Failure of hemoconcentration during standing to reveal plasma volume decline induced in the erect posture

1994 ◽  
Vol 77 (5) ◽  
pp. 2155-2162 ◽  
Author(s):  
J. Lundvall ◽  
P. Bjerkhoel
Keyword(s):  
Plasma Volume ◽  
Supine Position ◽  
Venous Blood ◽  
Control Level ◽  
Quiet Standing ◽  
Fluid Loss ◽  
Erect Posture ◽  
Arterial Blood ◽  
Dependent Position ◽  
The Right

The hypothesis was tested that the hemoconcentration observed during standing provides erroneous information about the induced plasma volume (PV) decline. Male volunteers (n = 10) stood quietly for 15 min after supine rest. On standing arterial hemoglobin (Hb) rose slowly to reach an increase of 5.9 +/- 0.3% (SE) after 15 min. Early after resuming the supine position, Hb increased further to 9.2 +/- 0.5% above control level and then declined gradually. Venous antecubital blood from the left arm supported horizontally at heart level in both the supine and standing positions (no hydrostatic load) showed very similar changes. However, Hb in venous blood collected during standing from the right arm held in the natural dependent position rose much more markedly than that in arterial blood and in venous blood from the horizontal arm (470 +/- 122, 105 +/- 24, and 55 +/- 7% greater increase at 5, 10, and 15 min, respectively). Taken together, these observations indicated that 1) analyses of arterial blood sampled from the standing subject grossly underestimated the prevailing “overall” hemoconcentration and PV decline, a phenomenon ascribed to incomplete mixing of blood between dependent and nondependent regions; 2) arterial blood sampled from the recumbent subject early (60 s) after completion of standing reflected the “true” overall intravascular hemoconcentration, with a calculated PV decline of no less than 511 +/- 27 ml, because the supine position facilitated proper mixing of blood between circulatory compartments; 3) data from common venous sampling from the dependent arm during standing primarily reflected a regional hemoconcentration (fluid loss) in the arm rather than PV decline; and 4) short-term quiet standing caused a more prominent and hemodynamically important decrease in PV than usually believed.

scholarly journals The Influence of Respiratory Movements upon the Circulating Leukocytes

Blood ◽  
1952 ◽  
Vol 7 (5) ◽  
pp. 533-544 ◽  
Author(s):  
H. R. BIERMAN ◽  
K. H. KELLY ◽  
F. L. CORDES ◽  
N. L. PETRAKIS ◽  
H. KASS ◽  
...  
Keyword(s):  
Leukocyte Count ◽  
Valsalva Maneuver ◽  
Venous Blood ◽  
Control Level ◽  
Significant Degree ◽  
Forced Expiration ◽  
Direct Puncture ◽  
Arterial Blood ◽  
The Right ◽  
Respiratory Movements

Abstract 1. The leukocyte content of venous and arterial blood of 17 subjects was studied repeatedly and frequently during respirations and the Valsalva and Muller maneuvers. The venous and arterial samples were drawn simultaneously and were obtained by direct puncture from freely-flowing peripheral veins or arteries or by catheterization from the right ventricle, pulmonary artery, hepatic vein, left ventricle or aorta. 2. During the Valsalva maneuver, the arterial leukocyte count decreased markedly with relatively little alteration in the simultaneous venous counts; upon release of the forced expiration both counts promptly regained the control level. 3. During the Muller maneuver, increases in both arterial and venous leukocyte counts occurred in one patient, while no significant effect was observed in venous samples in a second subject. 4. During inspiration the arterial leukocyte count fell and the simultaneous venous count rose with reciprocal changes upon expiration. These changes occurred whether the initial counts were elevated, normal or leukopenic. 5. The changes in leukocyte number of both arterial and venous blood during respiratory movements are not due to hemoconcentration or hemodilution and suggest a tidal ebb and flow of leukocytes into and from the pulmonary circulation of a significant degree.

scholarly journals Vasoactive Substances in Pulmonary Embolism

1977 ◽  
Author(s):  
M.H. Todd ◽  
J.B. Forrest ◽  
J. Hirsh
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Autologous Blood ◽  
Venous Blood ◽  
Pulmonary Vasculature ◽  
Artery Pressure ◽  
Vasoactive Substances ◽  
Arterial Blood ◽  
The Right

