Behavioral and hormonal influence on blood volume restitution after hemorrhage in swine

1989 ◽  
Vol 256 (1) ◽  
pp. R207-R216
Author(s):  
D. E. Carlson ◽  
E. J. DeMaria ◽  
R. W. Campbell ◽  
D. S. Gann
Keyword(s):  
Blood Volume ◽  
Plasma Catecholamines ◽  
Peripheral Resistance ◽  
Right Atrial ◽  
Hormonal Responses ◽  
Yorkshire Pigs ◽  
Behavioral Conditioning ◽  
Group 2 ◽  
Right Atrial Volume ◽  
Group 1

Hemorrhage of 14 ml.kg-1.5 min-1 was done in two groups of chronically prepared, splenectomized Yorkshire pigs that were conditioned behaviorally to lie in a Panepinto sling. In group 1 the conditioning included early use of active restraint. It was done before the preparative surgery and on postoperative day 3 before the experiment on day 4. In group 2 the use of active restraint was minimized during conditioning that was extended to postoperative days 4 and 5 before the experiment on day 6. Before hemorrhage, core temperature and plasma catecholamines, cortisol, adrenocorticotropin, vasopressin, and renin were greater in group 1 than in group 2; but blood volume, hematocrit, and body weight were identical. Peak hormonal concentrations were greater or more sustained during the 1st h after hemorrhage in group 1 than in group 2. Restitution of blood volume was greater in group 1 than in group 2 at 4 and 7 h. Greater total peripheral resistance at 2 h after hemorrhage and greater restitution of plasma protein by 7 h in group 1 contributed to its accelerated volume restoration. Comparison of arterial pressure and of right atrial volume (conductance catheter) between groups suggested that a greater response of arterial or right atrial stretch receptors in group 1 could not account for the results. We suggest that the method and duration of behavioral conditioning and the time for recovery from surgery are important determinants of the hemodynamic and hormonal responses to hemorrhage and their subsequent influence on the restitution of blood volume.

Atrial peptide release after hemorrhage in unanesthetized swine

1989 ◽  
Vol 256 (4) ◽  
pp. R915-R921
Author(s):  
D. E. Carlson ◽  
E. J. DeMaria ◽  
R. W. Campbell ◽  
C. Chrostek ◽  
C. T. Graeber ◽  
...  
Keyword(s):  
Blood Volume ◽  
Venous Pressure ◽  
Right Atrial ◽  
Atrial Volume ◽  
Related Factors ◽  
Hormonal Responses ◽  
Peptide Release ◽  
Yorkshire Pigs ◽  
Group 2 ◽  
Group 1

Hemorrhage of 14 ml/kg in 5 min was done in two groups of chronically prepared, splenectomized Yorkshire pigs. Group 1 was studied on post-operative day 4 and was conditioned behaviorally with "active restraint", whereas group 2 was studied on postoperative day 6 and was conditioned with behavioral "shaping." The peak decrease in blood volume occurred by 0.25 h after hemorrhage in both groups. However, plasma atrial natriuretic factor (ANF) as measured by radioimmunoassay did not decrease significantly until 2 h in group 1 and 0.5 h in group 2 even though the recovery of blood volume was significantly more rapid in group 1 than in group 2. The responses of ANF differed significantly between groups, suggesting that ANF release after hemorrhage is influenced by prior handling and the time for recovery from surgery. In both groups, some pigs showed increases in ANF during the 1st h after hemorrhage, and changes in ANF were unrelated to decreases in central venous pressure or absolute right atrial volume determined with a conductance catheter. In contrast, changes in ANF after hemorrhage correlated positively with several variables including atrial rate and changes in vasopressin. Multiple regression suggested that the effect of reduced atrial volume on ANF release was opposed by these latter variables or related factors. Furthermore, known actions of ANF do not appear to account for the observed hemodynamic and hormonal responses to hemorrhage.

