Does tumescent liposuction damage the lymph vessels in lipoedema patients?

Background Lymphatic insufficiency might play a significant role in the pathophysiology of lipoedema. Liposuction is up to now the best treatment. As liposuction is invasive, the technique could destruct parts of the lymphatic system and by this aggravate the lymphatic component and/or induce lymphoedema. We investigated the function of the lymphatic system in lipoedema patients before and after tumescent liposuction and thus whether tumescent liposuction can be regarded as a safe treatment. Methods Lymphoscintigraphy was performed to quantify the lymph outflow of 117 lipoedema patients. Mean clearance percentages of radioactive protein loaded after 1 min with respect to the total injected dose and corrected for decay of the radiopharmaceutical in the subcutaneous lymphatics were used as functional quantitative parameters as well as the clearance percentages and inguinal uptake 2 h post injection. The results of lymphatic function in lipoedema patients were compared with values obtained from normal healthy volunteers. We also compared 50 lymphoscintigraphies out of the previous 117 lipoedema patients before and six months after tumescent liposuction. Results In 117 lipoedema patients clearance 2 h post injection in the right and left foot was disturbed in 79.5 and 87.2% respectively. The inguinal uptake 2 h post injection in the right and left groin was disturbed in 60.3 and 64.7% respectively. In 50 lipoedema patients mean clearance and inguinal uptake after tumescent liposuction were slightly improved, 0.01 (p = 0.37) versus 0.02 (p = 0.02), respectively. This is statistically not relevant in clearance. Conclusion Lipoedema legs have a delayed lymph transport. Tumescent liposuction does not diminish the lymphatic function in lipoedema patients, thus tumescent liposuction can be regarded as a safe treatment.

Download Full-text

Evaluation of the total distribution volume of 18F-FBPA in normal tissues of healthy volunteers by non-compartmental kinetic modeling

Annals of Nuclear Medicine ◽

10.1007/s12149-019-01427-9 ◽

2019 ◽

Vol 34 (3) ◽

pp. 155-162

Author(s):

Victor Romanov ◽

Kayako Isohashi ◽

Galal Alobthani ◽

Rouaa Beshr ◽

Genki Horitsugi ◽

...

Keyword(s):

Healthy Volunteers ◽

Goodness Of Fit ◽

Boron Concentration ◽

Distribution Volume ◽

Post Injection ◽

Residual Distribution ◽

Activity Data ◽

Normal Tissues ◽

Logan Plot ◽

The Right

Abstract Objective Boron neutron capture therapy (BNCT) is a noninvasive radiation therapy method for cancer treatment. In BNCT, 4-borono-2-[18F]-fluoro-L-phenylalanine (18F-FBPA) PET has been employed to estimate 10B accumulation in target tumors and normal tissues if 10B borono-L-phenylalanine (10B-BPA) is used as a boron carrier. The purpose of the current study was to evaluate the total distribution volume (Vt) of 18F-FBPA in normal organs of healthy volunteers by kinetic analysis and to estimate boron concentration in normal organs for the therapeutic dose of 10B-BPA using obtained Vt values. Methods Six healthy volunteers were injected with 18F-FBPA (3–5 MBq/kg), and 7 PET-CT scans were performed subsequently. 18F-FBPA radioactivity in whole blood and plasma was measured before, and eight times after the injection. PET images were analyzed by PMOD software. Twelve volumetric regions of interest including the brain, heart, right lung, spleen, liver, parotid salivary glands, esophagus, stomach, pancreas, intestines, and bone marrow were drawn manually for each subject and analyzed with the Logan plot and two Ichise multilinear analyses (MA1 and MA2). The better model was defined by several goodness-of-fit parameters and residual distribution. After Vt values had been derived, boron concentration was estimated in ppm for the 10B-BPA-fructose (10B-BPA-fr) dose 30 g 1 and 2 h post-injection using Vt and interpolated plasma activity data. Results The Ichise MA2 model showed the best fit among all models. Akaike Information Criterion (AIC) was the lowest for the Ichise’s MA2 in all regions (mean AIC value − 14.0) comparing to the other models (Logan plot mean AIC 31.4; Ichise MA1 model mean AIC − 4.2). Mean Vt values of the Ichise MA2 model ranged from 0.94 ± 0.14 ml/ml in the pancreas to 0.16 ± 0.02 ml/ml in the right lung. Estimated boron concentration for 10B-BPA-fr had the highest value in the pancreas (14.0 ± 1.9 ppm 1 h after, and 5.7 ± 1.7 ppm 2 h after the 18F-FBPA administration) and the lowest value in the right lung (2.4 ± 0.3 ppm 1 h, and 1.0 ± 0.3 ppm 2 h post-injection). Conclusion The 10B concentration in normal tissues was best estimated using Vt values of 18F-FBPA with the Ichise multilinear analysis 2 (MA2). Trail registry The UMIN clinical trial number: UMIN000022850.