Embolisation of the pulmonary vasculature with microspheres releases prostaglandin-1ike substances, PGLS (Piper and Vane, N.Y. Acad. Sei. 180: 363, 1971) but the capacity of autologous blood clots (ABC) to release pulmonary vasoactive substances is disputed. Ten normal mongrel dogs were anesthetised with pentobarbitone sodium and instrumented. Pulmonary venous blood was continuously superfused over isolated tissues for bioassay and then returned to the animal. Injection of ABC into the right atrium increased pulmonary artery pressure from 21 ± 6.5 mm Hg to 38 ± 15 mm Hg (mean ± S.D.), increased arterial pCO2 and decreased arterial pO2. No significant changes in heart rate, systemic arterial blood pressure or cardiac output occurred. In three animals contractions of the blood superfused assay tissues occurred following embolism. This effect was produced in normal assay tissues and those pretreated with antagonists of ACh, Serotonin, Histamine and Catecholamines and could therefore be attributed to PGLS. No cardiovascular or assay tissue tension changes were observed when equivalent volumes of saline or clot lysate were injected into the right atrium.Therefore, pulmonary embolism with ABC can release PGLS which may contribute to the pulmonary artery pressure rise. Vasoactive substances may normally be inactivated in the lung but in some animals appear in pulmonary venous blood.(Supported by the Ontario Heart Foundation)

Hyperoxia of cerebral venous blood and cisternal cerebrospinal fluid following arterial air embolism

1972 ◽  
Vol 37 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Norval M. Simms ◽  
Don M. Long ◽  
James H. Matthews ◽  
Shelley N. Chou
Keyword(s):  
Cerebrospinal Fluid ◽  
Oxygen Tension ◽  
Venous Blood ◽  
Air Embolism ◽  
Carbon Dioxide Tension ◽  
Acid Base ◽  
Content Type ◽  
Arterial Blood ◽  
Base Parameters ◽  
The Right

✓ Oxygen tension and acid-base parameters of cerebral venous blood and cisternal cerebrospinal fluid, as well of femoral arterial blood, were studied in 14 dogs following injection of varying amounts of room air into the right vertebral artery. Acute elevations in oxygen tension were demonstrated in both cerebral venous blood and CSF, whereas hypoxemia occurred concomitantly in systemic arterial blood. Post-embolic increases in carbon dioxide tension with reciprocal diminutions in pH were evident in all sampling sites. The pathophysiological bases for these air-induced alterations are discussed.

Pulmonary ventilation, blood gases, and blood pH after training of the arms or the legs

1975 ◽  
Vol 38 (2) ◽  
pp. 250-256 ◽  
Author(s):  
B. Rasmussen ◽  
K. Klausen ◽  
J. P. Clausen ◽  
J. Trap-Jensen
Keyword(s):  
Pulmonary Ventilation ◽  
Venous Blood ◽  
Blood Gases ◽  
Pronounced Increase ◽  
Quantitative Correlation ◽  
Arterial Blood ◽  
Oxygen Dissociation ◽  
Ventilatory Equivalent ◽  
Muscle Groups ◽  
The Right

In two groups of young healthy subjects who performed arm training (N = 5) and leg training (N = 5), respectively, the respiratory adaptation to submaximal exercise with trained and nontrained muscle groups was compared by measurement of the ventilatory equivalent (Ve/Vo2, pH, and blood gases (Pco2, Po2, and So2) in arterial blood and in venous blood from exercising extremities. After training Ve/Vo2 was significantly reduced during exercise with trained muscles, but unchanged during exercise with nontrained muscles. The reduction in Ve/Vo2 was closely related to a less pronounced increase in heart rate and in arterial lactate content, but showed no quantitative correlation to changes in arterial adaptations in trained muscles are mainly responsible for the reduction in Ve/Vo2. After training during exercise with trained as well as nontrained muscles a shift to the right of the blood oxygen dissociation curve occurred as extremities was lower while corresponding Po2 was higher.