Prediction of oligodendroglial tumor subtype and grade using perfusion weighted magnetic resonance imaging

2007 ◽  
Vol 107 (3) ◽  
pp. 600-609 ◽  
Author(s):  
Robert G. Whitmore ◽  
Jaroslaw Krejza ◽  
Gurpreet S. Kapoor ◽  
Jason Huse ◽  
John H. Woo ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Blood Volume ◽  
Tumor Grade ◽  
Grade Ii ◽  
Cytogenetic Profile ◽  
Group 2 ◽  
Oligodendroglial Neoplasms ◽  
Grade Iii ◽  
Group 1

Object Treatment of patients with oligodendrogliomas relies on histopathological grade and characteristic cytogenetic deletions of 1p and 19q, shown to predict radio- and chemosensitivity and prolonged survival. Perfusion weighted magnetic resonance (MR) imaging allows for noninvasive determination of relative tumor blood volume (rTBV) and has been used to predict the grade of astrocytic neoplasms. The aim of this study was to use perfusion weighted MR imaging to predict tumor grade and cytogenetic profile in oligodendroglial neoplasms. Methods Thirty patients with oligodendroglial neoplasms who underwent preoperative perfusion MR imaging were retrospectively identified. Tumors were classified by histopathological grade and stratified into two cytogenetic groups: 1p or 1p and 19q loss of heterozygosity (LOH) (Group 1), and 19q LOH only on intact alleles (Group 2). Tumor blood volume was calculated in relation to contralateral white matter. Multivariate logistic regression analysis was used to develop predictive models of cytogenetic profile and tumor grade. Results In World Health Organization Grade II neoplasms, the rTBV was significantly greater (p < 0.05) in Group 1 (mean 2.44, range 0.96–3.28; seven patients) compared with Group 2 (mean 1.69, range 1.27–2.08; seven patients). In Grade III neoplasms, the differences between Group 1 (mean 3.38, range 1.59–6.26; four patients) and Group 2 (mean 2.83, range 1.81–3.76; 12 patients) were not significant. The rTBV was significantly greater (p < 0.05) in Grade III neoplasms (mean 2.97, range 1.59–6.26; 16 patients) compared with Grade II neoplasms (mean 2.07, range 0.96–3.28; 14 patients). The models integrating rTBV with cytogenetic profile and grade showed prediction accuracies of 68 and 73%, respectively. Conclusions Oligodendroglial classification models derived from advanced imaging will improve the accuracy of tumor grading, provide prognostic information, and have potential to influence treatment decisions.

Is oxygen supply a limiting factor for survival during rewarming from profound hypothermia?

2006 ◽  
Vol 291 (1) ◽  
pp. H441-H450 ◽  
Author(s):  
Timofei V. Kondratiev ◽  
Kristina Flemming ◽  
Eivind S. P. Myhre ◽  
Mikhail A. Sovershaev ◽  
Torkjel Tveita
Keyword(s):  
Blood Volume ◽  
Tissue Oxygenation ◽  
Limiting Factor ◽  
Myocardial Tissue ◽  
Circulating Blood Volume ◽  
Profound Hypothermia ◽  
Group 3 ◽  
Vascular Beds ◽  
Group 2 ◽  
Group 1

It has been postulated that unsuccessful resuscitation of victims of accidental hypothermia is caused by insufficient tissue oxygenation. The aim of this study was to test whether inadequate O2supply and/or malfunctioning O2extraction occur during rewarming from deep/profound hypothermia of different duration. Three groups of rats ( n = 7 each) were used: group 1 served as normothermic control for 5 h; groups 2 and 3 were core cooled to 15°C, kept at 15°C for 1 and 5 h, respectively, and then rewarmed. In both hypothermic groups, cardiac output (CO) decreased spontaneously by >50% in response to cooling. O2consumption fell to less than one-third during cooling but recovered completely in both groups during rewarming. During hypothermia, circulating blood volume in both groups was reduced to approximately one-third of baseline, indicating that some vascular beds were critically perfused during hypothermia. CO recovered completely in animals rewarmed after 1 h ( group 2) but recovered to only 60% in those rewarmed after 5 h ( group 3), whereas blood volume increased to approximately three-fourths of baseline in both groups. Metabolic acidosis was observed only after 5 h of hypothermia (15°C). A significant increase in myocardial tissue heat shock protein 70 after rewarming in group 3, but not in group 2, indicates an association with the duration of hypothermia. Thus mechanisms facilitating O2extraction function well during deep/profound hypothermia, and, despite low CO, O2supply was not a limiting factor for survival in the present experiments.

