Artificial Intelligence ; Hemodynamic Monitoring

Artificial Intelligence ; Hemodynamic Monitoring

49 healthy people without the cardiovascular diseases and cerebral pathology with ages of 17-84, divided 3 groups participated to a study. The results have shown that the maximal and medial speed of the major cerebravascular was gradually reduced as increase of age. The highest reduction of speed found in the vascular in the medial brain, followed by anterior, posterior, basal brain and at last of spine. There is no different between vascular and ages in the speed indicators in the healthy persons.
Hemodynamic Phenomena ; Ultrasonography, Doppler, Transcranial ; Ultrasonics ; Ultrasonography

Increased or decreased pulmonary blood flow (PBF) and an increased pulmonary vascular resistance (PVR), represent common and important change in pulmonary hemodynamics. In this study, we constructed 3 hemodynamic models in 5 dogs, that is, an increased and a decreased PBF model, and an increased PVR model. A CT perfusion scan was performed in each hemodynamic model. Perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT), and maximal slope (MS) were calculated automatically by specialized software and analyzed for changes according to hemodynamic status. In terms of the normal state, blood flow was affected by gravity and dependent area showed higher BF and BV and lower MS and MTT than the non-dependent area. The decreased PBF model showed a significant increase in BF and MS (p=0.046, 0.005) but no significant change in BV (p > 0.05), and a slight elongation of MTT (p > 0.05) versus the normal state. The increased PBF model showed a slightly increased BV and a slightly decreased MTT (p > 0.05). The increased PVR model showed significant reduction in BF, BV, and MS (p < 0.000, 0.007, 0.000) and a slight increase in MTT, but without statistical significance (p > 0.05). However, it was noticeable that the distribution of MTT with respect to gravity in the normal lung was completely reversed in the increased PVR model. In conclusion, based on our understanding of perfusion characteristic in normal state, abnormal regional hemodynamic changes in the lung can be detected and evaluated. Predicting changes in pulmonary vascular resistance should be possible by a thorough analysis of CT perfusion parameters.
Animals ; Dogs ; *Hemodynamic Phenomena ; *Pulmonary Circulation ; *Radiography, Thoracic ; *Tomography, X-Ray Computed

BACKGROUND: Hyperdynamic circulation due to reduced peripheral vascular resistance and increased cardiac output, and the development of portal hypertension are the hemodynamic changes observed in patients with liver cirrhosis. Such hemodynamic abnormalities appear in patients with late stage liver cirrhosis. Therefore, hemodynamic indices, which represent hyperdynamic circulation and portal hypertension, are significant for the prognosis of patients with liver cirrhosis. The aim of this study was to determine the hemodynamic indices associated with the prognosis of patients with liver cirrhosis. METHODS: A total of 103 patients diagnosed with liver cirrhosis between December 1999 and June 2003, with a mean follow-up period of 73 weeks, ranging from 7 to 168 weeks, were recruited. Using Child-Pugh classification, the mean arterial pressure, heart rate and hepatic venous pressure gradient (HVPG) were measured. The indices of Doppler ultrasonography, including the portal and splenic venous flows, and the resistance of the hepatic, splenic, and renal arteries were also measured using the arterial pulsatility index (PI). The prognostic values of these indices were determined by their comparison with the patient survivals. RESULTS: Significant hemodynamic indices for a bad prognosis were high HVPG (> or=15 mmHg) and renal arterial PI (> or=1.14) (p< 0.05). A Child-Pugh score > or=10 was important for a poor prognosis (p< 0.05). CONCLUSION: Severe portal hypertension (HVPG> or=15 mmHg) and high renal arterial resistance (PI> or=1.14) were valuable hemodynamic indices for the prognosis of patients with liver cirrhosis. Therefore, it was concluded that the measurement of these hemodynamic indices, in addition to the Child-Pugh classification, is helpful in the prognosis of patients with liver cirrhosis.
Female ; *Hemodynamic Processes ; Humans ; Korea/epidemiology ; Liver Cirrhosis/*mortality/*physiopathology ; Male ; Middle Aged ; Prognosis ; Survival Rate