scholarly journals 759 Platypnoea orthodeoxia syndrome following middle-lower bilobectomy: a case report

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Paolo Spontoni ◽  
Laura Stazzoni ◽  
Cristina Giannini ◽  
Giulia Costa ◽  
Marco Angelillis ◽  
...  
Keyword(s):  
Supine Position ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Treatment Modalities ◽  
Valsalva Manoeuvre ◽  
Arterial Blood Gas ◽  
Cardiac Catheterization Laboratory ◽  
The Third ◽  
Arterial Blood ◽  
The Right

Abstract Aims PlatypneaOrthodeoxiasyndrome (POS) is a rare clinical condition characterized by dyspnoea and arterial desaturation, typically occurring in orthostatism and vanishing in a supine position. The real pathophysiologic triggers are still not completely understood. Methods and results In January 2021, a 76-year-old female patient was admitted to our department for the management of a large mass in the right lung (69 × 54 × 76 cm). Pre-operative Computed Tomography (CT)-scan showed a lesion of the right lower lobe, with suspected infiltration of posterior costal pleura and bronchoscopy revealed distal occlusion of intermedious bronchus. Surgical treatment was planned: extrapleural lower bilobectomy with the removal of the VI rib to reduce intracavity space was performed, using postero-lateral thoracotomy approach. On the third post-operative day, an acute neurologic deficit with left-sided paralysis, associated with desaturation and hypotension, occurred during a new attempt to mobilize the patient. Nonetheless the patient showed complete resolution of symptoms in supine position. A new similar episode of severe desaturation (SO2 80%) was observed in the 7th post-operative day. Arterial blood gas test showed PO2 37 mmHg; PCO2 27 mmHg; SO2 80.3%, pH 7.61, tHb 12.4 g/dl; O2Hb 78.4%. CT pulmonary angiography excluded a suspicious of pulmonary embolism. A right to left atrial shunt was suspected. Contrast-enhanced transcranial Doppler ultrasound showed microembolic signals in the basal cerebral arteries. Transoesophageal echocardiography was performed, confirming an interatrial septum with an exuberant hyperdynamic movement and showing an abundant passage of contrast from the right atrium to the left, even without the Valsalva manoeuvre, compatible with an important patent foramen ovale (PFO). Patient was referred to the cardiac Catheterization Laboratory for percutaneous closure of PFO. The device was successfully placed via right femoral venous catheter access and on transesophageal echocardiogram guidance. The procedure was performed without any complications. The implanted device was noted to be in a stable position with trivial residual inter-atrial shunting immediately after the procedure. The day after implantation, positional discomfort improved remarkably and the patient was able to stand-up with no symptoms, maintaining normal saturation (SaO2 100%). The patient was discharged and sent home on the third post-implantation day. The 4 month follow-up examination showed a good andstable condition. Conclusions Platypnoea Orthodeoxia Syndrome after lobectomy is a rare cause of postoperative dyspnoea/hypoxia.It is the result of right-to-left shunt via interatrial communication. Mediastinal relocation, stretching of the atrial septum are among the functional elements necessary for the clinical manifestations. It is essential to have a high index of suspicion to detect POS in patient with dyspnoea given the subtle and positional nature of the symptoms. Physicians should always consider POS in patients with unexplained dyspnoea; hence the treatment modalities could alleviate symptoms and be potentially curative.

Plasma volume changes in middle-aged male and female subjects during marathon running

1985 ◽  
Vol 59 (2) ◽  
pp. 559-563 ◽  
Author(s):  
L. G. Myhre ◽  
G. H. Hartung ◽  
S. A. Nunneley ◽  
D. M. Tucker
Keyword(s):  
Plasma Volume ◽  
Venous Blood ◽  
Fluid Loss ◽  
Marathon Running ◽  
Base Line ◽  
Middle Aged ◽  
Male And Female ◽  
Early Exercise ◽  
Male Subjects ◽  
Female Subjects

