• Title/Summary/Keyword: Vasodilators

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Management of Persistent Pulmonary Hypertension in Preterm Infants

  • Lee, Byong Sop
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.1-6
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    • 2021
  • Persistent pulmonary hypertension of the newborn (PPHN) is a consequence of the failure of a decrease in the elevated pulmonary vascular resistance after birth. Pulmonary vasodilators, including inhaled nitric oxide (iNO), have been the mainstream of targeted therapy for PPHN, but no drugs have been proven to be effective in preterm infants with PPHN. The fetus remains hemodynamically stable despite lower arterial oxygen tension and pulmonary blood flow as compared to full-term newborns. This adaptation is due to the lower oxygen requirement and high oxygen-carrying capacity of fetal circulation. The immature lungs of preterm infants are more vulnerable to reactive oxygen species, and the response of pulmonary vascular dilatation to blood oxygen tension is blunted in preterm infants. Recently, iNO has been reported to be effective in a selected group of preterm infants, such as those with prolonged preterm rupture of membrane-oligohydramnios-pulmonary hypoplasia sequence. PPHN in preterm infants, along with maximum supportive treatment based on fetal physiology and meticulous assessment of cardiovascular function, is in dire need of new treatment guidelines, including optimal dosing strategies for pulmonary vasodilators.

Univentricular heart: a report of 2 cases (단심실증의 수술치험 2)

  • 박이태
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.625-631
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    • 1984
  • A modified Fontan procedure was performed on two patients with Univentricular heart. The first patient had UVH of right ventricular type with trabecular pouch and had various associated anomalies, such as common atrium, common atrioventricular valve and combined pulmonary stenosis. The second patient had UVH of left ventricular type with outlet chamber and the associated anomalies were atrial septal defect, tricuspid stenosis and combined pulmonary stenosis. Postoperative hemodynamic insufficiency, fluid retention and renal insufficiency were occurred in the first patient, but relieved with the aid of inotropics and vasodilators. We thought that the good postoperative course and surgical result were gained from the widely patent atriopulmonary anastomosis.

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Intensive management of acute right heart failure (급성 우심 부전의 집중 치료)

  • Kim, Gi Beom;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1041-1048
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    • 2007
  • Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

Pulmonary hypertension in infants with bronchopulmonary dysplasia

  • Kim, Gi-Beom
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.688-693
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    • 2010
  • An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type natriuretic peptide (BNP) or N-terminal-proBNP must be conducted in the BPD patients with greater than moderate degree to prevent PH and to ensure early treatment if PH is present. In the BPD patients with significant PH, multi-modality treatment, including treatment for correcting an underlying disease, oxygen supply, use of diverse selective pulmonary vasodilators (inhaled nitric oxide, inhaled prostacyclins, sildenafil, and endothelin-receptor antagonist) and other methods, is mandatory.

Influences of Several Vasodilators on the Pain Threshold in Healthy Men (건강인에 있어서 각종 혈관 확장제가 동통 역치에 미치는 영향)

  • Pak, Myong;Choe, Huhn;Mashimo, Takashi;Yagi, Masaharu;Sasaki, Shigeta;Tomi, Katsuji;Yoshiya, Ikuto
    • The Korean Journal of Pain
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    • v.3 no.2
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    • pp.144-148
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    • 1990
  • 정상인에서 Guanethidine Nicardipine Nitroglycerine Prostaglandin $E_1$을 피하주사하고 지속적인 복사열을 주사한 후에 Pain Meter NYT-5를 이용하여 동통역치를 측정하였다. 통증역치는 Guanethidine과 Nicardipine에 의해 상승되었으며 Nitroglycerine에 의해서는 거의 변화가 없고 Prostaglandin $E_1$에 의해서는 감소되었다. 이러한 변화는 지각신경섬유의 말단 감각수용체에 대한 감수성이 이들 혈관확장제에 대하여 서로 다른 작용을 나타내는것 같다.

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Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report- (정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.364-368
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    • 2004
  • Congenital pulmonary vein stenosis is a rare anomaly and related to high mortality due to progressive pulmonary hypertension and heart failure in infancy. Aggressive anti-failure medication and surgical treatment is recommended. Surgical options are balloon dilatation, endovascular stent, pneumonectomy, lung transplantation, patch grafting, and sutureless repair. We report a case of congenital pulmonary vein stenosis with normal anatomical connection successfully treated with sutureless technique and using pulmonary vasodilators, such as Sildenafil, lloprost and iNO postoperatively.