Modified Fontan Procedure with the Simultaneous Bidirectional Cavopulmonary Shunt

1995 ◽  
Vol 3 (1) ◽  
pp. 29-34
Author(s):  
Kim Yong Jin ◽  
Jun Tae Gook ◽  
Lee Jeong Ryul ◽  
Rho Joon Ryang ◽  
Suh Kyung Phill
Keyword(s):  
Pericardial Effusion ◽  
Pulmonary Artery ◽  
Fontan Procedure ◽  
Vena Cava ◽  
Right Atrial ◽  
Postoperative Arrhythmia ◽  
Bidirectional Cavopulmonary Shunt ◽  
Group 2 ◽  
Cavopulmonary Shunt ◽  
Group 1

We reviewed our experience of 56 patients from 1989 to 1992 who underwent a modified Fontan procedure and a bidirectional cavopulmonary shunt simultaneously. There were 39 male and 17 female patients and their weight ranged from 6.54 to 29kg (mean weight 13.58 ± 3.96kg). Patient age ranged from 16 to 135 months (mean age 42.8 ± 3.7 months). Diagnoses included single ventricle in 29, tricuspid atresia in 11, double outlet of right ventricle in 10, hypoplastic left heart syndrome in 4, and pulmonary atresia with intact ventricular septum in 2 patients. The techniques of inferior vena cava to pulmonary artery (IVC-PA) connection were anastomosis of proximal superior vena cava (SVC) to pulmonary artery (PA) in 27 (group 1), direct atriopulmonary anastomosis with roof formation in 29 patients (group 2). There were significant differences in postoperative 1-hour right atrial (RA) pressure and period of chest tube drainage between group 1 and group 2. The early mortality was 12.5% (7/56), and 2 late deaths (4.1%) occurred with a mean follow-up period of 22.4 months. Risk factors for the late postoperative arrhythmia were immediate postoperative arrhythmia and prolonged pleuro-pericardial effusion. Direct connection of the remaining proximal SVC to PA with the bidirectional cavopulmonary shunt may have less pleuro-pericardial effusion and late arrhythmia than atriopulmonary anastomosis.

P426Routine use of transoesophageal echocardiography in patients with atrial fibrillation or atrial flutter undergoing cardioversion

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
K Etsadashvili ◽  
N Kuridze ◽  
T Kavtiashvili ◽  
T S Chaligava ◽  
V Chumburidze
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Left Atrial ◽  
Anticoagulation Therapy ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Cardiac Thrombus ◽  
Group 2 ◽  
Anticoagulated Patients ◽  
Group 1

Abstract Background. According to the recent guidelines, effective anticoagulation is recommended for a minimum of 3 weeks before the cardioversion of Atrial Fibrillation/Atrial Flutter. Transoesophageal echocardiography (TOE) could be considered, but is not mandatory to exclude/confirm the cardiac thrombus before the cardioversion in adequately anticoagulated patients. Aim of the study was to reveal the incidence of thrombus or spontaneous echo contrasting (SEC) by TOE before cardioversion, despite effective anticoagulation. Material and methods. Patients, where TOE was performed to evaluate the evidence of thrombus/SEC before the cardioversion of AF/Atrial flutter at our clinic in period of 2016-2018, were studied. Incidence of intracardiac thrombus and its relation to patients’ gender, age, hypertension, diabetes, atrial diameter, LVEF, duration of Atrial Fibrillation/Atrial flutter, as well as to anticoagulation regimen were evaluated. Results. All patients received recommended anticoagulation therapy, DOACs or VKAs, for a minimum of 3 weeks before the TOE. Finally 180 patients were divided in two groups: group 1 (121 patients) without evidence of thrombus and group 2 (59 patients) where TOE revealed the thrombus. Thrombus was found in 37 (20.5%) patients, and SEC was found in 22 (12.2%) patients. There were no difference between the two groups with respect to: gender (85 male (70%) in group 1 vs. 38 male (64%) in group 2, p = NS), age (62.8 ± 8.73 vs. 63.0 ± 9.04, p = NS), hypertension (78 (64.4%) vs. 44 (74.6%), p = NS), diabetes (17 (14%) vs. 7 (12%), p = NS), CHAD2DS2-VASc score (2.2 ± 1.8 vs. 2.4 ± 4.0, p = NS), LVEF (48.1 ± 7.1% vs. 46.4 ± 7.3%, p = NS), duration of arrhythmia (7.7 ± 11.6 months vs. 9.7 ± 14.0 months, p = NS), type on anticoagulation (DOACs 59 (48.3%) vs. 30 (50.8%), p = NS, VKA (Warfarin) 54 (44.6%) vs. 29 (49.1%), p = NS)) respectively. Only difference in atrial diameter was found statistically significant between the two groups: left atrial diameter (42.6 ± 3.3mm vs. 45.3 ± 3.6mm, p &lt; 0.001) and right atrial diameter (39.4 ± 3.3mm vs. 40.8 ± 2.3mm, p = 0.001) respectively. Conclusion. Thrombus/SEC could persist despite the effective anticoagulation therapy for ≥3 weeks. Therefore all patients should perform TOE before the cardioversion to avoid the incidence of stroke.

