scholarly journals Effects of Acute Bleeding Followed by Hydroxyethyl Starch 130/0.4 or a Crystalloid on Propofol Concentrations, Cerebral Oxygenation, and Electroencephalographic and Haemodynamic Variables in Pigs

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Aura Silva ◽  
Ana Liza Ortiz ◽  
Carlos Venâncio ◽  
Almir P. Souza ◽  
Luísa Maria Ferreira ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Hydroxyethyl Starch ◽  
Cerebral Oxygenation ◽  
Plasma Concentrations ◽  
Volume Replacement ◽  
Cerebral Oximetry ◽  
Total Power ◽  
Organ Perfusion ◽  
Acute Bleeding ◽  
Young Pigs

Bleeding changes the haemodynamics, compromising organ perfusion. In this study, the effects of bleeding followed by replacement with hydroxyethyl starch 130/0.4 (HES) or lactated Ringer’s (LR) on cerebral oxygenation and electroencephalogram-derived parameters were investigated. Twelve young pigs under propofol-remifentanil anaesthesia were bled 30 mL/kg and, after a 20-minute waiting period, volume replacement was performed with HES (GHES;N=6) or LR (GRL;N=6). Bleeding caused a decrease of more than 50% in mean arterial pressure (P<0.01) and a decrease in cerebral oximetry (P=0.039), bispectral index, and electroencephalogram total power (P=0.04andP<0.01, resp.), while propofol plasma concentrations increased (P<0.01). Both solutions restored the haemodynamics and cerebral oxygenation similarly and were accompanied by an increase in electroencephalogram total power. No differences between groups were found. However, one hour after the end of the volume replacement, the cardiac output (P=0.03) and the cerebral oxygenation (P=0.008) decreased in the GLRand were significantly lower than in GHES(P=0.02). Volume replacement with HES 130/0.4 was capable of maintaining the cardiac output and cerebral oxygenation during a longer period than LR and caused a decrease in the propofol plasma concentrations.

scholarly journals Use of polypeptide neuroprotection for prevention of postoperative cognitive dysfunction after cardiac surgery: a pilot prospective randomized placebo-controlled clinical study

2017 ◽  
Vol 21 (4) ◽  
pp. 69
Author(s):  
M. A. Putanov ◽  
M. A. Sokolova ◽  
P. I. Lenkin ◽  
V. Yu. Slastilin ◽  
I. G. Baskakova ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Cognitive Dysfunction ◽  
Study Design ◽  
Cerebral Oxygenation ◽  
Plasma Concentrations ◽  
Postoperative Cognitive Dysfunction ◽  
Cerebral Oximetry ◽  
S100b Protein ◽  
Control Group

