• Title/Summary/Keyword: central blood pressure

Search Result 206, Processing Time 0.025 seconds

Effects of changing position on cardiac output & on patient's discomforts after cardiac surgery (개심술을 받은 환자의 체위에 따른 심박출량 및 불편감에 관한 연구)

  • Yu Mi;Kwon Eun-Ok;Choi Yun-Kyoung;Kang Hyun-Ju;Oh Se-Eun
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.7 no.2
    • /
    • pp.256-270
    • /
    • 2000
  • Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows : 1) Changes in cardiac output were absent in different angle positions, 0, 30. 45 degrees(F=.070, P=.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(P>.05). 2) Changes in central venous pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(P>.05), diastolic PAP(P>.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(P>.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.

  • PDF

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs

  • Oliveira, Marilia Teresa de;Feranti, Joao Pedro Scussel;Coradini, Gabriela Pesamosca;Chaves, Rafael Oliveira;Correa, Luis Felipe Dutra;Linhares, Marcella Teixeira;Thiesen, Roberto;Silva, Marco Augusto Machado;Brun, Mauricio Veloso
    • Journal of Veterinary Science
    • /
    • v.22 no.3
    • /
    • pp.44.1-44.15
    • /
    • 2021
  • Background: Intraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes. Objectives: The aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy. Methods: Twenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg-1·h-1 of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure. Results: All animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg-1·h-1), differing from the G20 group (2.17 ± 0.52 mL·kg-1·h-1) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61℃) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017). Conclusions: The use of lactated Ringer's solution at the rate of 10 mL·kg-1·h-1 seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg-1·h-1 rates of infusion.

Effects of Intracerebroventricular TFMPP on Rabbit Renal Function (뇌실내 TFMPP가 가토신장기능에 미치는 효과)

  • Lim, Young-Chai;Choi, Johng-Bom;Kim, Kyung-Keun;Kook, Young-Johng
    • The Korean Journal of Pharmacology
    • /
    • v.28 no.2
    • /
    • pp.137-146
    • /
    • 1992
  • The central tryptaminergic system has been shown to play an important role in the regulation of renal function: $5-HT_1$ receptor mediate diuresis and natriuresis, whereas both $5-HT_2$ and $5-HT_3$ mediate antidiuresis and antinatriuresis. Recently, $5-HT_1$ receptors are further subdivided into many subtypes, and central $5-HT_{1A}$ subtype was shown to mediate diuretic and natriuretic effects. The present study was undertaken to delineate the role of $5-HT_{1B}$ subtype. Trifluoromethylphenylpiperazine (TFMPP), a selective $5-HT_{1B}$ agonist in doses ranging from 8 to $750\;{\mu}g/kg$ icv elicited diuresis, natriuresis and kaliuresis in dose-dependent fashion, with the fractional excretion of filtered Na reaching 5.44% with $250\;{\mu}g/kg$ icv. The natriuresis outlasted the transient increases in renal hemodynamics, suggesting humoral mediation in the decreased tubular Na reabsorption. Plasma concentration of atrial natriuretic peptide increased along with the natriuresis. Systemic blood pressure transiently increased. When given intravenously, no diuresis and natriuresis was elicited, indicating the central mechanism. The icv TFMPP effects were not significantly affected by icv methysergide, a nonselective $5-HT_1$ blocker. Both ketanserin and MDL 72222, selective $5-HT_2$ and $5-HT_3$ antagonists, resp., did not abolish the TFMPP effects. Nor did NAN-190, $5-HT_{1A}$ blocker, affect the TFMPP effects. These observations suggest that central $5-HT_{1B}$ receptors may play a role in the central regulation of renal function by exerting diuretic and natriuretic influences, mainly through natriuretic factors.