Abstract 12966: Combination of Urine Sodium Concentration and Plasma Brain Natriuretic Peptide Level Best Predicted the Clinical and Hemodynamic Effects of Tolvaptan Therapy in Patients With Heart Failure

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yuichi Sato ◽  
Kaoru Dohi ◽  
Tetsushiro Takeuchi ◽  
Muneyoshi Tanimura ◽  
Emiyo Sugiura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Symptom Score ◽  
Predictive Value ◽  
Urine Volume ◽  
Multivariate Logistic Regression Analysis ◽  
Right Atrial ◽  
Urine Sodium ◽  
Patients With Heart Failure ◽  
Group 2 ◽  
Group 1

Purpose: We identified the best predictors of clinical response to simple add-on tolvaptan (TLV) therapy in patients with heart failure (HF). Methods: We retrospectively enrolled 60 HF patients with excess fluid retention despite receiving adequate medical therapy including oral diuretics. All patients received simple add-on TLV (median of 7.5mg/day). They underwent right heart catheterization at baseline and after 7-day treatment. Results: Although the majority of patients were successfully treated with simple add-on TLV therapy (Group 1), but 22% (Group 2) were defined as being unsuccessfully treated because 1) HF symptom score worsened or 2) HF symptom score >6, and mean pulmonary capillary wedge pressure (PCWP) >18 mmHg and mean right atrial pressure (RAP) >10 mmHg after TLV therapy. Although the degrees of body weight reduction and increment of urine volume were similar between the two groups, HF symptom score and mean PCWP and RAP improved, and plasma BNP level decreased only in the group 1 after TLV therapy. The group 2 had lower urine sodium/creatinine ratio (UNa/UCr) and higher plasma BNP level than responders at baseline, and they were identified as the independent predictors of unsuccessful TLV therapy by multivariate logistic regression analysis. Receiver operating characteristic curve analysis showed that UNa/UCr was the strongest predictor of unsuccessful TLV therapy with cut-off point of 46.5 mEq/gCr (AUC 0.847, 95% CI; 0.718-0.976, sensitivity 77%, specificity 81%, P<0.001). Furthermore, combination with UNa/UCr 778 pg/ml best predicted unsuccessful TLV therapy with sensitivity of 54%, specificity of 100%, positive predictive value of 100%, negative predictive value of 89%, and accuracy of 90%. Conclusion: Simple add-on tolvaptan therapy ameliorated HF symptoms and provided hemodynamic improvement in majority of patients with HF, and the measurements of UNa/UCr and BNP level can help clinicians tailor HF treatment.

Impaired atrial natriuretic factor systemic clearance contributes to its higher levels in uremia.