A Study on the Moxa-extract Moxibustion Method (약쑥엑스제 뜸 방식에 관한 연구)

  • Jo, Bong-Kwan;Lee, Yoon-Ho;Yoon, Dong-Eop
    • Journal of Acupuncture Research
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    • v.23 no.4
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    • pp.1-14
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    • 2006
  • Objectives : We implemented the Moxa-Extract Moxibustion Method in order to improve the conventional moxibustion therapy. This method is aimed to eliminate burning wounds and smoke, which are the defects of conventional moxibustion therapy. And we performed to verify the efficiency by comparing the Moxa-Extract Moxibustion Method with the conventional Indirect Moxibustion Method. We measured the body heat and the lasting time of blood circulation improveent using thermography. We implemented the Moxa-Extract Moxibustion Method in order to improve the conventional moxibustion therapy. This method is aimed to eliminate burning wounds and smoke, which are the defects of conventional moxibustion therapy. And we performed to verify the efficiency by comparing the Moxa-Extract Moxibustion Method with the conventional Indirect Moxibustion Method. We measured the body heat and the lasting time of blood circulation improvement using thermography. Methods : The moxibustion therapy has two kinds of effects: The formers are pharmacological effects of the Moxa's vasodilators and antioxidants. The latters are thermal effects which cause improvement of the blood circulation. To remove the demerits without omission of above therapeutic effects, we extracted the vasodilators and antioxidant compounds from the Moxa-CH2Cl2 fraction Moxa-EtOA and composed the moxibustion kit with (Ba0.8 Sr0.2)0.996 Y0.004 TiO2 + 0.5WT SiO2% positive Temperature Coefficients Thermistor. The experimental demonstrations have been made by the stimulating the spot which is CV4(Kwan-Won), CV8(Shin-Guel), CV12(Jung-Wan) acupuncture points of the conception vessel meridian(CV). And stimulating time was one hour. We divided the subjects into 5 groups such as no stimulation group, conventional Indirect Moxibustion group, only Moxa-Extract stimulation group, only heat stimulation group, and Moxa-Extract Moxibustion group. In the different cases, we have measured the body heat in pre-stimulation, just after stimulation, 2 hours after, and 4 hours after. Results : he body heats of the group who were stimulated by the Moxa-Extract Moxibustion method were increased by over the $2^{\circ}C$. And the body heats of the group who were stimulated by the Indirect Moxibustion Method were increased by average the $1^{\circ}C$. We have evaluated that the Moxa-Extract Moxibustion Method is improvement on the Indirect Moxibustion Method by the increasing rate is 200% and increasing time is 150% with the body heat of the abdominal region. Conclusion : We have implemented the Moxa-Extract Moxibustion Method and evaluated the efficiency of the Moxa-Extract Moxibustion Method comparing with the Indirect Moxibustion Method.

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A Study on the Variations of the Body Trunk Temperature by the Drug-Pad Moxibustion Method (약패드 뜸 방식을 이용한 체간온도변화에 대한 연구)

  • Yoon Dong-Eop;Jo Bong-Kwan
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.55 no.8
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    • pp.386-396
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    • 2006
  • We implemented the Drug-Pad Moxibustion Method in order to improve the conventional moxibustion therapy. This method is aimed to eliminate burning wounds and smoke, which are the defects of conventional moxibustion therapy. And we performed to verify the efficiency by comparing the Drug-Pad Moxibustion Method with the conventional Indirect Moxibustion Therapy. We measured the body heat and the lasting time of blood circulation improvement using thermography. The moxibustion therapy has two kinds of effects: The formers are pharmacological effects of the Moxa's vasodilators and antioxidants. The latters are thermal effects which cause improvement of the blood circulation. To remove the demerits without omission of above therapeutic effects, we extracted the vasodilators and antioxidant compounds from the Moxa-$CH_2Cl_2$ fraction Moxa-EtOAc and composed the moxibustion kit with $(Ba_{0.8}\;Sr_{0.2})_{0.996}\;Y_{0.004}\;TiO_2+0.5_{WT}\;SiO_2%$ Positive Temperature Coefficients Thermistor. The experimental demonstrations have been made by the stimulating the spot which is CV4(Kwan-Won), CV8(Shin-Guel), CV12(Jung-Wan) acupuncture points of the conception vessel meridian(CV). And stimulating time was one hour. We divided the subjects into 5 groups such as no stimulation group, conventional Indirect Moxibustion group, only Drug-Pad stimulation group, only heat stimulation group, and Drug-Pad Moxibustion group. In the different cases, we have measured the body heat in pre-stimulation, just after stimulation, 2 hours after, and 4 hours after. The body heats of the group who were stimulated by the Drug-Pad Moxibustion Method were increased by over the $2^{\circ}C$. And the body heats of the group who were stimulated by the Indirect Moxibustion Method were increased by average the $1^{\circ}C$. We have evaluated that the Drug-Pad Moxibustion Method is improvement on the conventional Indirect Moxibustion Method by the heat-increasing rate is 200% and the lasting time is 150% with the body heat of the abdominal region. In the conclusions, We have implemented the Drug-Pad Moxibustion Method and evaluated the efficiency of the Drug-Pad Moxibustion Method comparing with the conventional Indirect Moxibustion Method.

