Hemodynamic Responses to Crystalloid and Colloid Fluid Boluses during Noncardiac Surgery

2021 ◽  
Author(s):  
Christian Reiterer ◽  
Barbara Kabon ◽  
Sven Halvorson ◽  
Daniel I. Sessler ◽  
Edward J. Mascha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Index ◽  
Weighted Average ◽  
Bolus Administration ◽  
Before And After ◽  
Mean Pressure ◽  
Administration Time ◽  
Time Weighted Average ◽  
The Difference ◽  
Crystalloid Administration

Background Colloids are thought to sustain blood pressure and cardiac index better than crystalloids. However, the relative effects of intraoperative hydroxyethyl starch and crystalloid administration on the cardiac index and blood pressure remain unclear. This study therefore tested in this subanalysis of a previously published large randomized trial the hypothesis that intraoperative goal-directed colloid administration increases the cardiac index more than goal-directed crystalloid administration. Further, the effects of crystalloid and colloid boluses on blood pressure were evaluated. Methods This planned subanalysis of a previous trial analyzed data from 973 patients, of whom 480 were randomized to colloids and 493 were randomized to crystalloids. Fluid administration was guided by esophageal Doppler. The primary outcome was the time-weighted average cardiac index during surgery between the colloid and crystalloid group. The secondary outcomes were the cardiac index just after bolus administration, time elapsed between boluses, and the average real variability during surgery. The study recorded cardiac index, corrected flow time, and blood pressure at 10-min intervals, as well as before and after each bolus. Results Time-weighted average of cardiac index over the duration of anesthesia was only slightly greater in patients given colloid than crystalloid, with the difference being just 0.20 l · min–1 · m–2 (95% CI, 0.11 to 0.29; P < 0.001). However, the hazard for needing additional boluses was lower after colloid administration (hazard ratio [95% CI], 0.60 [0.55 to 0.66]; P < 0.001) in a frailty time-to-event model accounting for within-subject correlation. The median [quartiles] number of boluses per patient was 4 [2, 6] for colloids and 6 [3, 8] for crystalloids, with a median difference (95% CI) of –1.5 (–2 to –1; P < 0.001). The average real mean arterial pressure variability did not differ significantly between the groups (difference in means [95% CI] of –0.03 (–0.07 to 0.02) mmHg, P = 0.229). Conclusions There were not clinically meaningful differences in the cardiac index or mean pressure variability in patients given goal-directed colloid and crystalloids. As might be expected from longer intravascular dwell time, the interval between boluses was longer with colloids. However, on a case basis, the number of boluses differed only slightly. Colloids do not appear to provide substantial hemodynamic benefit. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants?

2020 ◽  
Author(s):  
Levent Korkmaz ◽  
Ahmet Ozdemir ◽  
Özge Pamukçu ◽  
Tamer Güneş ◽  
Mehmet Adnan Ozturk
Keyword(s):  
Blood Pressure ◽  
Operating Characteristic ◽  
Ductus Arteriosus ◽  
Area Under The Curve ◽  
Therapeutic Effects ◽  
Study Group ◽  
Cardiac Syndrome ◽  
Before And After ◽  
The Difference

Objective This study aimed to detect which of the two main medicines suggested in the treatment of postligation cardiac syndrome (PLCS)—dobutamine or mirinone—possesses a more therapeutic effect. While doing this, clinicians are provided with a broader perspective on the treatment and follow-up of cases. The desire was to increase the treatability and monitor ability of the cases in question and hence their survivability. Study Design A retrospective review of a cohort of infants with PLCS was conducted between March 2012 and December 2018. In the treatment of infants with PLCS, dobutamine (dobutamine study group-DSG) or milrinone (milrinone study group-MSG) was used. The respiration, cardiac, echocardiography, and perfusion parameters of the cases were assessed both before and after ligation. Based on the data obtained, both the effects of the medicines on PLCS and the difference between their therapeutic effects were studied. The accuracy of prognostication was assessed with receiver operating characteristic analyses. Results PLCS was detected in 29 (34.1%) of 85 patent ductus arteriosus ligation cases in total. Of all the PLCS cases, 13 (44.8%) were treated with dobutamine and 16 (55.2%) with milrinone. It was observed that the effects of the medicines on the respiratory system and cardiovascular system manifested in the third and 6th hour, respectively. It was detected that both medicines had more effect on the systolic blood pressure (SBP) (area under the curve [AUC]: 0.997/0.996, p = 0.001/0.002) than on the diastolic blood pressure (AUC: 0.911/0.843, p = 0.032/0.046). Conclusion Dobutamine and milrinone, two primary medicines that can be used in the treatment of cases with PLCS, possess similar therapeutic effects on this pathology. In addition, their postoperative therapeutic effects on the SBP are more in the foreground.