  • PDF

The Effect and Safety of Alveolar Recruitment Maneuver using Pressure-Controlled Ventilation in Acute Lung Injury and Acute Respiratory Distress Syndrome (급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성)

  • Chung, Kyung Soo;Park, Byung Hoon;Shin, Sang Yun;Jeon, Han Ho;Park, Seon Cheol;Kang, Shin Myung;Park, Moo Suk;Han, Chang Hoon;Kim, Chong Ju;Lee, Sun Min;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
    • /
    • v.63 no.5
    • /
    • pp.423-429
    • /
    • 2007
  • Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of $30cmH_2O$ and a PEEP of $20cmH_2O$ in a 2-minute PCV mode. The venous $O_2$ saturation, central venous pressure, blood pressure, pulse rate, $PaO_2/FiO_2$ ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean $PaO_2/FiO_2$ ratio was 130.3 before RM. The $PaO_2/FiO_2$ ratio increased by 45% after alveolar RM. The $PaO_2/FiO_2$ ratio reached a peak 60 minutes after alveolar RM. The Pa$CO_2$ increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.

General Pharmacology of DA-8159, a New Pyrazolopyrimidinone Derivative (새로운 피라졸로피리미디논 유도체 DA-8159의 일반약리작용)

  • 오태영;김동환;손문호;김동성;안병옥;김순회;김원배
    • Biomolecules & Therapeutics
    • /
    • v.11 no.1
    • /
    • pp.41-50
    • /
    • 2003
  • General pharmacological properties of DA-8159, a new pyrazolopyrimidinone derivative were examined in laboratory animals to investigate its safety profile. The oral administration of DA-8159 (1, 5 or 30 mg/kg) in mice and rats had no effect on general behaviors and central nervous system of the animals in test systems, such as hexobarbital-induced sleeping time, motor coordination, normal body temperature, writhing syndromes induced by 0.75% acetic acid solution, chemo-shock produced by pentetrazole solution and rotar rod test. Anesthetized cats treated intravenously with DA-8159 (0.1, 0.3, 1, 3 or 10 mg/kg) showed transient and mild decrease in blood pressure. However, heart rate, respiration rate and tidal volume were not changed by intravenous DA-8159. In the isolated organs including ileum, heart (sinus rate of atria and contractility of papillary muscle), trachea of guinea pigs and phrenic nerve of rats, DA-8159 ($10^{-8}$$10^{-5}$ mg/L) did not elicit any effect or inhibitory action on the chemically or electrically stimulated contraction. DA-8159 did not influence gastric secretion, pH and total acid output in rats and intestinal propulsion in mice. The administration of DA-8159 in rats had no effect on the platelet aggregation induced by ADP in rabbit plasma, urinary volume and electrolyte ion ($Na^{+}$, $K^{+}$, $Cl^{-}$) excretion in rats. Prothrombin time (PT) of the rats showed a mild but significant increase after administration of DA-8159. Activated partial thromboplastin time (APTT), however, was not affected by DA-8159. These results indicate that DA-8159 does not exert any of serious pharmacological effects.

Influence of Prostaglandin $F_{2{\alpha}}$ given intracerebroventricularly on the renal function of the rabbits (가토(家兎)의 신장기능(腎臟機能)에 미치는 측뇌실내(側腦室內) Prostaglandin $F_{2{\alpha}}$의 영향(影響))