BACKGROUND: Cisatracurium , an R-cis, R-cis isomer of atracurium, is a benzoquinolinium non-depolarizing muscle relaxant with intermediate duration of action that has the advantage of minimal histamine release compared to the parent compound atracurium. Similar studies have described cisatracurium to have cardiovascular stability up to 7 times the ED95 dose. However, few have been conclusive owing to concomitant use of agents that can cause potential histamine release and hemodynamic effects. This study was specifically designed to minimize these variables. The promise of the clinical advantages of the use of cisatracurium merits investigation against its parent compound atracurium in the Filipino population especially in terms of hemodynamic stability when utilized intraoperatively. The study was conducted to evaluate the onset of action, conditions for intubation, duration of neuromuscular block and side effects of cisatracurium compared to atracurium among Filipino surgical patients METHODOLOGY: A prospective, randomized, double-blind study was performed in eighty one (81) healthy patients of ASA Physical Status 1 and 2 undergoing elective surgical procedures treated with either 0.15 mg/kg cisatracurium (3 x ED 95) n=39 or 0.5 mg/kg atracurium (3 x ED 95) n=42 administered over 5 seconds intravenous bolus under adequate anesthesia, before surgical stimulation. We compared the time course of the neuromuscular block and determined whether the muscle relaxants caused cutaneous and systemic evidence of histamine release. Induction of general anesthesia commenced with the use of propofol-fentanyl in oxygen. Stabilization of the Neuromuscular junction was achieved prior to the administration of the muscle relaxants with the use of tetanic stimulation of 50 Hz; for 5 seconds followed by single twitch stimuli for 2 minutes. Neuromuscular transmission was assessed by recording the mechanical twitch response to train-of-four nerve stimulations every 10 seconds. Cutaneous manifestations, blood pressures and heart rates were recorded periodically. RESULTS: Time to 95 percent block were 77.09-155.99 seconds with cisatracurium. and 64.60 - 128.21 seconds with atracurium. The administration of either muscle relaxant resulted in complete neuromuscular block in all patients providing good to excellent intubating conditions. The time to spontaneous recovery (T4:T1 ratio 80 percent) were noted to be within the range of 63.48 - 103.48 minutes for cisatracurium whereas those treated with atracurium recovered within the range of 74.76 - 92.64 minutes and none necessitated reversal from the muscle relaxants. One patient from the cisatracurium group and two from the atracurium group were noted to have cutaneous flush. CONCLUSION: When given a dose of 3 x ED 95, except for onset, cisatracurium group did not differ significantly from the atracurium group with regard to onset, duration, intubating conditions, and hemodynamic stability.
Human ; Middle Aged ; Adult ; Young Adult ; Adolescent ; INTUBATION ; HEMODYNAMIC ; ANESTHESIA ; CISATRACURIUM ; ATRACURIUM ; HISTAMINE ; MUSCLE RELAXANTS, CENTRAL

This case report is about a four year old boy diagnosed since birth to have TOF. He had a co-existing cerebral infarct secondary to a cerebrovascular accident that occurred at age 3 years. Lately, he was manifesting signs and symptoms of increasing intracranial pressure secondary to brain abscess. The challenge posed is the frequent occurrence of hypercyanotic spells in this patient. How the anesthesiologist circumvented a severe case of intraoperative "tet" spells is hereby presented.
Human ; Male ; Child Preschool ; SURGERY ; ANESTHESIOLOGISTS ; INTRACRANIAL PRESSURE ; TETRALOGY OF FALLOT ; HEMODYNAMIC ; PEDIATRICS ; PHENYLEPHRINE

This discussion will focus on non-narcotic adjuvants to regional anaesthesia. Specifically, this paper will explore the use of alpha-2-adrenergic agonists (i.e. clonidine), anticholinestease (neostigmine) and a phencyclidine (ketamine) combined with local anaesthetics for regional and peripheral nerve blocks or used systematically to enhanced analgesia from local anaesthetic techniques. The spinal gaba- ergic system (i.e. midazolam) is primarily an inhibitory system. Enhancing inhibition is an exciting mechanism that is being explored at the present time, and is not discussed in this paper.
ANESTHESIA ; PAIN ; ANALGESIA ; HEMODYNAMIC ; ANESTHESIA, CONDUCTION ; CLONIDINE ; KETAMINE ; NEOSTIGMINE ; ANESTHETICS, LOCAL

We report a hemodynamical assessment of the blood turnover pattern as well as the imaging of cavernous hemangioma in a cavernous sinus using time-resolved contrast enhanced 2D projection MRA, also known as MR-DSA, and conventional digital subtraction angiography (DSA), before and after radiotherapy. MR-DSA showed very fast dynamical images of a contrast turnover pattern and was well matched with the findings obtained from DSA. MR-DSA is a non-invasive study, and can replace DSA in examining a vascular tumor for the initial work-up and follow-up examination.
Angiography, Digital Subtraction/*methods ; Cavernous Sinus/*radiography ; Female ; Hemangioma, Cavernous/*radiography ; *Hemodynamic Processes ; Human ; Magnetic Resonance Angiography ; Middle Aged

BACKGROUND: The timing principle entails administration of a single bolus of non-depolarizing muscle relaxant, followed by an induction agent at the onset of neuromuscular blockade. Three different mivacurium dose regimens were compared to determine its safety and efficacy for rapid tracheal intubation in Filipinos METHODS: Sixty ASA I or II patients, 20-65 years old, surgery requiring orotracheal intubation were randomly allocated into three groups. Group I received 0.20 mg/kg, Group II 0.25 mg/kg, and Group III 0.30 mg/kg mivacurium over for twenty seconds. At the onset of 3-5 percent change in TOF, considered as the onset time, anesthesia was induced with thiopental at 5 mg/kg; laryngoscopy was accomplished at 95 percent neuromuscular blockade. Intubating conditions were assessed according to the Copenhagen Consensus Conference CCC rating scale RESULTS: The mean onset times for Groups I to III were 64.5 +/- 16.6 seconds, 47.5 +/- 10.8 seconds and 21.5 +/- 7.96 respectively, while the time to 95 percent blocks were 85.5 +/- 30.7 seconds, 57.8 +/- 9.8 seconds, and 35.0 +/- 9.9 seconds. Intubating conditions were either good or excellent in all patients. All patients were satisfied with the manner of induction of anesthesia CONCLUSION: Mivacurium at a dose of 0.3 mg/kg using the timing principle consistently provided good to excellent intubating conditions, 35-45 seconds after induction of anesthesia and is an acceptable alternative to succinylcholine for rapid tracheal intubation. (Author)
Human ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; INTUBATION, TRACHEAL ; ANESTHESIA ; LARYNGOSCOPY ; HEMODYNAMIC ; SUCCINYLCHOLINE ; MIVACURIUM ; NEUROMUSCULAR BLOCKADE