The effect of cardiopulmonary bypass on gastric and colonic mucosal perfusion: a tonometric assessment

Perfusion ◽  
1994 ◽  
Vol 9 (2) ◽  
pp. 101-108 ◽  
Author(s):  
S.K. Ohri ◽  
C.T. Bowles ◽  
A. Siddiqui ◽  
A. Khaghani ◽  
B.E. Keogh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiopulmonary Bypass ◽  
Cardiac Index ◽  
Potential Effect ◽  
Strongly Correlated ◽  
Intramucosal Ph ◽  
Arterial Blood ◽  
Mucosal Perfusion ◽  
Haemodynamic Stress ◽  
The Difference

In a study to assess the potential effect of nonpulsatile hypothermic cardiopulmonary bypass (CPB), intramucosal pH (pHi) of the gastric and colonic mucosae was determined by tonometry ( n = 8). During the hypothermic phase of CPB, gastric and colonic pHi did not change significantly. Forty minutes after the start of rewarming, despite increases in the cardiac index and mean arterial blood pressure, gastric pHi fell from 7.53 ± 0.02 to 7.31 ± 0.03 ( p = 0.017) and colonic pHi fell from 7.50 ± 0.02 to 7.32 ± 0.03 ( p = 0.028). Forty minutes after the end of CPB both the colonic ( p = 0.017) and gastric ( p = 0.046) pHi remained depressed below pre-CPB values. The difference in the arterial (pHa) and the gastric mucosal pH changed from -0.097 before CPB to 0.016, 40 minutes after the end of CPB ( p = 0.027). This alteration in the pHa-pHi underlines the importance of measuring intramucosal pH by tonometry, since the pHa and pHi may move in opposite directions during episodes of haemodynamic stress. Both the gastric and colonic pHi were found to have a linear correlation with the pHa, although changes in the gastric pHi ( r = 0.41, p = 0.018) were more strongly correlated with the pHa than the colonic pHi ( r = 0.23, p = 0.19) in the rewarming phase of CPB and the immediate post-CPB period when there was a tendency towards intramucosal acidosis. The development of intramucosal acidosis in the rewarming and immediate post-CPB phases following hypothermic nonpulsatile CPB may impair the gut barrier and predispose patients to the absorption of luminal toxins.

scholarly journals Differences in blood pressure before and after consuming cucumber juice (Cucumis sativus) in women aged 30-40 years

2010 ◽  
Vol 22 (3) ◽  
Author(s):  
Martin Franklin ◽  
Edeh Roletta Haroen ◽  
Sri Tjahajawati
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cucumis Sativus ◽  
Decrease Blood Pressure ◽  
Before And After ◽  
Quasi Experimental ◽  
The Difference ◽  
The Village

Introduction: Cucumber contains pottasium that can decrease blood pressure. This study was implemented to obtain data about the difference in blood pressure before and after consuming cucumber essence (Cucumis sativus) at women aged 30-40 years. Aim of this research is to analyzed difference s of blood pressure between before and after consuming cucumber essence (Cucumis sativus) at women aged 30-40 years. Methods: This study was a quasi-experimental with pair measurement statistic data test. Total samples of this study were 30 women at RW 02, Sukawarna district, Sukajadi, house of the village-head. Results: the average of systole before consume cucumber essence was 119,29 mmHg and after to be 115,09 mmHg. The average of diastole before consume cucumber essence was 80,91 mmHg and after to be 78,16 mmHg. Statsitic analysis showed if α = 0,05 (t0,975) value of tcalc both systolic and diastolic blood pressure > ttable so that H0 rejected and H1 accepted. Conclusion: this study showed a difference in blood pressure between before and after consuming cucumber essence (Cucumis sativus) at women aged 30-40 years.