An Experimental Study on the Effect of the Coronary Vasodilator-mixed Cardioplegic Solution on Myocardial Protection during Prolonged Aortic Cross-Clamping (심혈관 확장제를 첨가한 심정지액의 심근보호에 미치는 효과)

  • Jo, Gyu-Do;Kim, Se-Hwa;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.732-739
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    • 1985
  • This study was experimentally undertaken to evaluate the effect of the coronary vasodilator-mixed cardioplegic solution on myocardial protection during prolonged aortic cross-clamping. The dogs were divided into two groups: control group A[received hypothermic cardioplegic solution without any additive coronary vasodilator], and comparing group 8[received hypothermic cardioplegic solution, mixed with various coronary vasodilators and Inderal]. Group A further was divided into two subgroups: subgroup A-1[ischemic time, 90 minutes], and subgroup A-2 [ischemic time, 240 minutes]. Group B further was divided into five subgroups: subgroup B-1 [received papaverine mixed hypothermic cardioplegic solution], subgroup B-2[received nitroglycerin mixed hypothermic cardioplegic solution], subgroup B-3 [received nitroprusside mixed hypothermic cardioplegic solution, subgroup B-4[received hydralazine mixed hypothermic cardioplegic solution], and subgroup B-5 [received inderal mixed hypothermic cardioplegic solution]. The specimens from all of the subgroups were studied by electron microscopic examination. The specimens of subgroups [B-l, B-2 8-3, and B-4], received coronary vasodilators mixed hypothermic cardioplegic solutions, were also compared by methylene blue induced staining of the myocardium and coronary vessels. The results obtained were as followings: l. On electron microscopic examination, all of the specimens, including subgroup A-2, showed no irreversible change of the myocardium. But the best result was obtained from the subgroup B-l, treated by papaverine mixed hypothermic cardioplegic solution. The subgroup B-2, treated by nitroglycerin, was next. And the subgroup B-5, treated by Inderal, was agreeable, comparing the electron microscopic finding with control group in the effect of myocardial protection. 2. The distribution in the myocardium of cardioplegic solution was demonstrated with the aid of methylene blue staining in the subgroups of B-l, B-2, B-3, and B-4, and they were the groups treated by papaverine, nitroglycerin, nitroprusside, and hydralazine in their grouping order. The best result was obtained from the subgroup B-1 [papaverine]. The subgroup B-2 [nitroglycerin] was next. The subgroup B-3 [nitroprusside] was moderate in finding of the colorization. The subgroup B-4 [hydralazine] was the poorest in the distribution of the cardioplegic solution in the myocardium. From these results, it appeared that myocardial protection during ischemic arrest for open heart surgery could be enhanced considerably when coronary dilatation was assured.

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Falls Risk Factors of Inpatients (입원환자의 낙상 위험 예측 요인)

  • Kim, Eun-Kyung;Lee, Jae-Chang;Eom, Mi-Ran
    • Journal of Korean Academy of Nursing
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    • v.38 no.5
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    • pp.676-684
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    • 2008
  • Purpose: The purpose of this study was to identify the risk factors for falls and to suggest data for developing a program for preventing falls. Methods: This was a case-control study in five university hospitals and a general hospital. In total, 216 patients over the age of 18 yr admitted from January 1 to December 31, 2007 participated. One hundred eight patients with experience of falling were matched by gender, age level, diagnosis, and length of stay with 108 patents with no experience of falling admitted on the same unit. A quality assurance coordinator nurse in each hospital examined 35 fall risk factors developed by researchers. Results: In acute hospitals, history of falls, orientation ability, dizziness or vertigo, general weakness, urination problems, transfer/mobility difficulty, walking dependency, impatience, benzodiazepines, diuretics, and vasodilators showed significance on adjusted-odds ratios for fall. Logistic regression analysis was performed to elucidate the factors that influence falls. The probability of falls was increased by dizziness/vertigo, general weakness, and impatience/agitation. Conclusion: This finding can be used as a useful resource in developing nursing intervention programs to predict and prevent the falls of inpatients.