Estimation of splanchnic blood flow by the Fick principle in man and problems in the use of indocyanine green

1995 ◽  
Vol 30 (1) ◽  
pp. 106-112 ◽  
Author(s):  
A Uusaro
2016 ◽  
Vol 125 (2) ◽  
pp. 304-312 ◽  
Author(s):  
Sayako Itakura ◽  
Kenichi Masui ◽  
Tomiei Kazama

Abstract Background Rapid fluid infusion resulting in increased hepatic blood flow may decrease the propofol plasma concentration (Cp) because propofol is a high hepatic extraction drug. The authors investigated the effects of rapid colloid and crystalloid infusions on the propofol Cp during target-controlled infusion. Methods Thirty-six patients were randomly assigned to 1 of 3 interventions (12 patients per group). At least 30 min after the start of propofol infusion, patients received either a 6% hydroxyethyl starch (HES) solution at 24 ml·kg−1·h−1 or acetated Ringer’s solution at 24 or 2 ml·kg−1·h−1 during the first 20 min. In all groups, acetated Ringer’s solution was infused at 2 ml·kg−1·h−1 during the next 20 min. The propofol Cp was measured every 2.5 min as the primary outcome. Cardiac output, blood volume, and indocyanine green disappearance rate were determined using a pulse dye densitogram analyzer before and after the start of fluid administration. Effective hepatic blood flow was calculated as the blood volume multiplied by the indocyanine green disappearance rate. Results The rapid HES infusion significantly decreased the propofol Cp by 22 to 37%, compared to the Cp at 0 min, whereas the rapid or maintenance infusion of acetate Ringer’s solution did not decrease the propofol Cp. Rapid HES infusion, but not acetate Ringer’s solution infusion, increased the effective hepatic blood flow. Conclusions Rapid HES infusion increased the effective hepatic blood flow, resulting in a decreased propofol Cp during target-controlled infusion. Rapid HES infusion should be used cautiously as it may decrease the depth of anesthesia.


2011 ◽  
Vol 4 (04) ◽  
pp. 212-217 ◽  
Author(s):  
Michel Court-Payen ◽  
Aram Ter Minassian ◽  
Niels Olsen ◽  
Inge Kanstrup ◽  
Claude Dubray ◽  
...  

Shock ◽  
2004 ◽  
Vol 21 ◽  
pp. 3-4
Author(s):  
M. A. Choudhry ◽  
Z. F. Ba ◽  
S. Rana ◽  
I. H. Chaudry

Perfusion ◽  
2021 ◽  
pp. 026765912110559
Author(s):  
Hoong Lim

Extracorporeal membrane oxygenation (ECMO) can be delivered in veno-arterial (VA) and veno-venous (VV) configurations based on the cannulation strategy. VA and VV ECMO are delivered primarily for haemodynamic and respiratory support in patients with severe heart and lung failure, respectively. The Fick principle describes the relationship between blood flow and oxygen consumption – key parameters in the physiological management of extracorporeal support. This review will discuss the application of the Fick principle in: (i) recirculation in VV ECMO; (ii) the quantification of oxygen delivery (DO2) in VV ECMO and (iii) the quantification of transpulmonary blood flow and systemic arterial oxygen saturation in VA ECMO.


2017 ◽  
Vol 313 (4) ◽  
pp. L651-L658 ◽  
Author(s):  
John B. West

The early history of cardiac catheterization has many interesting features. First, although it would be natural to assume that the procedure was initiated by cardiologists, two of the three people who shared the Nobel Prize for the discovery were pulmonologists, while the third was a urologist. The primary objective of the pulmonologists André Cournand and Dickinson Richards was to obtain mixed venous blood from the right heart so that they could use the Fick principle to calculate total pulmonary blood flow. Cournand’s initial catheterization studies were prompted by his reading of an account by Werner Forssmann, who catheterized himself 12 years before. His bold experiment was one of the most bizarre in medical history. In the earliest studies that followed, Cournand and colleagues first passed catheters into the right atrium, and then into the right ventricle, and finally, the pulmonary artery. At the time, the investigators did not appreciate the significance of the low vascular pressures, nor that what they had done would revolutionize interventional cardiology. Within a year, William Dock predicted that there would be a very low blood flow at the top of the upright lung, and he proposed that this was the cause of the apical localization of pulmonary tuberculosis. The fact that the pulmonary vascular pressures are very low has many implications in lung disease. Cardiac catheterization changed the face of investigative cardiology, and its instigators were awarded the Nobel Prize in 1956.


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