scholarly journals EFEKTIVITAS BLACK GARLIC UNTUK MENURUNKAN TEKANAN DARAH PADA PASIEN HIPERTENSI

2020 ◽  
Vol 8 (2) ◽  
pp. 126-132
Author(s):  
Annaas Budi Setyawan ◽  
Siti Khoiroh Muflihatin
Keyword(s):  
Blood Pressure ◽  
P Value ◽  
Phytochemical Analysis ◽  
Test Analysis ◽  
Work Area ◽  
Lower Blood ◽  
Fermented Product ◽  
Before And After ◽  
Chemical Content ◽  
The Difference

Background: Black Garlic is a fermented product of garlic that can be used as a herbal medicine for hypertension management. Based on the results of phytochemical analysis in black garlic There are several chemical content such as allicin, S-allyl Cystein, flavonoids, and hydrogen sulfide. The content of SAC, allicin, flavonoids and hidrogen sulfide in black garlic is a compound that can be used to lower blood pressure. Objective: The objective of this research is to prove the effect of Black Garlic on reducing blood pressure in hypertensive patients. Methods: The research method used a one group pretest and posttest design without a comparison group (control). The sample in this study were 15 people with hypertension in the work area of the Sempaja Public Health Center. To find out the difference in blood pressure with hypertension before and after being given a daily treatment of decoction of Black Garlic. Results: The result of statistical test analysis showed that the variable systolic blood pressure of p-value is 0.001 < 0.05, and diasttolic blood pressure of p-value is 0.000 < 0.05. Conclusion: The result showed that there was a significant influence on blood pressure before and after giving black garlic.

scholarly journals Mean Blood Pressure and Velocity for Calculation of Ventricular Systolic Work

1998 ◽  
Vol 41 (1) ◽  
pp. 27-28
Author(s):  
Milan Valach
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Pressure ◽  
Weighted Average ◽  
Average Pressure ◽  
Mean Pressure ◽  
The Mean ◽  
Definition Of ◽  
Ejection Phase

In physiology, the mean arterial pressure is defined as an average pressure during one or several cardiac cycles. When calculus is not used, the mean pressure is approximately calculated as the diastolic pressure plus one third of the pulse pressure. In this article it is demonstrated that, when ventricular systolic work is concerned, the above definition of mean pressure must be replaced by a weighted average during the ejection phase of the systole. This gives a formula, by which a much higher estimate of the mean pressure is obtained.

scholarly journals Effect of Adrenomedullin on Cardiovascular Response to Sympathetic Autonomic Stress in Normotensive and Hypertensive Nigerians

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Simiat Olanike Elias ◽  
Irene Yewande Bamgbade
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Response ◽  
Statistical Significance ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
The Body ◽  
Pressor Test ◽  
Before And After ◽  
The Difference ◽  
Insignificant Correlation

Adrenomedullin is a potent vasodilator with established cardio-protective potentials when the body is exposed to stress. Sympathetic autonomic stress can lead to systolic (SBP) and diastolic blood pressure (DBP) reactivity which is a predictor of stroke. This study was to determine the effect of Adrenomedullin on cardiovascular response to sympathetic autonomic stress using the Cold Pressor Test in normotensive (NT) and hypertensive (HT) adults. Cardiovascular response to the CPT was measured among 30 NT and 30 HT participants, via blood pressure and heart rate before and after exposure to the cold pressor test (CPT). Plasma Adrenomedullin (ADM) was also determined by means of ELISA. Data were expressed as mean±S.E.M and statistical significance was accepted at 95% confidence interval. Exposure to CPT led to significant increases in SBP and DBP in both NT and HT participants with greater effect in HT (p<0.0001). Plasma Adrenomedullin was significantly higher among the NT but the difference on effect of response to CPT in both groups of participants was not significant. There was a negative and insignificant correlation between the ADM level and change in SBP and DBP among the NT participants but a positive and insignificant correlation with both SBP and DBP among the HT participants. We conclude that plasma Adrenomedullin may prevent the development of hypertension in black individuals.