Download Full-text

Comparative Arterial Antithrombotic Activity of Clopidogrel and Acetyl Salicylic Acid in the Pig

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646307 ◽

1992 ◽

Vol 68 (05) ◽

pp. 500-505 ◽

Cited By ~ 32

Author(s):

Ch M Samama ◽

Ph Bonnin ◽

M Bonneau ◽

G Pignaud ◽

E Mazoyer ◽

...

Keyword(s):

Platelet Aggregation ◽

Femoral Artery ◽

Bleeding Time ◽

Ex Vivo ◽

Flow Reduction ◽

Cyclic Flow ◽

Left Femoral Artery ◽

Before And After ◽

The Right ◽

Induced Aggregation

SummaryWe investigated the comparative antithrombotic properties of clopidogrel, an analogue of ticlopidine, and aspirin, using the Folts' model on femoral arteries in 22 pigs. On each animal, clopidogrel or aspirin were used to treat the thrombotic process on the left femoral artery and to prevent this process on the right femoral artery. Sequentially: an injury and stenosis were carried out on the left femoral artery; the thrombotic process was monitored with a Doppler during a 30-min observation period for cyclic flow reductions or permanent cessation of flow; after the first cyclic flow reduction occurred, clopidogrel (5 mg kg-1) or aspirin (2.5, 5, 100 mg kg-1) were injected intravenously; if cyclic flow reductions were abolished, epinephrine (0.4 µg kg-1 min-1) was injected to try to restore cyclic flow reductions and/or permanent cessation of flow; then injury and stenosis were applied on the right femoral artery. Before and after injection of clopidogrel or aspirin, ear immersion bleeding times and ex-vivo platelet aggregation were performed. Clopidogrel (n = 7) abolished cyclic flow reductions in all animals and epinephrine did not restore any cyclic flow reduction. On the right femoral artery, cyclic flow reductions were efficiently prevented, even for two injuries. Basal bleeding time (5 min 28) was lengthened (>15 min, 30 min after clopidogrel and remained prolonged even after 24 h). ADP-induced platelet aggregation was inhibited (more than 78%). Comparatively, aspirin had a moderate and no dose-dependent effect. Aspirin 2.5 mg kg-1 (n = 6) abolished cyclic flow reductions in 2 animals, CFR reoccurred spontaneously in one animal and epinephrine restored it in a second animal. Aspirin 5 mg kg-1 (n = 6) abolished cyclic flow reductions in only 3 animals and epinephrine always restored it. Aspirin 100 mg kg-1 (n = 3) was unable to abolish cyclic flow reductions. On the right femoral artery, aspirin did not significantly prevent cyclic flow reductions which occurred in all animals after one (n = 14) or two injuries (n = 1), except for one animal. Basal bleeding time was lengthened but it shortened rapidly, reaching its basal value after 24 h. ADP-induced aggregation was not significantly inhibited, whereas arachidonic acid induced aggregation was always inhibited. Clopidogrel appears as a more potent antithrombotic drug than aspirin in this model, in treating and preventing spontaneous or epinephrine-induced cyclic flow reductions and lengthening bleeding time.