  • Kook, Young-Johng;Ko, Kwang-Hoo
    • The Korean Journal of Pharmacology
    • /
    • v.12 no.2 s.20
    • /
    • pp.43-49
    • /
    • 1976
  • The facts that $PGE_2$ produced diuresis in the rabbit when given into a lateral ventricle of the brain and that $PGF_{2{\alpha}}$ is abundantly found in the brain prompted us to investigate the effects of $PGF_{2{\alpha}}$ introduced directly into the ventricle on the renal function. $PGF_{2{\alpha}}$ given intraventriculary in doses of $10{\mu}g\;and\;100{\mu}g$ elicited prompt diuresis, 10-fold increase of sodium excretion and two-fold increment of potassium excretion. Free water reabsorption also increased along with the increased osmolar clearance. Neither renal plasma flow nor glomerular filtration rate did change significantly. This, along with the fact that the percentage of reabsorbed sodium filtered decreased from 99.5 to 93.9, indicates the tubular site of the diuretic and natriuretic action. Atropine pretreatment did not influence the renal effects of intraventricular $PGF_{2{\alpha}}$. Intravenously administered $PGF_{2{\alpha}}$ in doses of 30 to $100{\mu}g$ did not produce any significant change in renal function. Intraventricular $PGF_{2{\alpha}}$ had no effect on the systemic blood pressure, whereas intravenous administration brought about a transient hypotension. These observations suggest that $PGF_{2{\alpha}}$ induces diuresis and natriuresis via central mechanism, that the site of the action resides in renal tubules, and that the reabsorption of sodium is inhibited in the proximal tubule, possibly through mediation of certain humoral agent. Overall, it is suggested that $PGF_{2{\alpha}}$ might play a roll in regulating renal function through the center.

  • PDF

Emerging Genomics Technologies in Nutritional Sciences: Applications to obesity and hypertension research

  • Mouss, Naima-Moustaid;Sumithra Urs;Kim, Suyeon;Heo, Young-Ran
    • Proceedings of the Korean Nutrition Society Conference
    • /
    • 2002.05a
    • /
    • pp.29-41
    • /
    • 2002
  • While the sequencing of several genomes was underway, several advanced techniques in genetics, molecular biology and protein chemistry emerged. Within the nutritional sciences, while the focus on nutrition education, epidemiology and public health aspects remains essential; it is crucial to incorporate the new advances in gene and protein discovery in nutritional studies. Nutrition is a discipline that has always integrated social, biochemical and physiological sciences from the studies at the molecule level to studies at the population level. For this reason, nutritionists are in a prime position to readily incorporate the current genomics approaches in nutrition research, All the available analytical techniques can and should be used in modern nutritional sciences. These include genetics, genomics, proteomics and metabolomics which also require integration and use of bioinformatics and computational methods for data analysis and management. These applications will be briefly reviewed with a primary focus on what the genomics and genetics approaches offer to nutritionists. We will use one of our research focus areas to illustrate uses of some of these applications in obesity-hypertension research. Our central hypothesis is that adipose tissue is an endocrine organ that plays a major role in obesity and related hypertension. We are primarily studying the renin angiotensin system (RAS). We provide evidence from our own studies and others for the paracrine as well as endocrine role of adipocyte-derived angiotensin II in adipocyte gene expression, adiposity and blood pressure regulation. Both cell culture studies as well as knockout and transgenic mice models are used to test our hypothesis. Genomics and proteomics technologies are currently developed to complement our physiological and molecular studies on the RAS and for a fine analysis of this system and its function in health and disease.