Circulatory fluid shifts were studied in middle-aged runners (6 males and 5 females, ages 32–58 yr) during a 42.2-km marathon race run in mild weather (dry-bulb temperature = 17.5–20.4 degrees C). Running times for the subjects were 3:12–4:40 (mean values were 3:34 for males and 4:10 for females). Venous blood samples were taken without stasis in all subjects seated at rest before the start of the race and within 3 min of finishing; eight of the subjects also paused for samples at 6 and 27 km during the race. At 6 km, body weight loss averaged less than 1%, whereas plasma volume (PV) had decreased by 6.5% in male subjects and 8.6% in female subjects. By the end of the race, hypohydration had reached 3.2% in male subjects and 2.9% in female subjects, but PV in both groups remained stable. Sweat rates during the race averaged 545 and 429 g X m-2 X h-1 for male and female subjects, respectively, with ad lib. water intake replacing 21–72% of fluid loss. Increases in plasma protein concentration throughout the race reflected the observed initial decrease in PV. The interpretation of PV responses to exercise and/or hypohydration is critically dependent on selection of base-line conditions; we were able to control for posture-exercise effects by treating the early exercise (6 km) sample as the base line for examining the effects of later fluid loss. Under these conditions, the vascular compartment resisted volume depletion. The ability to maintain stable PV can be explained in part by relationships among oncotic and hydrostatic pressures in the intra- and extravascular fluid compartments.

Arterial blood gases of the domestic hen

1965 ◽  
Vol 208 (4) ◽  
pp. 798-800 ◽  
Author(s):  
Hugo Chiodi ◽  
James W. Terman
Keyword(s):  
Arterial Oxygen Saturation ◽  
Venous Blood ◽  
Blood Gases ◽  
Arterial Oxygen ◽  
Dissociation Curve ◽  
Arterial Blood Gases ◽  
Blood Samples ◽  
Arterial Blood ◽  
The Right ◽  
Domestic Hen

Individual blood samples were collected anaerobically from the brachial arteries of adult White Rock hens and were analyzed for Po2, Pco2, pH, oxygen content and capacity, and CO2 content and capacity. A dissociation curve was constructed from data on equilibration of pooled venous blood. The average arterial oxygen saturation was 90%, the Pco2 was about 32 mm Hg, the Po2 was between 94 and 99 mm Hg, and the pH averaged 7.49. The dissociation curve, as has been shown before, was shifted to the right of most homeothermic species.

The oxygen dissociation curve: quantifying the shift

Perfusion ◽  
2004 ◽  
Vol 19 (3) ◽  
pp. 141-144 ◽  
Author(s):  
Carole Hamilton ◽  
Barbara Steinlechner ◽  
Eva Gruber ◽  
Paul Simon ◽  
Gregor Wollenek
Keyword(s):  
Ph Value ◽  
Venous Blood ◽  
Critical Role ◽  
Treatment Strategies ◽  
Oxygen Affinity ◽  
Blood Gases ◽  
Dissociation Curve ◽  
Oxyhaemoglobin Dissociation Curve ◽  
Arterial Blood ◽  
The Right

An oxyhaemoglobin dissociation curve (ODC) quantifies the most important function of red blood cells and that is the affinity for oxygen and its delivery to the tissues. Oxygen affinity for haemoglobin plays a critical role in the delivery of oxygen to the tissues and is changed by shifting to the left or right. A shift to the left implies an increased oxygen affinity and, hence, tighter binding due to the higher oxygen saturation in relation to the pO2.On the other hand, a shift to the right corresponds to a decreased oxygen affinity and easier release of oxygen to the tissues. It is well known that the ODC shifts in response to changes in pH, pCO2 and 2,3 diphosphoglycerate. However, how much the ODC shifts has never been quantified. Arterial and venous blood gases were taken during cardiopulmonary bypass and two indices were used to quantify the shift of the ODC; the p50 shift and the SO2 difference. Arterial blood shifted to the right by 49-0.1 mmHg at a pH of 7.24 and shifted to the left by -3.59-0.05 mmHg at a pH of 7.51. The change in arterial saturation was minimal, rising by 0.8% and dropping by -5% and did not correlate to p50 shifting and changes in pH, but demonstrated changes dependent on the concentration of dyshaemoglobins. The venous blood exhibited a greater range of p50 shifting at each pH value. At a pH of 7.24, the p50 shifted to the right by 4.89-2 mmHg and at a pH of 7.51 the p50 shifted to the left by -4±1.8 mmHg. Unlike the arterial blood, the change in saturation correlated well to p50 shifting. It is shown here for the first time how much the curve shifts with changes in pH and how this may be used to evaluate treatment strategies.