1992 ◽  
Vol 2 (12) ◽  
pp. 1704-1708
Author(s):  
R Paniagua ◽  
M Franco ◽  
E Rodriguez ◽  
G Sanchez ◽  
G Morales ◽  
...  
Keyword(s):  
Blood Volume ◽  
Atrial Natriuretic Factor ◽  
Systemic Clearance ◽  
Group 4 ◽  
Natriuretic Factor ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1 ◽  
Atrial Natriuretic

To evaluate the interaction between plasma levels and the systemic uptake of atrial natriuretic factor (ANF) with thyroid hormone levels during acute renal failure (ARF), seven groups of rats were analyzed: Group 1, Controls (C); Group 2, ARF; Group 3, filtering kidney with uremia; Group 4, ARF with thyroxine (T4) supplement (ARF + T4); Group 5, thyroidectomy (Tx); Group 6, ARF on Tx rats (Tx + ARF); Group 7, Tx + ARF supplemented with T4 (Tx + ARF + T4). Plasma creatinine (Cr), urea, T4, blood volume, and ANF were measured; ANF half-life (ANF t1/2; expressed in seconds) was calculated. Rats with ARF developed uremia (Cr, 377 +/- 58 versus 41 +/- 5 mumol/L), significant reduction in T4 (40 +/- 4 versus 89.2 +/- 6 nmol/L). elevation of ANF (287.7 +/- 35 versus 60.9 +/- 8 fmol/mL), and lengthening of ANF t1/2 (69.7 +/- 8 versus 37.2 +/- 6 s) compared with C (P less than 0.01). T4 supplements to ARF rats resulted in a lesser degree of uremia (Cr, 283 +/- 27; P less than 0.05) and normalization of ANF t1/2 (31.4 +/- 5); however, ANF levels remained higher than C (100.4 +/- 11.4 versus 60.9 +/- 8; P less than 0.01). Tx by itself did not change either parameter. The filtering kidney with uremia group developed mild uremia (Cr, 199 +/- 8), T4 fell (58 +/- 8), ANF levels rose (83.4 +/- 5.4), and ANF t1/2 was prolonged (54.5 +/- 12). Tx before ARF doubled the ANF level and lengthened ANF t1/2 similarly than in ARF. T4 addition (Tx + ARF + T4) normalized ANF t1/2 (29.8 +/- 3) in spite of a persistently high ANF (145.7 +/- 21). Blood volume did not change in any group.(ABSTRACT TRUNCATED AT 250 WORDS)

Activation of ANP synthesis during congestive heart failure in rats treated with monocrotaline

1995 ◽  
Vol 268 (1) ◽  
pp. H391-H398 ◽  
Author(s):  
L. Comini ◽  
G. Agnoletti ◽  
A. Panzali ◽  
G. Mantero ◽  
E. Pasini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Plasma Concentration ◽  
Ventricular Hypertrophy ◽  
Right Atrial ◽  
Peritoneal Effusion ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

We studied plasma concentration, content, and mRNA for atrial natriuretic peptide (ANP-mRNA) in heart chambers of monocrotaline-treated rats. Three distinct groups emerged: group 1, with moderate congestive heart failure (CHF; pleural effusion < 1 ml; no peritoneal effusion); group 2, with severe CHF (pleural and peritoneal effusion > 1 ml); and group 3, with right hypertrophy and no CHF. Group 1 and 2 rats had right atrial and ventricular hypertrophy, raised plasma ANP (from 16.31 +/- 11.32 to 98.50 +/- 22.50 and 124.09 +/- 57.29 pg/ml, respectively; P < 0.001), and depletion of right atrial ANP (from 143.23 +/- 29.79 to 21.70 +/- 17.70 and 18.12 +/- 14.64 nmol/g, respectively; P < 0.001). Ventricular ANP concentration was unchanged. ANP-mRNA rose in the right atrium [10.6 (P < 0.02) and 7.9 (P < 0.01) times] and right ventricle (53.0 and 46.6 times; P < 0.01). In left unhypertrophied chambers it also increased, although to a smaller extent. Group 3 rats had isolated right ventricular hypertrophy, normal ANP levels in plasma and tissues, and no activation of synthesis. These data suggest that 1) plasma concentration and ANP synthesis are increased only in animals with CHF, 2) activation of ANP synthesis is maximal in early stages of CHF and is not related to the degree of hypertrophy, and 3) ANP-mRNA is also expressed in unhypertrophied heart chambers of rats with CHF but is not expressed in hypertrophied chambers of animals without CHF.

scholarly journals Dynamics of characteristics of cerebral circulation during combined treatment with amlodipine and bisoprolol

2017 ◽  
Vol 94 (12) ◽  
pp. 908-914
Author(s):  
Irina L. Zapesochnaya ◽  
A. G. Avtandilov
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Flow Velocity ◽  
Combined Therapy ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Downward Trend ◽  
Hypertensive Patients ◽  
Group 2 ◽  
Group 1

