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Physiology of Human Hemorrhage and Compensation.
Authors: Convertino VA, Koons NJ, Suresh MR Abstract Hemorrhage is a leading cause of death following traumatic injuries in the United States. Much of the previous work in assessing the physiology and pathophysiology underlying blood loss has focused on descriptive measures of hemodynamic responses such as blood pressure, cardiac output, stroke volume, heart rate, and vascular resistance as indicators of changes in organ perfusion. More recent work has shifted the focus toward understanding mechanisms of compensation for reduced systemic delivery and cellular utilization of oxygen as a more comprehensive approach t...
Source: Comprehensive Physiology - February 13, 2021 Category: Physiology Tags: Compr Physiol Source Type: research

Transcranial Doppler Ultrasound During Critical Illness in Children: Survey of Practices in Pediatric Neurocritical Care Centers*
Conclusions: At least 27 pediatric neurocritical care centers use transcranial Doppler during clinical care. In the majority of centers, studies are performed and interpreted by credentialed personnel, and findings are used to guide clinical management. Further studies are needed to standardize these practices.
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Postreperfusion Blood Pressure Variability After Endovascular Thrombectomy Affects Outcomes in Acute Ischemic Stroke Patients With Poor Collateral Circulation
Conclusion: Postreperfusion BP management by decreasing BPV may have influence on improving clinical outcome in cases of poor collateral circulation among patients achieving successful recanalization after ERT. Introduction Endovascular recanalization therapy (ERT) has been adopted as standard stroke care in patients with acute ischemic stroke (1–6). Time to recanalization and degree of recanalization are the most important predictors of clinical outcomes after ERT (7). Before recanalization, an effort to reduce the time from symptom onset to reperfusion is critical for penumbral salvage. After recanalization...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Combining Human Umbilical Cord Blood Cells With Erythropoietin Enhances Angiogenesis/Neurogenesis and Behavioral Recovery After Stroke
In conclusion, our results suggest that hUCBC infusion in combination with EPO administration demonstrates therapeutic efficacy in the treatment of stroke-induced injury by promoting neurogenesis and angiogenesis. Further research that delineates the therapeutic mechanism of systemically administered hUCBC and EPO is required. Ethics Statement All experimental procedures involving animals were performed in accordance with the Guide for the Care and Use of Laboratory Animals as adopted and promulgated by the U. S. National Institutes of Health and were approved by CHA University Institutional Animal Care & Use Com...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Management of Chronic Hypertension Following Intracerebral Hemorrhage
Acute blood pressure control after a cerebrovascular event is integral in the immediate care of these patients to preserve perfusion to ischemic areas and prevent intracerebral bleeding. The majority of patients with ischemic stroke or intracerebral hemorrhage (ICH) present with preexisting hypertension and therefore require a treatment plan after the acute phase. The presence of chronic hypertension after ICH has often been discussed as a modifiable risk factor for recurrent events. Clinical evidence is relatively lacking for clinicians to understand the extent of blood pressure lowering and the optimal agents to use in t...
Source: Critical Care Nursing Quarterly - March 4, 2019 Category: Nursing Tags: Original Articles Source Type: research

Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the...
Source: JEMS Special Topics - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Columns Cardiac & Resuscitation Special Topics Patient Care Source Type: news