Coupling of Central Venous Pressure and Intracranial Pressure in a 6-Year-Old Patient With Fontan Circulation and Intracranial Hemorrhage

2011 ◽  
Vol 91 (5) ◽  
pp. 1611-1613 ◽  
Author(s):  
Clara Kurishima ◽  
Masayo Tsuda ◽  
Yuko Shiima ◽  
Masashi Kasai ◽  
Seiki Abe ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Central Venous Pressure ◽  
Intracranial Hemorrhage ◽  
Venous Pressure ◽  
Fontan Circulation ◽  
Central Venous

scholarly journals Prospective Study of Central Venous Pressure Trends during Major Neurosurgical Procedures in an Elective Operation Theatre Setting of a Tertiary Care Centre

2021 ◽  
Vol 8 (07) ◽  
pp. 369-373
Author(s):  
Rajeev Damodaran Sarojini ◽  
Sanjay Sahadevan ◽  
Jayakumar Christhudas
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Prospective Study ◽  
Central Venous Pressure ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Ultra Sound ◽  
Neurosurgical Procedures ◽  
Central Venous ◽  
Intraoperative Period

BACKGROUND There are extensive variations in central venous pressure during intraoperative period of a major neurosurgical patients. Monitoring of central venous pressure is vital for guiding the administration of fluids, blood and blood products. Central venous pressure (CVP) also measures the intracranial pressure indirectly. Increased intracranial pressure thereby reduces the cerebral blood flow, leading to cerebral ischemia. METHODS This is a prospective study where 25 major neurosurgical cases posted for elective major neurosurgery were selected. Right subclavian vein was selected for cannulation, by blind technique in all these cases. CVP was recorded every 15 minutes. Central venous catheter was connected to a pressure transducer linked to a multichannel monitor; zeroing was done and the CVP reading obtained. RESULTS Central venous pressure reading was done serially and showed the trends in haemodynamics in various stages of surgery. Initial intraoperative periods showed lower values due to intravenous (I / V) induction of anaesthesia, use of mannitol and diuretics. Later on, the trends changed to higher side subsequent to administration of fluids and blood as required. CONCLUSIONS Monitoring of CVP is an important component of haemodynamic monitoring along with non-invasive blood pressure (NIBP), intra-arterial blood pressure (IABP), and urine output. Central venous pressure can be used to aspirate an air embolism occurring during the intraoperative period after employing Durant’s position. KEYWORDS CVP, NIBP , USS – Ultra Sound Scan, IVC – Inferior Vena Cava, IVCCI – Inferior Vena Cave Collapsibility Index, PEEP – Positive End Expiratory Pressure, C / L – Central Line, IABP.

The bronchial cast syndrome after the Fontan procedure: further evidence of its etiology

2001 ◽  
Vol 11 (3) ◽  
pp. 345-351 ◽  
Author(s):  
Colin J. McMahon ◽  
Michael R. Nihill ◽  
Adele Reber
Keyword(s):  
Central Venous Pressure ◽  
Venous Pressure ◽  
Pulmonary Atresia ◽  
Fontan Circulation ◽  
Central Venous ◽  
Caval Vein ◽  
Superior Caval Vein ◽  
Hemodynamic Assessment ◽  
The Right ◽  
Bronchial Casts

We describe a three-year-old boy who presented with recurrent expectoration of bronchial casts six months following creation of a fenestrated lateral tunnel Fontan circulation for pulmonary atresia with intact ventricular septum. Cardiac catheterization demonstrated elevated central venous pressure with two areas of stenosis within the Fontan circuit, specifically at the junction of the right superior caval vein and the right pulmonary artery, and between the atrial baffle and the right superior caval vein. Insertion of Palmaz stents in these areas resulted in a reduction in central venous pressure, and a transient reduction in production of casts. Eight weeks after catheterization, however, he produced further casts, which resulted in hypoxia, respiratory arrest and death. We reviewed the autopsied specimens obtained from patients with the Fontan circulation over an eleven-year period at our institution in order to ascertain the prevalence of subclinical production of bronchial casts. We found no casts in the thirteen patients examined. Hemodynamic assessment is vital in all patients who develop this syndrome, and should be the primary focus of investigation, rather than solely directing efforts at lysis of casts.

Importance of dynamic central venous pressure in Fontan circulation

2018 ◽  
Vol 33 (6) ◽  
pp. 664-670 ◽  
Author(s):  
JeongHye Kim ◽  
Seiko Kuwata ◽  
Clara Kurishima ◽  
Yoichi Iwamoto ◽  
Hirotaka Ishido ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Venous Pressure ◽  
Fontan Circulation ◽  
Central Venous

Hemodynamic performance of the Fontan circulation compared with a normal biventricular circulation: a computational model study

2014 ◽  
Vol 307 (7) ◽  
pp. H1056-H1072 ◽  
Author(s):  
Fuyou Liang ◽  
Hideaki Senzaki ◽  
Clara Kurishima ◽  
Koichi Sughimoto ◽  
Ryo Inuzuka ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Venous Pressure ◽  
Fontan Circulation ◽  
Patient Specific ◽  
Model Parameters ◽  
Ventricular Contractility ◽  
Central Venous ◽  
Hemodynamic Performance

The physiological limitations of the Fontan circulation have been extensively addressed in the literature. Many studies emphasized the importance of pulmonary vascular resistance in determining cardiac output (CO) but gave little attention to other cardiovascular properties that may play considerable roles as well. The present study was aimed to systemically investigate the effects of various cardiovascular properties on clinically relevant hemodynamic variables (e.g., CO and central venous pressure). To this aim, a computational modeling method was employed. The constructed models provided a useful tool for quantifying the hemodynamic effects of any cardiovascular property of interest by varying the corresponding model parameters in model-based simulations. Herein, the Fontan circulation was studied compared with a normal biventricular circulation so as to highlight the unique characteristics of the Fontan circulation. Based on a series of numerical experiments, it was found that 1) pulmonary vascular resistance, ventricular diastolic function, and systemic vascular compliance play a major role, while heart rate, ventricular contractility, and systemic vascular resistance play a secondary role in the regulation of CO in the Fontan circulation; 2) CO is nonlinearly related to any single cardiovascular property, with their relationship being simultaneously influenced by other cardiovascular properties; and 3) the stability of central venous pressure is significantly reduced in the Fontan circulation. The findings suggest that the hemodynamic performance of the Fontan circulation is codetermined by various cardiovascular properties and hence a full understanding of patient-specific cardiovascular conditions is necessary to optimize the treatment of Fontan patients.

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