Objective: to assess dynamics of cerebral blood flow when starting combined therapy with amlodipine and bisoprolol in hypertensive patients working in the Far North under various labor schedules. Material and methods. We studied 140 patients with grade 1-2 hypertension divided into two groups depending on their work schedule. Group 1 (n=72) included subjects working only at daytime; group 2 (n=68) consisted of subjects working in shifts. All patients received combined therapy with amlodipine and bisoprolol. The final mean daily dose of amlodipine/bisoprolol amounted to 8,3±1,3/9,8±1,6 mg/day and 9,5±1,5/14,5±1,2 mg/day in groups 1 and 2 respectively. Doppler ultrasound of the common carotid, internal carotid and vertebral arteries (OCA, BCA and PA, respectively) was performed before, 12 weeks, and 6 months after onset of therapy. Results. At the end-point of intervention (6 months) patients of group 1 showed an increase in peak systolic velocity (Vps) in OCA, BCA and PA (by 4,1, 5,9 and 5,5% respectively) and maximum end-diastolic flow velocity (Ved) in ОCA and ВCA (by 5,8 and 5,2% respectively). Patients of group 2 showed an increase of Vps in OCA, BCA and PA by 6,3, 8,4 and 7,1% respectively; Ved in OCA and BCA by 6,4 and 14,5% respectively. All patients exhibited a pronounced downward trend of the peripheral resistance index of in all studied arteries. The tendency to a decrease in the thickness of the intima-media complex was documented: by 4,1%, in group 1, 6,8% in group 2, without reaching the normal level. Conclusion. 6-month starting combined therapy with amlodipine and bisoprolol in hypertensive patients has positive effect on cerebral hemodynamics manifest as the increase in parameters of cerebral blood flow velocity and reduced peripheral resistance index. Pronounced downward trend in the thickness of the intima-media monitoring in both groups was apparent but without reaching the standard level.

scholarly journals Successful outcomes of a new combined solution of hyaluronic acid, chondroitin sulfate and poloxamer 407 for submucosal injection: animal survival study

2019 ◽  
Vol 07 (04) ◽  
pp. E576-E582 ◽  
Author(s):  
Henry Córdova ◽  
Miriam Cuatrecasas ◽  
Ana García-Rodríguez ◽  
Andrea Montenegro ◽  
Jordana Melo ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Chondroitin Sulfate ◽  
Poloxamer 407 ◽  
En Bloc ◽  
Submucosal Injection ◽  
Combined Solution ◽  
Yorkshire Pigs ◽  
Group 2 ◽  
Early Healing ◽  
Group 1

Abstract Background and study aims Endoscopic resection requires use of submucosal injection. This study was conducted to assess efficacy and impact on early healing of hyaluronic acid combined with chondroitin sulfate and poloxamer 407 (Ziverel) when used as a solution for submucosal injection. Materials and methods Prospective and comparative study of gastric endoscopic mucosal resection (EMR) with three groups of two Yorkshire pigs. Six submucosal cushions were created in each animal by injecting 2 mL of Ziverel (Group 1) or succinylated gelatin (SG) (Group 2), enabling 12 EMR in each group. Submucosal cushions were created with Ziverel in Group 3, without resection. Electrosurgery unit settings were the same in all cases. EMR defects and injection sites were marked with clips. The animals were sacrificed 7 days later. EMR specimen size and duration of procedure were recorded. EMR specimens and EMR scars and injection sites were evaluated by a blinded pathologist. Results We successfully performed 24 EMR (15 en-bloc and 9 piecemeal, without differences between groups 1 and 2). Mean EMR specimen dimensions were significantly larger in Group 1 (median 19 mm, range 6 – 40 vs 16.6 mm, range 5‑25; P = 0.019), without changing the electrocautery unit settings. Blinded histopathologist assessment of EMR specimens showed less fibrosis in the submucosa and a trend to fewer cautery artifacts with Ziverel and did not identify any significant differences in early healing of resection sites. Conclusion The combination of Ziverel enables EMR and does not negatively affect early healing.

Sign in / Sign up

Export Citation Format

Share Document