Effect of Hydraulic Expansion on Arteriovenous Fistula of Hemodialysis Patients

2019 ◽  
Author(s):  
Wanjun Ren ◽  
Yuejuan Du ◽  
Huili Jiang ◽  
Dongmei Xu
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Stroke Volume ◽  
Arteriovenous Fistula ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Secondary Patency ◽  
Conventional Surgery ◽  
Surgery Group ◽  
The Mean

Background Chronic kidney disease has become a serious public health problem in China. Our study is to explore effect of hydraulic expansion on arteriovenous fistula (AVF) of hemodialysis patients. Methods A total of 190 patients with end-stage renal disease (ESRD) were randomly divided into hydraulic expansion group (n = 117) and conventional surgery group (n = 73). Age, sex, the cause of ESRD, height, weight, body mass index (BMI), blood pressure, and diameter of artery and vein from ultrasonography before surgery from patients were recorded. Doppler ultrasonography of vessel was performed with a 12-MHz scanning probe for vascular measurements. The time of first cannulation was recorded. Primary and secondary patency rates were compared between the two groups. Results The mean arterial pressure for this cohort of patients was around 98.12 mm Hg. The mean diameters of artery and vein ready for anastomoses measured by ultrasonography before surgery were 1.96 and 2.04 mm, respectively. Age, weight, BMI, sex ratio, the cause of renal failure, history of catheter insertion, mean arterial pressure, frequency of hemodialysis, blood flow of hemodialysis, and the mode of anastomoses of AVF in conventional surgery group were similar to hydraulic expansion group. There were no differences in stroke volume of radius arterial and venous pressure before dilation between the two groups. The stroke volume of radius artery increased significantly after hydraulic expansion than before dilation and control group. The primary patency rates of AVF in patients with hydraulic expansion were higher significantly than conventional surgery group. The secondary patency rates in conventional surgery group were not different from hydraulic expansion group. Conclusion Hydraulic expansion showed no difference from conventional surgery in complication after operation, and could decrease the time reliance on catheters and the risk of catheter-related infection, thrombosis, and decrease the related medical care costs.

scholarly journals Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

Effects of N-acetylcysteine on arterial neo-intimal hyperplasia in rat model of arteriovenous fistula

2018 ◽  
Vol 20 (2) ◽  
pp. 190-194
Author(s):  
Amirmohsen Jalaeefar ◽  
Arash Mohammadi Tofigh ◽  
Atoosa Gharib ◽  
Mohsen Khandaghy ◽  
Mohammad Reza Rahimi
Keyword(s):  
Arteriovenous Fistula ◽  
Rat Model ◽  
Intimal Hyperplasia ◽  
Intima Media Thickness ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Clinical Issue ◽  
Significant Difference ◽  
Hematoxylin And Eosin ◽  
The Mean

Introduction: Arteriovenous fistula is the best choice for vascular access in hemodialysis patients. However, arteriovenous fistula dysfunction is a major clinical issue. The most common cause of arteriovenous fistula failure is intimal hyperplasia. In this study, we have investigated the effect of N-acetylcysteine on neo-intimal hyperplasia after arteriovenous fistula creation in rats. Methods: This study was conducted in 24 rats which were randomly divided into two groups: control and N-acetylcysteine groups. An end-to-side anastomosis was made between the femoral artery and vein. The control group received distilled water intraperitoneally while the animals in N-acetylcysteine group received 300 mg/kg/day of N-acetylcysteine via the same route. After 28 days, the thickness of intima and media was measured using hematoxylin and eosin. Results: There was no significant difference between the two groups regarding age ( p = 0.6) and weight ( p = 0.1). The mean intima thickness in N-acetylcysteine group was significantly less than control group (17 ± 20 and 119 ± 46 µm, respectively; p < 0.001). The mean intima/media thickness in the N-acetylcysteine group was significantly less than control group (0.5 ± 0.63 vs 2.05 ± 1.17 µm; p < 0.001). Conclusion: N-acetylcysteine is effective in inhibiting neo-intimal hyperplasia in a rat model of arteriovenous fistula.

scholarly journals The evolution of mean arterial pressure in critically ill patients on vasopressors before and during a trial comparing a specific mean arterial pressure target to usual care

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie-Hélène Masse ◽  
Neill K. J. Adhikari ◽  
Xavier Théroux ◽  
Marie-Claude Battista ◽  
Frédérick D’Aragon ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Usual Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Hypertension ◽  
The Mean ◽  
Change In Mean

