- and age-matched control group, evidenced by a higher mean arterial pressure and a reduced response in parasympathetic modulation to active and passive orthostasis.

Hypotension induced by passive head-up tilt: endocrine and circulatory mechanisms

1986 ◽  
Vol 251 (4) ◽  
pp. R742-R748 ◽  
Author(s):  
K. Sander-Jensen ◽  
N. H. Secher ◽  
A. Astrup ◽  
N. J. Christensen ◽  
J. Giese ◽  
...  
Keyword(s):  
Heart Rate ◽  
Young Adults ◽  
Angiotensin Ii ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pancreatic Polypeptide ◽  
Pulse Pressure ◽  
Head Up Tilt ◽  
Plasma Hormone ◽  
Arterial Plasma

Circulatory changes and arterial plasma hormone concentrations were measured in seven healthy young adults during 30 and 60 degrees passive head-up tilt with the subjects supported by a saddle. The 30 degrees tilt induced a decrease in pulse pressure (Pp) from 45 +/- 2 to 35 +/- 4 (mean +/- SE) mmHg concomitant with an increase in heart rate (HR) from 58 +/- 4 to 78 +/- 8 beats/min and a marginal increase in mean arterial pressure (MAP). Norepinephrine increased from 180 +/- 20 to 310 +/- 40 pg/ml, aldosterone increased fivefold, and angiotensin II increased from 8 +/- 2 to 22 +/- 7 pg/ml. The 60 degrees tilt initially produced changes, which were qualitatively similar to the 30 degrees tilt. However, after 19 +/- 3 min sudden decreases were seen in MAP (94 +/- 3 to 50 +/- 8 mmHg), in Pp (38 +/- 5 to 18 +/- 4 mmHg), and in HR (90 +/- 7 to 57 +/- 6 beats/min). Concomitantly, epinephrine doubled while norepinephrine remained unchanged; the vagally controlled hormone pancreatic polypeptide increased from 29 +/- 3 to 51 +/- 8 pmol/l, vasopressin from 4 +/- 1 to 126 +/- 58 pg/ml, and angiotensin II from 23 +/- 9 to 35 +/- 12 pg/ml. The hypotensive bradycardiac episode was immediately reversible on termination of the head-up tilt.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Changes of Vital Parameters after Administration of Butorphanol during Tiletamine-Zolazepam-Ketamine-Xylazine Anaesthesia for Joint Surgery in Miniature Pigs

2008 ◽  
Vol 77 (2) ◽  
pp. 251-256 ◽  
Author(s):  
P. Raušer ◽  
L. Lexmaulová ◽  
R. Srnec ◽  
J. Lorenzová ◽  
H. Kecová ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Physiological Saline ◽  
Control Group ◽  
Miniature Pigs ◽  
Joint Surgery ◽  
Vital Functions ◽  
End Tidal ◽  
Vital Parameters

The study compares the effects of butorphanol in pigs undergoing joint surgery in tiletamine-zolazepam-ketamine-xylazine (TKX) anaesthesia. A total of 12 pigs were divided into 2 groups by 6 animals - BUT (anaesthetized with TKX combination and butorphanol) and CON (control group - anaesthetized with TKX combination only). All pigs were sedated with a mix of tiletamin-zolazepam-ketamin-xylazin, put into total anaesthesia using propofol, and connected to an anaesthesiology unit (O2-Air). For 40 min we logged the heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), haemoglobin saturation by oxygen (SpO2) and end-tidal CO2 concentration (ETCO2) values. Ten minutes after connecting to the devices, the pigs in the BUT group were intravenously administered butorphanol (0.2 mg/kg) in the total volume of 2 ml, or physiological saline in the same volume. The pigs in the BUT group had a lower (p < 0.05) HR in 5th, 10th and 25th min, and a lower RR in the 10th, 15th and 20th min. MAP, ETCO2 and SpO2 values did not differ substantially. Butorphanol can thus be identified as a suitable analgesic TKX supplement to anaesthesia of miniature pigs with minimum effect on vital functions.

scholarly journals CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY VERSUS FIBER-OPTIC BRONCHOSCOPE DURING OROTRACHEAL INTUBATION IN PATIENTS UNDERGOING ELECTIVE SURGERY

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S180-85
Author(s):  
Moazzam Ali ◽  
Maliha Khawar ◽  
Maryam Nazneen ◽  
Zaqawat Nazneen
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Fiber Optic ◽  
Cardiovascular Response ◽  
Macintosh Laryngoscope ◽  
Orotracheal Intubation ◽  
Control Group ◽  
Female Ratio ◽  
The Mean

Objective: To compare the hemodynamic response between flexible fiber optic bronchoscope (FOB) andMacintosh laryngoscope during orotracheal intubation. The secondary objective was to calculate the timerequired for intubation between these two techniques Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia, Frontier Corps Hospital Quetta, from Oct 2016 to Apr2017. Methodology: Eighty patients fulfilling the inclusion/exclusion criteria were included in this study and weredivided randomly into two groups. Group L was intubated with Macintosh laryngoscope (control group) whereas group F was intubated with Fiber optic bronchoscope. Mean arterial pressure and heart rate was recorded as baseline, pre-intubation and then every 01 minute for 03 minutes. Changes in heart rate and mean arterial pressure were recorded in the proforma by another anesthetist who was blinded to the procedure performed. Results: The mean age in group L was 41.23 ± 8.37 years and in group F was 40.73 ± 9.77 years. The mean weight in group L was 69.63 ± 8.92 kg and in group F was 70.6 ± 9.20 kg. In group L, male to female ratio was 26:14 whereas in group F it was 28:12. Mean heart rate and mean arterial pressure did not show significant change over time between groups. Time required for intubation was significantly less (22.45 ± 4.12 secs) in laryngoscopy group versus Fiber-Optic Bronchoscope group (44.68 ± 5.88 secs). Conclusion: In conclusion we can say that our study demonstrated that using laryngoscope or Fiber-OpticBronchoscope for orotracheal..........

Pulse pressure variation–guided fluid therapy after cardiac surgery: A pilot before-and-after trial

2014 ◽  
Vol 29 (6) ◽  
pp. 992-996 ◽  
Author(s):  
Satoshi Suzuki ◽  
Nicholas C.Z. Woinarski ◽  
Miklos Lipcsey ◽  
Cristina Lluch Candal ◽  
Antoine G. Schneider ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Fluid Therapy ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Pressure Variation ◽  
Before And After
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