  • PDF

Effects of Kanagawa Hemolysin on Blood Pressure and Arterial Tone in Rats

  • Kim, Young-Moon
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.6 no.4
    • /
    • pp.225-233
    • /
    • 2002
  • Kanagawa hemolysin (KH), an exotoxin produced from Kanagawa phenomenon-positive Vibrio parahemolyticus, has been shown to possess various biological activities including hemolysis, enterotoxicity, cytotoxicity, and cardiotoxicity. The aim of this study was to investigate the effect of KH on the cardiovascular system and its mechanism, employing in vivo and in vitro experiments of the rat. Intracerebroventricular (icv) administration of 100 mHU KH produced a marked and continuous pressor effect (icv KH-pressor effect), and the icv pressor effect was not repeatable. However, intravenous (iv) injection of the same dose of KH induced a prominent depressor effect (iv KH-depressor effect). The icv KH-pressor effect was inhibited by acid-denaturation, while the iv KH-depressor effect was not. Simultaneous icv administration of the three agents (ouabain, diltiazem, or bumetanide: $10{\mu}g/kg$ each) significantly reduced the pressor effect. The icv KH-pressor effect was inhibited by treatment with iv phentolamine or chlorisondamine, but was not affected by iv candesartan. The iv KH-depressor effect was repeatable and was attenuated by treatment with iv NAME or methylene blue. In vitro experiments using isolated thoracic aorta, $10^{-6}$ M phenylephrine (PE) and 50 mM KCl produced a sustained contraction. In rings contracted with either agents, KH showed relaxant responses in a concentration- dependent fashion and the relaxation (KH-vasorelaxation) was not dependent on the existence of the endothelium. The KH-vasorelaxation in the endothelium-intact rings contracted by PE was abolished by methylene blue treatment. In summary, the present findings suggest that in the icv KH-pressor effect the cation leak-inducing action of KH is implicated, which leads to the increased central sympathetic tone, that the iv KH-depressor effect results from the vasorelaxation via NO-guanylate cyclase system, and that the KH-vasorelaxation is independent of the endothelium and the guanylate cyclase system is involved in it. In conclusion, the mechanism of KH producing the icv pressor effect may not be identical to that of KH producing the iv depressor effect.

Ginsenosides Have a Suppressive Effect on c-Fos Expression in Brain and Reduce Cardiovascular Responses Increased by Noxious Stimulation to the Rat Tooth

  • Jung, Ji-Yeon;Seong, Kyung-Joo;Moon, In-Ohk;Cho, Jin-Hyoung;Kim, Sun-Hun;Kim, Won-Jae
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.17 no.2
    • /
    • pp.121-125
    • /
    • 2013
  • The purpose of this study is to investigate the antinociceptive effects of ginsenosides on toothache. c-Fos immunoreactive (IR) neurons were examined after noxious intrapulpal stimulation (NS) by intrapulpal injection of 2 M KCl into upper and lower incisor pulps exposed by bone cutter in Sprague Dawley rats. The number of Fos-IR neurons was increased in the trigeminal subnucleus caudalis (Vc) and the transitional region between Vc and subnucleus interpolaris (Vi) by NS to tooth. The intradental NS raised arterial blood pressure (BP) and heart rate (HR). The number of Fos-IR neurons was also enhanced in thalamic ventral posteromedial nucleus (VPMN) and centrolateral nucleus (CLN) by NS to tooth. The intradental NS increased the number of Fos-IR neurons in the nucleus tractus solitarius (NTS) and rostral ventrolateral medulla (RVLM), hypothalamic supraoptic nucleus (SON) and paraventricular nucleus (PVN), central cardiovascular regulation centers. Ginsenosides reduced the number of c-Fos-IR increased by NS to tooth in the trigeminal Vc and thalamic VPMN and CLN. Naloxone, an opioid antagonist, did not block the effect of ginsenoside on the number of Fos-IR neurons enhanced by NS to tooth in the trigeminal Vc and thalamic VPMN and CLN. Ginsenosides ameliorated arterial BP and HR raised by NS to tooth and reduced the number of Fos-IR neurons increased by NS to tooth in the NTS, RVLM, hypothalamic SON, and PVN. These results suggest that ginsenosides have an antinociceptive effect on toothache through non-opioid system and attenuates BP and HR increased by NS to tooth.

Interactions between the $FTO$ rs9939609 polymorphism, body mass index, and lifestyle-related factors on metabolic syndrome risk

  • Baik, In-Kyung;Shin, Chol
    • Nutrition Research and Practice
    • /
    • v.6 no.1
    • /
    • pp.78-85
    • /
    • 2012
  • Whether the $FTO$ polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the $FTO$ rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the $FTO$ risk allele whose BMI is $29kg/m^2$ or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than $25kg/m^2$. In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the $FTO$ risk alleles who had BMI of $29kg/m^2$ or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.