Abstract Background In randomized clinical controlled trials, the choice of usual care as the comparator may be associated with better clinician uptake of the study protocol and lead to more generalizable results. However, if care processes evolve to resemble the intervention during the course of a trial, differences between the intervention group and usual care control group may narrow. We evaluated the effect on mean arterial pressure of an unblinded trial comparing a lower mean arterial pressure target to reduce vasopressor exposure, vs. a clinician-selected mean arterial pressure target, in critically ill patients at least 65 years old. Methods For this multicenter observational study using data collected both prospectively and retrospectively, patients were recruited from five of the seven trial sites. We compared the mean arterial pressure of patients receiving vasopressors, who met or would have met trial eligibility criteria, from two periods: [1] at least 1 month before the trial started, and [2] during the trial period and randomized to usual care, or not enrolled in the trial. Results We included 200 patients treated before and 229 after trial initiation. There were no differences in age (mean 74.5 vs. 75.2 years; p = 0.28), baseline Acute Physiology and Chronic Health Evaluation II score (median 26 vs. 26; p = 0.47) or history of chronic hypertension (n = 126 [63.0%] vs. n = 153 [66.8%]; p = 0.41). Mean of the mean arterial pressure was similar between the two periods (72.5 vs. 72.4 mmHg; p = 0.76). Conclusions The initiation of a trial of a prescribed lower mean arterial pressure target, compared to a usual clinician-selected target, was not associated with a change in mean arterial pressure, reflecting stability in the net effect of usual clinician practices over time. Comparing prior and concurrent control groups may alleviate concerns regarding drift in usual practices over the course of a trial or permit quantification of any change.

Hemodynamic impact of VASQ device in vascular access creation

2020 ◽  
pp. 112972982098315
Author(s):  
Roberto Palumbo ◽  
Sara Dominijanni ◽  
Alessia Centi ◽  
Gabriele D’Urso ◽  
Paola Tatangelo ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Complication Rate ◽  
Neointimal Hyperplasia ◽  
Arterial Flow ◽  
Control Group ◽  
Secondary Patency ◽  
Arteriovenous Fistulae ◽  
The Mean ◽  
The Impact

Background: Native arteriovenous fistula is the preferred vascular access in term of functionality, efficiency and complication rate. Nevertheless, research continues to seek strategies to reduce the risk of neointimal hyperplasia and hemodynamic modification. The aim of the study was to evaluate the impact on hemodynamic of the VasQ device in arteriovenous fistulae creation. Methods: The analysis included patients who underwent to fistula creation with or without implantation of the VasQ device between May and September 2019. The hemodynamic parameters were evaluated pre-operatively and at a follow-up of 1, 3, 6 months. The patency and complication rate were evaluated. Results: Fifteen VasQ devices were implanted during 30 arteriovenous fistula surgery. The baseline patients features were similar between groups (VasQ treated/control). At baseline, preoperative arterial flow was similar; radial artery diameter at surgical site was 3.4 ± 0.8 mm in treated and 2.8 ± 0.5 mm in the control group. The mean arterial flow at 1 month was 480 ± 210 mL/min in treated and 561 ± 27 mL/min in the control group. At 3 months the mean arterial flow in treated was 645 ± 143 mL/min versus 824 ± 211 mL/min ( p = 0.02) in the control group; at 6 months the arterial flow was 714 ± 146 mL/min versus 810 ± 194 mL/min ( p = 0.05) in control group. The cardiac output flow at 6 months in the treated group was 4458 ± 928 mL/min versus 5599 ± 1355 mL/min ( p = 0.05) in the control group. At 6 months the primary patency was 73% and 80% and the secondary patency 80% and 86% in treated compared to the control group, respectively. No VASQ device complications were recorded. Conclusion: The analysis of these data suggested that using VasQ device could be protective against the hemodynamic modification that occur during arteriovenous fistulae creation.

scholarly journals CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY VERSUS FIBER-OPTIC BRONCHOSCOPE DURING OROTRACHEAL INTUBATION IN PATIENTS UNDERGOING ELECTIVE SURGERY

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S180-85
Author(s):  
Moazzam Ali ◽  
Maliha Khawar ◽  
Maryam Nazneen ◽  
Zaqawat Nazneen
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Fiber Optic ◽  
Cardiovascular Response ◽  
Macintosh Laryngoscope ◽  
Orotracheal Intubation ◽  
Control Group ◽  
Female Ratio ◽  
The Mean