Download Full-text

EFEKTIVITAS METODE DEMONSTRASI DALAM MENINGKATKAN HASIL BELAJAR SISWA SEKOLAH MENENGAH KEJURUAN PADA PENGAJARAN SISTEM KOLOID

JURNAL PENELITIAN BIDANG PENDIDIKAN ◽

10.24114/jpp.v19i1.3044 ◽

2013 ◽

Vol 19 (1) ◽

pp. 28

Author(s):

Hamda Situmorang ◽

Manihar Situmorang

Keyword(s):

High School ◽

High School Students ◽

Abstract Concept ◽

Vocational High School ◽

School Students ◽

Lecture Method ◽

Colloid System ◽

Before And After ◽

The Right ◽

And Control

Abstract Implementation of demonstration method in the teaching of chemistry is assigned as the right strategy to improve students’ achievement as it is proved that the method can bring an abstract concept to reality in the class. The study is conducted to vocational high school students in SMKN1 Pargetteng getteng Sengkut Pakfak Barat at accademic year 2013. The teaching has been carried out three cycles on the teaching of chemistry topic of colloid system. In the study, the class is divided into two class, experiment class and control class. The demontration method is used to teach students in experimental class while the teaching in control class is conducted with lecture method. Both are evaluated by using multiple choise tests before and after the teaching procedures, and the ability of students to answer the problems are assigned as students’ achievements. The results showed that demonstration method improved students’ achievement in chemistry. The students in experimental class who are taughed with demonstration method (M=19.08±0.74) have higher achievements compare with control class (M=12.91±2.52), and both are significantly different (tcalculation 22.85 > ttable 1.66). The effectivity of demostration method in experimental class (97%) is found higer compare to conventional method in control class (91%).

Download Full-text

EDUKASI TERHADAP REMAJA DALAM PENINGKATAN PENGETAHUAN TENTANG PENGGUNAAN GAME DENGAN BIJAK

Jurnal Pemberdayaan Masyarakat Universitas Al Azhar Indonesia ◽

10.36722/jpm.v2i1.361 ◽

2020 ◽

Vol 2 (1) ◽

pp. 11

Author(s):

Ikhsan Fuady ◽

Rangga Saptya MP

Keyword(s):

Side Effects ◽

Violent Behavior ◽

Daily Lives ◽

Before And After ◽

Improper Use ◽

Effective Role ◽

Education And Outreach ◽

The Right ◽

Dedicated Team ◽

User Ratings

AbstrakPemanfaatan game dikalangan remaja memiliki peran yang efektif sebagai wadah untuk hiburan. Tetapi pemanfaatan game tidak tepat memiliki efek samping game terhadap kehidupan sehari hari remaja, mulai dari kurang bersosialIsasi hingga perilaku kekerasan dikalangan remaja. Penyuluhan terhadap remaja bertujuan untuk memberikan pemahaman kepada remaja tentang variasi game berdasarkan rating pengguna, maupun cerdas dalam manajemen penggunaan game dalam kehidupan remaja sehari hari. Pengetahuan remaja tentang varian/ragam game berdasarkan rating relatif rendah sebagaian besar pemengetahuannya tersebar pada kategori sangat rendah dan rendah yaitu sebesar 65 persen. Metode edukasi dan sosialisasi ini adalah dengan beberapa tahapan. Tahap pertaman tim pengabdian memberikan edukasi dan diskusi tentang beragam bentuk game, karakteristik, serta karakteristik pengguna game yang tepat. Selanjutnya beberapa permainan dan kuis untuk meingkatkan literasi remaja tentang pemanfaatan game secara bijak. Kegiatan penyuluhan ini mampu meningkatkan pemahaman para remaja dalam mengenali game yang baik digunakan, hal ini dapat dilihat dari peningkatan pengetahuan remaja relatif signifikan sebelum dan sesudah penyuluhan.Kata kunci: Edukasi, Game, Penyuluhan Abstract The use of games among teenagers has an effective role as a forum for entertainment. But the improper use of games has the side effects of games on the daily lives of adolescents, ranging from lack of socialization to violent behavior in adolescents. Counseling against adolescents aims to provide understanding to adolescents about the variety/variance of games based on user ratings, as well as being smart in managing game use in daily teenage life. Teenagers' knowledge about game variants/based on the rating is relatively low, most of the knowledge is spread in the very low and low categories, which is 65 percent. The method of education and outreach is by several stages. The first stage of the dedicated team provided education and discussion about various forms of games, characteristics, and characteristics of the right game user. Furthermore, some games and quizzes to improve teen literacy about game use wisely. This counseling activity can increase the understanding of teenagers in recognizing games that are well used, this can be seen from the relatively significant increase in adolescent knowledge before and after counseling.Keywords: Education, Games, Counseling