<p><strong>Aim.</strong> The study was designed to evaluate the efficacy of polypeptide neuroprotection using brain protein “Cellex” for prevention of postoperative cognitive dysfunction after cardiac surgery.<br /><strong>Methods.</strong> Our study included 60 patients undergoing elective cardiosurgical operations, who were randomized into two groups. In the “Cellex” group, the patients received 1.0 ml of “Cellex” subcutaneously daily during 8 days, beginning from the preoperative day, while the control group patients were given a saline placebo. The cognitive function was assessed using a Montreal cognitive assessment (MoCA) test on the day before surgery and also at Days 3 and 7 postoperatively. The plasma concentrations of S100b protein were measured before surgery, and at Days 3 and 7. The patients’ gas exchange, hemodynamics and cerebral oxygenation were monitored. In addition, the efficacy of “Cellex” and the severity of cognitive dysfunction were evaluated intraoperatively under cardiopulmonary bypass.<br />Results. The duration of intervention and mechanical ventilation, as well as hemodynamics and cerebral oximetry data did not differ significantly between the groups. There was a transient decline of cognitive functions and an increase in plasma concentration of S100b at Day 3 after surgery in both groups (p&lt;0.05). At Day 7, the MoCA score was still decreased in the control group (p&lt;0.003), but returned to the baseline in the “Cellex” group. These effects became more pronounced after cardiopulmonary bypass. The intraoperative PaCO2 correlated with cerebral oxygenation surgery by the beginning and at the end of surgery (rho = 0.305, p = 0.033 and rho = 0.533; p&lt;0.001). <br />Conclusion. The perioperative use of “Cellex” can attenuate cognitive dysfunction after cardiac surgery, especially when following interventions under cardiopulmonary bypass.</p><p>Received 25 May 2017. Revised 9 November 2017. Accepted 13 November 2017.</p><p><strong>Funding:</strong> The study was carried out with support of the “Farm-Sintez” company’s grant. The money was spent for purchase of the preparation, the authors’ honoraria and purchase of a kit for determining S100b protein concentration. The sponsors’ support had no impact on the study design and data acquisition, analysis and interpretation. The “Farm-Sintez” company’s representatives were not participating in the preparation and publication of the article.</p><p><strong>Conflict of interest:</strong> The study was carried out with support of the “Farm-Sintez” company’s grant.</p><p><strong>Author contributions</strong><br />Conception and study design: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, M.Yu. Kirov <br />Data collection and analysis: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, I.G. Baskakova, A.N. Kiriluk, D.N. Kazarinov, K.M. Checkaya, T.S. Isakova, M.A. Rumyanceva, V.Yu. Slastilin <br />Statistical data analysis: M.M. Sokolova <br />Drafting the article: M.A. Putanov, M.M. Sokolova <br />Critical revision of the article: M.Yu. Kirov <br />Final approval of the version to be published: M.A. Putanov, M.M. Sokolova, P.I. Lenkin, V.Yu. Slastilin, I.G. Baskakova, A.N. Kiriluk, D.N. Kazarinov, K.M. Checkaya, T.S. Isakova, M.A. Rumyanceva, M.Yu. Kirov</p>

IN SITU AND PILOT ORGAN PERFUSION TECHNIQUES FOR THE STUDY OF METABOLIC DYNAMICS

1972 ◽  
Vol 68 (2_Supplb) ◽  
pp. S9-S25 ◽  
Author(s):  
John Urquhart ◽  
Nancy Keller
Keyword(s):  
Cardiac Output ◽  
Large Fraction ◽  
Experimental Studies ◽  
Test Substance ◽  
Organ Perfusion ◽  
Systemic Blood ◽  
Experimental Control ◽  
Arterial Blood ◽  
Vascular Connections

ABSTRACT Two techniques for organ perfusion with blood are described which provide a basis for exploring metabolic or endocrine dynamics. The technique of in situ perfusion with autogenous arterial blood is suitable for glands or small organs which receive a small fraction of the animal's cardiac output; thus, test stimulatory or inhibitory substances can be added to the perfusing blood and undergo sufficient dilution in systemic blood after passage through the perfused organ so that recirculation does not compromise experimental control over test substance concentration in the perfusate. Experimental studies with the in situ perfused adrenal are described. The second technique, termed the pilot organ method, is suitable for organs which receive a large fraction of the cardiac output, such as the liver. Vascular connections are made between the circulation of an intact, anaesthetized large (> 30 kg) dog and the liver of a small (< 3 kg) dog. The small dog's liver (pilot liver) is excised and floated in a bath of canine ascites, and its venous effluent is continuously returned to the large dog. Test substances are infused into either the hepatic artery or portal vein of the pilot liver, but the small size of the pilot liver and its blood flow in relation to the large dog minimize recirculation effects. A number of functional parameters of the pilot liver are described.

scholarly journals Retraction notice to “Volume replacement with hydroxyethyl starch solution in children” [Br J Anaesth 70 (1993) 661–5]

2020 ◽  
Vol 125 (3) ◽  
pp. 413-414
Author(s):  
J. Boldt ◽  
C. Knothe ◽  
E. Schindler ◽  
H. Hammermann ◽  
F. Dapper ◽  
...  
Keyword(s):  
Hydroxyethyl Starch ◽  
Volume Replacement ◽  
Starch Solution ◽  
Retraction Notice

Severe Valvular Disease

2017 ◽  
Author(s):  
Yafen Liang ◽  
Andrew Shaw
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Disease Severity ◽  
Perioperative Period ◽  
Valvular Disease ◽  
Organ Perfusion ◽  
Forward Flow ◽  
Pressure Dynamics ◽  
Valvular Diseases ◽  
Perioperative Assessment

