• 대한의용생체공학회:의공학회지
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• 제36권5호
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• pp.183-190
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• 2015

Invasive blood pressure (IBP) is measured for the patient's real time arterial pressure (ABP) to monitor the critical abrupt disorders of the cardiovascular system. It can be used for the estimation of cardiac output and the opening and closing time detection of the aortic valve. Although the unexplained inflections on ABP make it difficult to find the mathematical relations with other cardiovascular parameters, the estimations based on ABP for other data have been accepted as useful methods as they had been verified with the statistical results among vast patient data. Previous windkessel models were composed with systemic resistance and vascular compliance and they were successful at explaining the average systolic and diastolic values of ABP simply. Although it is well-known that the blood pressure reflection from peripheral arteries causes complex inflection on ABP, previous models do not contain any elements of the reflections because of the complexity of peripheral arteries' shapes. In this study, to simulate a reflection wave of blood pressure, a new mathematical model was designed with four elements that were the impedance of aorta, the compliance of aortic arch, the peripheral resistance, and the compliance of peripheral arteries. The parameters of the new model were adjusted to have three types of arterial blood pressure waveform that were measured from a patient. It was used to find the relations between the inflections and other cardiovascular parameters such as the opening-closing time of aortic valve and the cardiac output. It showed that the blood pressure reflection can bring wide range errors to the closing time of aortic valve and cardiac output with the conventional estimation based on ABP and that the changes of one-stroke volumes can be easily detected with previous estimation while the changes of heart rate can bring some error caused by unexpected reflections.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2000년도 추계학술대회논문집B
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• pp.371-376
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• 2000

In this study, the computational method is presented to simulate the hemodynamics of the patients after the Fontan procedure. The short-term feedback control models are implemented to assess the hemodynamic responses of the patients exposed to the stresses such as gravitational effect or hemorrhage. To construct the base line of the Fontan model, we assume an increase in venous tone, in heart rates, and in systemic resistance that are based on the clinical observations. For the verification of the present method we simulate the LBNP (lower body negative pressure) test for the normal and the Fontan model and we compare these with experimental data. Computational results show that the diastolic ABP(arterial blood pressure) increases but the systolic ABP decreases during LBNP. The increase in heart rate is due to the control system activated by the decreased mean ABP and CVP(central venous pressure). In case of the Fontan model, the increased venous tone is the reason of the diminished CVP change during LBNP. We also simulate 20% hemorrhage stress to the patient after the Fontan procedure and these results are compared with the experimental and the existing computational one. Computational results on the hemodynamics of patients after the Fontan procedure show that the mean ABP and cardiac output decrease. Heart rate and systemic resistance increase to compensate for the decrease in ABP. The sensitivity analysis according to the conduit resistance is also presented to delineate the effects of the local blood flow resistance. The cardiac output decreases according to the increase of the conduit resistance. The 50% increase in the conduit resistance causes about 3% decrease of cardiac output.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.957-965
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• 2021

Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.

• Archives of Pharmacal Research
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• 제24권1호
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• pp.64-68
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• 2001

Endothelin-1 (ET-1 ), a novel and potent vasoconstrictor in blood vessel, is known to have some functions in the rat central nervous system (CNS), In order to investigate the central functions of ET-1 , ET-1 was administered to the periaqueductal gray area (PAC) of anesthetized rats to induce barrel rolling and increase the arterial blood pressure (ABP). ET-1 had a modulatory effect on central cardiovascular and behavioral control. The selective N-methyl-D-aspartate (NMDA) receptor antagonist MK-801 (3${u}m/ol/kg$, i.p.) blocked the ET-1 induced responses, and both the nitric oxide synthase (NOS) inhibitor L-NAME (N-nitro-L-arginine mIThyl-ester 1 nmol/rat) and the nitric oxide (NO) scavenger hemoglobin (15 nmol/rat) had similar effects in redtAcing the IT-1 (10 pmol/rat)-induced behavioral changes and ABP elevation. However, NO donor sodium nitroprusside (SNP 10${u}g$, 1${u}g/rat$) decreased the ET-1 induced ABP elevation, and recovered the ET-1 -induced barrel rolling effect that was reduced by MK-801. These results suggest that ET-1 might have neuromodulatory functions such as ABP elevation and barrel rolling induction in the PAG of the rats via the NMDA receptor and NO.