scholarly journals Effects of Sevoflurane and Propofol on Organ Blood Flow in Left Ventricular Assist Devices in Pigs

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Paloma Morillas-Sendín ◽  
Emilio Delgado-Baeza ◽  
María Jesús Delgado-Martos ◽  
Mónica Barranco ◽  
Juan Francisco del Cañizo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Organ Blood Flow ◽  
Hemodynamic Parameters ◽  
Partial Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
The Brain

The aim of this study was to assess the effect of sevoflurane and propofol on organ blood flow in a porcine model with a left ventricular assist device (LVAD). Ten healthy minipigs were divided into 2 groups (5 per group) according to the anesthetic received (sevoflurane or propofol). A Biomedicus centrifugal pump was implanted. Organ blood flow (measured using colored microspheres), markers of tissue injury, and hemodynamic parameters were assessed at baseline (pump off) and after 30 minutes of partial support. Blood flow was significantly higher in the brain (both frontal lobes), heart (both ventricles), and liver after 30 minutes in the sevoflurane group, although no significant differences were recorded for the lung, kidney, or ileum. Serum levels of alanine aminotransferase and total bilirubin were significantly higher after 30 minutes in the propofol group, although no significant differences were detected between the groups for other parameters of liver function, kidney function, or lactic acid levels. The hemodynamic parameters were similar in both groups. We demonstrated that, compared with propofol, sevoflurane increases blood flow in the brain, liver, and heart after implantation of an LVAD under conditions of partial support.

scholarly journals Corrigendum to “Effects of Sevoflurane and Propofol on Organ Blood Flow in Left Ventricular Assist Devices in Pigs”

2016 ◽  
Vol 2016 ◽  
pp. 1-1 ◽  
Author(s):  
Paloma Morillas-Sendín ◽  
Emilio Delgado-Baeza ◽  
María Jesús Delgado-Martos ◽  
Mónica Barranco ◽  
Juan Francisco Del Cañizo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Organ Blood Flow ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist

Associations between hemodynamic parameters at rest and exercise capacity in patients with implantable left ventricular assist devices

2020 ◽  
pp. 039139882094988 ◽  
Author(s):  
Toru Kondo ◽  
Takahiro Okumura ◽  
Hideo Oishi ◽  
Yoshihito Arao ◽  
Hiroo Kato ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Left Ventricular ◽  
Hemoglobin Level ◽  
Ventricular Assist Devices ◽  
Right Atrial ◽  
Stroke Work ◽  
Hemodynamic Parameters ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist

Background: Hemodynamic parameters at rest are known to correlate poorly with peak oxygen uptake (VO2) in heart failure. However, we hypothesized that hemodynamic parameters at rest could predict exercise capacity in patients with left ventricular assist device (LVAD), because LVAD pump rotational speed does not respond during exercise. Therefore, we investigated the relationships between hemodynamic parameters at rest (measured with right heart catheterization) and exercise capacity (measured with cardiopulmonary exercise testing) in patients with implantable LVAD. Methods: We performed a retrospective medical record review of patients who received implantable LVAD at our institution from November 2013 to December 2017. Results: A total of 20 patients were enrolled in this study (15 males; mean age, 45.8 years; median duration of LVAD support, 356 days). The mean peak VO2 and cardiac index (CI) were 13.5 mL/kg/min and 2.6 L/min/m2, respectively. CI and hemoglobin level were significantly associated with peak VO2 (CI: r = 0.632, p = 0.003; hemoglobin: r = 0.520, p = 0.019). In addition, pulmonary capillary wedge pressure, right atrial pressure, and right ventricular stroke work index were also significantly associated with peak VO2. In multiple linear regression analysis, CI and hemoglobin level remained independent predictors of peak VO2 (CI: β = 0.559, p = 0.006; hemoglobin: β = 0.414, p = 0.049). Conclusions: CI at rest and hemoglobin level are associated with poor exercise capacity in patients with LVAD.

Endothelial Function in Patients With Continuous-Flow Left Ventricular Assist Devices

Angiology ◽  
2020 ◽  
Vol 72 (1) ◽  
pp. 9-15
Author(s):  
Pavel Poredos ◽  
Mateja K. Jezovnik ◽  
Rajko Radovancevic ◽  
Igor D. Gregoric
Keyword(s):  
Heart Failure ◽  
Blood Flow ◽  
Shear Stress ◽  
Continuous Flow ◽  
Tissue Perfusion ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Left Ventricular Assist

The endothelium plays a crucial role in maintaining cardiovascular homeostasis. Shear stress generated by flowing blood regulates the release of substances that provide adequate tissue perfusion. The extent of damage to endothelial cells depends on locally disturbed shear stress caused by the deteriorated flow. Patients with heart failure have reduced cardiac output, which results in reduced blood flow and negative shear stress. Reduced shear stress also affects microcirculation and reduces tissue perfusion. Consequently, the production of free oxygen radicals is increased and bioavailability of nitric oxide is additionally decreased. Therefore, endothelial dysfunction is involved in the progression of heart failure and cardiovascular events. Left ventricular assist devices (LVAD) are used for the treatment of patients with advanced heart failure. Older pulsatile flow LVADs were mostly substituted by continuous-flow LVADs (cf-LVADs). Despite the advantages of the cf-LVADs, the loss of pulsatility leads to different complications on the micro- and macrovascular levels. One of the pathogenetic mechanisms of cardiovascular complications with cf-LVADs may be endothelial dysfunction, which after the implantation of the device does not improve and may even deteriorate. In contrast, the pulsatile pattern of LVADs on blood flow could preserve endothelial function.

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