Objective: To compare the hemodynamic response between flexible fiber optic bronchoscope (FOB) andMacintosh laryngoscope during orotracheal intubation. The secondary objective was to calculate the timerequired for intubation between these two techniques Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia, Frontier Corps Hospital Quetta, from Oct 2016 to Apr2017. Methodology: Eighty patients fulfilling the inclusion/exclusion criteria were included in this study and weredivided randomly into two groups. Group L was intubated with Macintosh laryngoscope (control group) whereas group F was intubated with Fiber optic bronchoscope. Mean arterial pressure and heart rate was recorded as baseline, pre-intubation and then every 01 minute for 03 minutes. Changes in heart rate and mean arterial pressure were recorded in the proforma by another anesthetist who was blinded to the procedure performed. Results: The mean age in group L was 41.23 ± 8.37 years and in group F was 40.73 ± 9.77 years. The mean weight in group L was 69.63 ± 8.92 kg and in group F was 70.6 ± 9.20 kg. In group L, male to female ratio was 26:14 whereas in group F it was 28:12. Mean heart rate and mean arterial pressure did not show significant change over time between groups. Time required for intubation was significantly less (22.45 ± 4.12 secs) in laryngoscopy group versus Fiber-Optic Bronchoscope group (44.68 ± 5.88 secs). Conclusion: In conclusion we can say that our study demonstrated that using laryngoscope or Fiber-OpticBronchoscope for orotracheal..........

scholarly journals Effects of the Two Doses of Dexmedetomidine on Sedation, Agitation, and Bleeding During Pediatric Adenotonsillectomy

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Amir Shafa ◽  
Hastisadat Aledavud ◽  
Hamidreza Shetabi ◽  
Sedige Shahhosseini
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Recovery Room ◽  
Pediatric Patients ◽  
Sedation Score ◽  
Control Group ◽  
The Mean ◽  
Double Blinded

Background: Due to the importance of dexmedetomidine and its different dosages, here, we aimed to investigate and compare the effectiveness of the doses of 1 µg/kg and 2 µg/kg of dexmedetomidine in sedation, agitation, and bleeding in pediatrics undergoing adenotonsillectomy. Methods: This double-blinded randomized clinical trial was performed on 105 pediatric patients that were candidates for adenotonsillectomy. Then, the patients were divided into three groups receiving dexmedetomidine at a dose of 2 µg/kg, diluted dexmedetomidine at 1 µg/kg, and normal saline. The drugs were administered 15 minutes before operations via the intravenous method. The duration of extubation, mean arterial pressure (MAP), heart rate (HR), and SPO2 in the recovery were recorded. We also collected data regarding patients’ sedation and agitation every 15 minutes. Results: Our data showed no significant differences between the groups of patients regarding MAP, HR, and SPO2. However, the mean sedation score was significantly higher in patients receiving dexmedetomidine (2 µg/kg), and this score was lowest in the control group at the time of entrance to the recovery room. The patients that received dexmedetomidine at a dose of 1 µg/kg had the lowest agitation score after 45 minutes of being in the recovery room, and the patients treated with dexmedetomidine at a dose of 2 µg/kg had the lowest agitation score after 60 minutes of being in the recovery compared to other groups of patients. Conclusions: The use of the doses of 1 µg/kg and 2 µg/kg of dexmedetomidine was associated with proper sedation and a significant reduction in agitation. The patients also had lower amounts of bleeding. We recommend that anesthesiologists should pay more attention to dexmedetomidine at a dose of 2 µg/kg, especially in pediatric surgical procedures.

scholarly journals Effects of Different Doses of Magnesium Sulfate on Pneumoperitoneum-related Hemodynamic Changes in Patients Undergoing Gastrointestinal Laparoscopy

2019 ◽  
Author(s):  
Wei Tan ◽  
Dong-chen Qian ◽  
Meng-meng Zheng ◽  
Xuan Lu ◽  
Yuan Han ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Magnesium Sulfate ◽  
Systemic Vascular Resistance ◽  
Vascular Resistance ◽  
Control Group ◽  
Hemodynamic Changes ◽  
The Mean ◽  
Different Doses

Abstract Background The infusion of magnesium sulfate is well known to reduce arterial pressure and attenuate hemodynamic response to pneumoperitoneum. This study aimed to investigate whether different doses of magnesium sulfate can effectively attenuate the pneumoperitoneum-related hemodynamic changes and the release of vasopressin in patients undergoing laparoscopic gastrointestinal surgery. Methods Sixty-nine patients undergoing laparoscopic partial gastrectomy were randomized into three groups: group L received magnesium sulfate 30 mg/kg loading dose and 15 mg/kg/h continuous maintenance infusion for 1 h; group H received magnesium sulfate 50 mg/kg followed by 30 mg/kg/h for 1 h; and group S (control group) received same volume 0.9% saline infusion, immediately before the induction of pneumoperitoneum. Systemic vascular resistance (SVR), cardiac output (CO), mean arterial pressure (MAP), heart rate (HR), serum vasopressin and magnesium concentrations were measured. The extubation time, visual analogue scale were also assessed. The primary outcome is the difference in SVR between different groups. The secondary outcome is the differences of other indicators between groups, such as CO, MAP, HR, vasopressin and postoperative pain score. Results Pneumoperitoneum instantly resulted in a significant reduction of cardiac output and an increase in mean arterial pressure, systemic vascular resistance, and heart rate in the control group (P < 0.01). The mean arterial pressure (T2 – T4), systemic vascular resistance (T2 – T3) and the level of serum vasopressin were significantly lower (P < 0.05) and the cardiac output (T2 – T3) was significantly higher (P < 0.05) in group H than those in the control group. The mean arterial pressure (T4) and systemic vascular resistance (T2) were significantly lower in group H than those in group L (P < 0.05). Furthermore, the visual analogue scales at 5 min and 20 min, the level of vasopressin, and the dosage of remifentanil were significantly decreased in group H compared to the control group and group L (P < 0.01). Conclusion Magnesium sulfate could safely and effectively attenuate the pneumoperitoneum-related hemodynamic instability during gastrointestinal laparoscopy and improve postoperative pain at serum magnesium concentrations above 2 mmol/L.

