Hypovolaemia

Publication date: Available online 19 January 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Laura Kettley, Aidan Marsh The determination of intravascular volume in haemodynamically unstable patients is key to subsequent management. Administration of fluid remains the cornerstone of treatment but fluid loading in those patients not responsive to fluid is detrimental to outcome, as interstitial oedema impedes tissue oxygenation. Traditionally, static markers of cardiac preload such as central venous pressure have guided fluid therapy. Such markers have been shown to poorly predict fluid responsiveness. This has led to increased interest in dynamic variables such as the fluctuation of blood pressure and stroke volume in response to mechanical ventilation. These variables use the cyclical changes induced by positive pressure ventilation on right and left ventricular loading to measure changes in left ventricular stroke volume and arterial pressure. These dynamic indices, termed systolic pressure variation, pulse pressure variation and stroke volume variation, are superior in predicting fluid responsiveness in mechanically ventilated patients with a regular cardiac rhythm. In patients with spontaneous respiratory effort, the response of stroke volume to a passive leg raise is also an accurate indicator of fluid status.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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CONCLUSION: Both Eadyn and modified Eadyn cannot predict whether blood pressure increases with fluid administration in pediatric patients with hypotension. PMID: 31730254 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
In conclusion, preoperative use of mammography was strongly associated with fewer perioperative complications and less in-hospital mortality after major surgeries. The evidence provided by this study justifies the implementation of preoperative health checks in clinical practice.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Abstract The supine position is still the most frequently used type of positioning during surgical procedures. Positions other than the supine position lead to physiological alterations that have a relevant influence on the course of anesthesia and surgery. As a matter of principle, hemodynamic stability is at risk because venous blood is pooled in the lower positioned body parts. In addition, head down positions (Trendelenburg position) may lead to an impairment of respiratory function by reducing lung volumes as well as lung compliance. Upright positions (beach chair position) are characterized by a relativ...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Janovák L, Dékány I, Farkas E, Bari F Abstract Stroke is an important cause of mortality and disability. Treatment options are limited, therefore the progress in this regard is urgently needed. Nimodipine, an L-type voltage-gated calcium channel antagonist dilates cerebral arterioles, but its systemic administration may cause potential side effects. We have previously constructed chitosan nanoparticles as drug carriers, which release nimodipine in response to decreasing pH typical of cerebral ischemia. Here we have set out to evaluate this nanomedical approach to deliver nimodipine selectivel...
Source: Neuropharmacology - Category: Drugs & Pharmacology Authors: Tags: Neuropharmacology Source Type: research
AbstractObjectiveTo evaluate the efficacy of electro-acupuncture (EA) or transcutaneous electrical acupoint stimulation (TEAS) on perioperative cerebral blood flow (CBF) and neurological function in ischemic stroke (IS) patients undergoing carotid artery stenting (CAS).MethodsIn total, 124 consecutive IS patients were randomly allocated to the EA, TEAS, and sham groups (groups A, T, and S; 41, 42, and 41 cases, respectively) by software-derived random-number sequence. Groups A and T received EA and TEAS, respectively, at the Shuigou (GV 26) and Baihui (GV 20), Hegu (LI4) and Waiguan (TE 5) acupoints. Group S received sham ...
Source: Chinese Journal of Integrative Medicine - Category: Internal Medicine Source Type: research
Jaap J Vos, Thomas W L ScheerenIndian Journal of Anaesthesia 2019 63(11):877-885 Intraoperative hypotension (IOH) very commonly accompanies general anaesthesia in patients undergoing major surgical procedures. The development of IOH is unwanted, since it is associated with adverse outcomes such as acute kidney injury and myocardial injury, stroke and mortality. Although the definition of IOH is variable, harm starts to occur below a mean arterial pressure (MAP) threshold of 65 mmHg. The odds of adverse outcome increase for increasing duration and/or magnitude of IOH below this threshold, and even short periods of IOH seem...
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Brandt Smith, Janna L. Crossley, Ruth M. Elsey, James W. Hicks, and Dane A. Crossley II The effects of the embryonic environment on juvenile phenotypes are widely recognized. We investigated the effect of embryonic hypoxia on the cardiovascular phenotype of 4-year-old American alligators (Alligator mississippiensis). We hypothesized that embryonic 10% O2 preconditions cardiac function, decreasing the reduction in cardiac contractility associated with acute 5% O2 exposure in juvenile alligators. Our findings indicate that dobutamine injections caused a 90% increase in systolic pressure in juveniles that were incubated in 2...
Source: Journal of Experimental Biology - Category: Biology Authors: Tags: RESEARCH ARTICLE Source Type: research
This study aims to evaluate whether the choice of anesthesia modifies the association between shunting and in-hospital stroke/death after CEA.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Purpose of review There is a steadily increasing demand for procedural sedation outside the operating room, frequently performed in comorbid high-risk adult patients. This review evaluates the feasibility and advantages of sedation vs. general anesthesia for some of these new procedures. Recent findings Generally, sedation performed by experienced staff is safe. Although for some endoscopic or transcatheter interventions sedation is feasible, results of the intervention might be improved when performed under general anesthesia. For elected procedures like intra-arterial treatment after acute ischemic stroke, avoiding ...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: TECHNOLOGY, EDUCATION AND SAFETY: Edited by Stephan A. Loer Source Type: research
Conclusion: On comparing the effects of propofol and desflurane anesthesia for controlled hypotension on the levels of S-100β and GFAP, we noted that there was no significant difference in S-100β and GFAP levels between the 2 study groups. Clinical trial registration: Available at: http://cris.nih.go.kr, KCT0002698.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
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