Relationship of blood flow and myocardial Rb86 clearance in right and left ventricles

1963 ◽  
Vol 205 (2) ◽  
pp. 382-384 ◽  
Author(s):  
William D. Love ◽  
Lawrence P. O'Meallie
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Venous Blood ◽  
Percentage Error ◽  
Fick Principle ◽  
Mean Error ◽  
Arterial Blood ◽  
The Mean ◽  
The Right ◽  
Relationship Of

The rate of myocardial clearance of Rb86 from arterial blood and the rate of coronary blood flow were studied simultaneously during a 10-min period of isotope infusion in dogs. In order to measure blood flow to the right and left ventricles separately using the Fick principle, venous blood was obtained from an anterior cardiac vein and from the coronary sinus. The relationship of myocardial blood flow and Rb86 clearance was not detectably different in the right and left ventricles. The percentage error in predicting flow from clearance rose as the values increased. At rates of flow below 6 ml/g 10 min the mean error was 4.7%. From 6 to 12 ml/g 10 min the mean error was 10.0% in controls and 14.4% in a group with pulmonary embolism or obstruction of the pulmonary artery. Since the clearance technique does not require catheterization of a cardiac vein, this method can be used to study coronary blood flow under conditions approximating the undisturbed state.

scholarly journals OBSERVATIONS ON THE SITES OF REMOVAL OF BACTERIA FROM THE BLOOD IN PATIENTS WITH BACTERIAL ENDOCARDITIS

1945 ◽  
Vol 81 (1) ◽  
pp. 9-23 ◽  
Author(s):  
Paul B. Beeson ◽  
Emmett S. Brannon ◽  
James V. Warren
Keyword(s):  
Femoral Vein ◽  
Venous Blood ◽  
Bacterial Endocarditis ◽  
The Body ◽  
Mixed Venous Blood ◽  
Renal Veins ◽  
Arterial Blood ◽  
Venae Cavae ◽  
Bacterial Content ◽  
The Right

In 6 patients with bacterial endocarditis studies were made of the bacterial content of arterial and venous blood. Paired samples were collected, approximately simultaneously, from two different locations in the circulatory system, and colony counts were determined. As many as 48 specimens were taken for culture during a single period of study. Venous blood was drawn not only from different locations in the extremities, but also from the superior and inferior venae cavae, the right auricle, and the hepatic and renal veins. As would be expected, colony counts were highest in arterial blood. Blood from the antecubital veins gave colony counts only slightly lower than arterial blood. In the femoral veins, on the other hand, there were appreciably fewer organisms. This difference is attributed to the type of tissues drained by the two veins. Colony counts in blood from the superior and inferior venae cavae were also lower than arterial counts, the ratio being comparable to that found in femoral vein blood. In the renal veins colony counts were only slightly below the arterial level indicating that few organisms are removed from the blood during passage through the kidneys. The greatest reduction in bacterial content was found in hepatic vein blood. In 3 of the 6 subjects this reduction amounted to more than 95 per cent, and in all subjects the difference was very considerable. Mixed venous blood in the right auricle of the heart gave colony counts which were usually one-half to two-thirds as high as in corresponding samples of arterial blood. An interesting finding in these studies was a remarkable constancy of the bacterial content of arterial blood, during periods of 1 or 2 hours. Despite the fact that a considerable portion of the bacteria which leave the heart in arterial blood appear to be removed during a single circuit of the body, the number of bacteria in successive samples of arterial blood shows little change. This indicates that in bacterial endocarditis organisms are discharged into the blood from the endocardial vegetations at a comparatively even rate, rather than in a haphazard fashion as a result of the breaking off of infected particles.

Sign in / Sign up

Export Citation Format

Share Document