Download Full-text

Smartphone addiction and the relationship with head and neck pain and electromiographic activity of masticatory muscles

Work ◽

10.3233/wor-203398 ◽

2021 ◽

pp. 1-8

Author(s):

Fabiana Foltran Mescollotto ◽

Érica Brito Gonçalves ◽

Ester Moreira de Castro Carletti ◽

Ana Beatriz Oliveira ◽

Elisa Bizetti Pelai ◽

...

Keyword(s):

College Students ◽

Neck Pain ◽

Head And Neck ◽

Muscle Activity ◽

Neck Region ◽

Masticatory Muscles ◽

Smartphone Addiction ◽

Before And After ◽

Smartphone Use ◽

The Right

Background: Excessive use of smartphones may be associated with behavioral and physical health changes and might cause musculoskeletal alterations in the head and neck region. Objective: To evaluate the prevalence of smartphone addiction in college students and its correlation with symptoms of head and neck pain and masticatory and trapezius muscle activity while resting, before and after smartphone use. Methods: Twenty university students participated in the study. They answered the Smartphone Addiction Scale and the Fonseca Anamnestic Index. Next, the participants were seated and prepared for electromyography through the placement of surface electrodes on the masseter, temporal, and trapezius muscles. Rest condition data were collected for 10 seconds before and after 30 minutes of smartphone use. Results: The results showed that 35% of the evaluated individuals were classified as smartphone addicted and 35% reported no head or neck pain in the previous 30 days. There was no association between smartphone use and head and neck pain. In the electromyography, there was an increase in RMS values after smartphone use in the right and left masseter muscles and the left trapezius. Conclusion: College students presented a high prevalence of smartphone addiction and head and neck pain, but these were not statistically associated. There was a change in muscle activity only in the right trapezius muscles before and after 30 minutes of smartphone use. These findings are contrary to the current belief that the use of smartphones correlates with pain in the neck region and changes in the electrical muscle activity, leading to fatigue in the cervical muscles.

Download Full-text

Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02820-8 ◽

2021 ◽

Author(s):

Sergey Dydykin ◽

Friedrich Paulsen ◽

Tatyana Khorobykh ◽

Natalya Mishchenko ◽

Marina Kapitonova ◽

...

Keyword(s):

Prone Position ◽

Anatomical Study ◽

Structural Features ◽

Posterior Mediastinum ◽

Visual Navigation ◽

Anatomical Landmarks ◽

Video Assisted ◽

Before And After ◽

Human Cadavers ◽

The Right

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

Download Full-text

Evaluation of the morphology and mechanics of the right ventricle using echocardiography before and after transcatheter balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.130 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

KIRILL Malikov ◽

MARINA Kirichkova ◽

MARIA Simakova ◽

NARECK Marukyan ◽

OLGA Moiseeva

Keyword(s):

Pulmonary Artery ◽

Right Ventricle ◽

Pulmonary Artery Pressure ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Reverse Remodeling ◽