The pathophysiology of valvular diseases follows the fundamental principles of fluid and pressure dynamics. Alteration in any of the major components that determine forward flow can translate into a change in stroke volume, which in turn results in a change in cardiac output. The goal of managing severe valvular disease in the perioperative period is to maintain the forward flow required for end organ perfusion and minimize regurgitation. Accordingly, this chapter discusses the major principles involved in the pathophysiology of valve disease, as well as the perioperative assessment of disease severity and appropriate management based upon the type of lesion being encountered.

scholarly journals RETRACTED: VOLUME REPLACEMENT WITH HYDROXYETHYL STARCH SOLUTION IN CHILDREN

1993 ◽  
Vol 70 (6) ◽  
pp. 661-665 ◽  
Author(s):  
J. BOLDT ◽  
C. KNOTHE ◽  
E. SCHINDLER ◽  
H. HAMMERMANN ◽  
F. DAPPER ◽  
...  
Keyword(s):  
Hydroxyethyl Starch ◽  
Volume Replacement ◽  
Starch Solution

Cerebral Oxygen Saturation in Sickle Cell Patients Treated with Hydroxyurea:.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1677-1677
Author(s):  
Masoud Nahavandi ◽  
Fatemeh Tavakkoli ◽  
Melville Q. Wyche ◽  
Syed P. Hasan ◽  
Oswaldo Castro
Keyword(s):  
Sickle Cell Disease ◽  
Oxygen Saturation ◽  
Sickle Cell ◽  
Cerebral Oxygenation ◽  
Cerebral Oximetry ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Cell Disease ◽  
Non Invasive

Abstract Recently we reported the use of a non-invasive near-infrared optical spectroscopy technique to measure cerebral oxygenation (cerebral oximetry, rSO2%) in agroup of 27 adult patients with sickle cell disease (Eur J Clin Invest, 34:143,2004). The sickle cell patients’ rSO2 values were significantly lower (mean 47.7%) than those in normal subjects (mean 61.3%) even though none of the patients had clinical evidence of stroke or cerebral ischemia. We included patients with all Hb phenotypes, and regardless of hydroxyurea (HU) treatment. Transfusions improved cerebral oxygen saturation but the post-transfusion values still did not reach normal levels. Our findings were corroborated independently by Raj et al. who studied 25 children with sickle cell disease (J Pediat Hematol Oncol 26:279,2004). In order to determine if long-term HU treatment affects rSO2, we analyzed cerebral oximetry results in a subset of 31 patients with sickle cell anemia (Hb SS). Eleven of them were on long-term (more than 6 months) HU treatment at stable doses (1000–1500 mg/day). The table shows that the mean rSO2, Hb, Hct, and MCV in HU-treated patients were significantly higher than those in sickle cell anemia (SCA) patients not on HU. The rSO2 in HU-treated patients was 12.5% higher than in SS patients not on this drug. By comparison, we previously reported a 24% increment in rSO2 following transfusions. A group of 8 patients who were on long-term HU treatment were given also single 1000 mg oral doses of HU and their rSO2 was measured for 12 hours without noticeable change in cerebral oxygenation. Nor did rSO2 change after oxygen inhalation (3L/min). The cause of the low rSO2 in sickle cell patients is unknown and still under investigation. It is probably not related exclusively to the anemia, since, as previously reported, anemic subjects without sickle cell disease appear to have normal rSO2. These preliminary results indicate that chronic HU treatment is associated with higher rSO2 values in SCA. If validated in a larger number of patients, our findings suggest that cerebral oximetry could be a useful, non-invasive method for assessing a new in vivo effect of HU and red cell transfusion in sickle cell disease: increased blood oxygen saturation in the cerebral vasculature. HYDROXYUREA AND CEREBRAL OXYGEN SATURATION IN PATIENTS WITH SICKLE CELL DISEASE NO HYDROXYUREA (N=20) HYDROXYUREA (N=11) P value* rSO2 = cerebral oxygen saturation. *= t-test. Plus/minus figures represent SD Mean rSO2 (%) 41 ± 6.6 46 ± 7.6 0.025 Mean Hb (g/dl) 8.4 ± 1.4 9.68 ± 1.2 0.029 Mean Hct (%) 24± 3.4 28± 4.4 0.027 Mean MCV (fl) 89± 8 102± 7 0.028

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