scholarly journals Effect of Averrhoa bilimbi Fruit Extract on Blood Pressure and Mean Arterial Pressure of NaCl Induced Hypertensive Rats

2021 ◽  
Vol 20 (3) ◽  
pp. 631-636
Author(s):  
Rafida M ◽  
AH Safitri ◽  
Nurina Tyagita
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
Medical Science ◽  
Control Group ◽  
Hypertensive Rats ◽  
Fruit Extract ◽  
Significant Difference ◽  
The Mean

Objective:Averrhoa bilimbi fruit contains potassium and flavonoid expected to play a role in lowering blood pressure. This study aim to examine the effect of Averrhoa bilimbi fruit extract on blood pressure and mean arterial pressure in NaCl-induced hypertensive rats. Materials and methods: This research employs pre- and post-test randomized control group design and uses 15 rats which are divided into 3 groups. On day 6, all groups are pretreated with NaCl 8% solution to induce hypertension for 14 days. On day 20, the control, furosemide and bilimbi groups are respectively treated with distilled water, 0.72mg/200gBW furosemide, and 150mg/200gBW Averrhoa bilimbi fruit extract for 7 days. The (systolic and diastolic) blood pressure and mean arterial pressure of each group are evaluated on day 20 and 27. The results are analyzed with Repeated Anova. Results: The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group before treatment are (128.4±11.8/88.0±7.8mmHg); (142.8±13.6/85.4±16.7mmHg); and (144.8±15.1/98.0±14.9mmHg) respectively. The mean systolic and diastolic blood pressure of the control, furosemide and bilimbi group after being treated are (88.0±11.8/60.8±7.8mmHg); (98.0±13.6/71.0±16.7mmHg); and (85.4±15.1/65.0±14.9mmHg) respectively. The mean arterial pressure of the control, furosemide and bilimbi groups are (69.4±8.2mmHg); (79.6±14.8mmHg); (71.4±15.0mmHg) respectively. There is a statistically significant difference in the blood pressure and the mean arterial pressure among the groups (p=0.000). Averrhoa bilimbi fruit extract has an effect on the blood pressure and the mean arterial pressure of NaCl-induced hypertensive rats. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.631-636

scholarly journals Effect of Ajwa Dates Consumption to Inhibit the Progression of Preeclampsia Threats on Mean Arterial Pressure and Roll-Over Test

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Ida Royani ◽  
Suryani As’ad ◽  
Nasrudin A Mappaware ◽  
Mochammad Hatta ◽  
Rabia
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pregnant Women ◽  
Daily Intake ◽  
Intervention Group ◽  
Control Group ◽  
Intervention Period ◽  
Daily Consumption ◽  
Before And After ◽  
The Mean

Background. Preeclampsia is the major problem and the main leading cause of fetal and maternal mortality worldwide. The early prediction of preeclampsia in pregnant women is required to prevent the occurrence of preeclampsia. The mean arterial pressure (MAP) and roll-over test (ROT) are the combination of measurement which can be used to predict preeclampsia. On the contrary, Ajwa dates were reported to have an enormous activity which contributes to its role in improving health conditions. In this study, we aimed to evaluate the effect of daily consumption of seven Ajwa dates on prevention of preeclampsia, through MAP and ROT changes. Methods. Forty pregnant women (n = 40) were randomly assigned into the control group (n = 10) and the intervention group which received a daily intake of Ajwa dates (n = 30). The MAP and ROT were assessed before and after the 8-week intervention period. Results. The intervention group showed the significant reduction in MAP and ROT following the 8-week intervention period (p<0.05). Conclusion. Daily consumption of seven Ajwa dates has a remarkable potential to decrease the MAP and ROT in pregnant women at risk of developing preeclampsia, and thus, it can contribute to prevent the development of preeclampsia.

Sign in / Sign up

Export Citation Format

Share Document