scholarly journals Meditation Practice Improves Short-Term Changes in Heart Rate Variability

2020 ◽  
Vol 17 (6) ◽  
pp. 2128 ◽  
Author(s):  
Kang-Ming Chang ◽  
Miao-Tien Wu Chueh ◽  
Yi-Jung Lai
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Physiological Parameters ◽  
The Other ◽  
Meditation Practice ◽  
Short Term ◽  
Face To Face ◽  
Before And After ◽  
The Difference

Background: It is well known that meditation improves the physical and psychological condition of its practitioners. This study investigated the heart rate variability response of meditation practitioners in two Chan master teaching environments, namely face-to-face and video classes. Methods: Experimental sessions were conducted, one featuring face-to-face classes and the other featuring video classes. The difference in participants’ physiological parameters (blood pressure and heart rate variability) between the two experimental sessions was determined. In the first session, physiological parameters were recorded twice, before and after one teaching course, and the second session took place one month after the first. The first and second sessions had 45 and 27 participants, respectively. Those involved in the first experiment had no experience with meditation, whereas participants in the second experiment had practiced meditation for an average of 9 years (range = 1 to 27 years). Both experiments were conducted once a week, with each session lasting 1.5 h. Results: For both experiments, both heart rate and heart rate variability by age significantly decreased after one teaching course. Conclusions: Chan meditation practitioners benefit from receiving both face-to-face and video class teaching from a Chan master.

scholarly journals Efficacy and Safety of a Novel Mouthpiece for Esophagogastroduodenoscopy: A Multi-Center, Randomized Study

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 538
Author(s):  
Yuichiro Ikebuchi ◽  
Kazuya Matsumoto ◽  
Naoki Ueda ◽  
Taro Yamashita ◽  
Hiroki Kurumi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Past History ◽  
Randomized Study ◽  
Saturation Pulse ◽  
Examination Time ◽  
Before And After ◽  
History Of Endoscopy ◽  
History Of ◽  
Secondary Endpoints ◽  
The Difference

This randomized trial aimed to compare the safety and efficacy of the GAGLESS mouthpiece for esophagogastroduodenoscopy (EGD) with that of the conventional mouthpiece. In all, 90 participants were divided into the GAGLESS mouthpiece and conventional mouthpiece groups. The primary endpoint was the severity of pain using the visual analog scale (VAS), and secondary endpoints were examination time, past history of endoscopy, success of the procedure, systolic (SBP) and diastolic (DBP) blood pressure, oxygen saturation, pulse rate before and after EGD, and adverse events. Endoscopy was completed in all cases, and no complications were observed. VAS, when passing the scope through the pharynx, was 2.5 ± 2.4 and 2.0 ± 1.9 cm (p = 0.24) in the conventional and GAGLESS groups, respectively, and that, throughout the examination, was 2.5 ± 2.4 and 1.7 ± 1.5 cm (p = 0.06), respectively. The difference in blood pressure between the GAGLESS and conventional groups was not significant for SBP (p = 0.08) and significant for DBP (p = 0.03). The post-EGD difference in DBP was significantly lower in the GAGLESS group than in the conventional group. The results indicate that GAGLESS mouthpieces had a lower VAS during endoscopy than the conventional mouthpieces, and the changes in blood pressure were smaller with the GAGLESS mouthpiece.

Comparing the effects of cold compress and Xyla-p cream on hemodynamic changes in hemodialysis patients during venipuncture

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi
Keyword(s):  
Blood Pressure ◽  
Physiological State ◽  
Vital Signs ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.

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