Free Wall ◽

Artery Pressure ◽

Balloon Pulmonary Angioplasty ◽

Before And After ◽

The Right

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Chronic thromboembolic pulmonary hypertension (CTEPH) leads to a progressive increase in pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) with the development of severe dysfunction of the right heart and heart failure. Mortality for three years with an average pressure in the pulmonary artery (PA) of more than 50 mmHg is more than 90%. Balloon pulmonary angioplasty (BPA) has a significant advantage over other methods of surgical treatment, but it requires the determination of additional non-invasive markers of effectiveness. Transthoracic echocardiography (TTE) remains the main method for assessing the morphology and function of the heart. Purpose Compare different indicators reflecting the severity of CTEPH with TTE indicators before and after BPA. To evaluate the effectiveness of using BPA for the treatment of patients with CTEPH using routine TTE and speckle tracking mode. Materials and methods For 18 months 30 patients without concomitant cardiovascular pathology were subjected to several BPA sessions. Before treatment, 50% of patients belonged to the 3 CTEPH functional class (FC), 40% to 2 FC, 10% to 1 FC. The average number of sessions was 4.7 ± 1.3. Before the first BPA and after the last, all the patients were performed: six-minute walk test (6MWT, metres), Borg scale (in points), test for NT-proBNP (pg/ml); TTE with assessment of the right ventricle (RV) and left ventricle (LV) including areas of the right atrium (aRA, cm2), mean pulmonary artery pressure (PUPM,mmHg),RV free wall strain (GLSFW, %), RV free wall strain rate (GLSRFW, sm/sec), RV free wall postsystolic shortening (PSSFW, %), tricuspid annular plane systolic excursion (TAPSE, sm), tricuspid annulus systolic velocity (TASV, sm/sec). Results. Before the first BPA session, the 6MWT in the patient group averaged 315.9 ± 9.08 metres, after - 439.5 ± 11.45 m; the Borg from 5.4 ± 0.94 points decreased to 4 ± 1.01 points; NT-proBNP before the treatment was 1513 ± 13.01 pg/ml, after - 171 ± 6.09; according to TTE the ratio of RV/ LV before and after treatment was 1.31 ± 0.02 and 0.97 ± 0.04; aRA was 29.3 ± 4.87 and 22.3 ± 3.53 cm2; basal RV - 52 ± 5.11 and 44 ± 7.26 mm; PUPM decreased from 76.6 ± 7.65 to 31.3 ± 3.78 mmHg; GLSFW from -14.69 ± 2.33 came to 17.5 ± 3.45 %; GLSRFW with -0.9 ± 0.09 to -1.7 ± 0.11 cm/sec; TAPSE from 16.7 ± 1.87 to 18.2 ± 2.34 cm; TASV from 10.11 ± 1.45 to 12.25 ± 1.98 cm/s, PSSFW before treatment was -18.4 ± 1.2%, after treatment in 66% of patients disappeared, in 34% became an average of 17.4 ± 0.9% The distribution of STEPH FC has also changed. Conclusion. BPA leads to an improvement in the tolerance of physical activity, clinical indicators, and parameters of central hemodynamics in the pulmonary circulation, evaluated according to direct manometry, and leads to reverse remodeling of the RV in the long term. Performing a staged BPA leads to an improvement in the functional parameters of contractility of the RV.

Download Full-text

Hemodynamic Responses in Lower Limb Lymphedema Patients Undergoing Physical Therapy

Biology ◽

10.3390/biology10070642 ◽

2021 ◽

Vol 10 (7) ◽

pp. 642

Author(s):

Bianca Brix ◽

Olivier White ◽

Christian Ure ◽

Gert Apich ◽

Paul Simon ◽

...

Keyword(s):

Physical Therapy ◽

Lymphatic System ◽

Orthostatic Intolerance ◽

Hemodynamic Responses ◽

Stand Test ◽

Beneficial Effects ◽

Sit To Stand ◽

Complete Decongestive Therapy ◽

Before And After ◽

Baseline Values

Background: Lymphedema arises due to a malfunction of the lymphatic system, leading to extensive tissue swelling. Complete decongestive therapy (CDT), which is a physical therapy lasting for 3 weeks and includes manual lymphatic drainages (MLD), leads to fluid mobilization and increases in plasma volume. Here, we investigated hemodynamic responses induced by these fluid shifts due to CDT and MLD. Methods: Hemodynamic parameters were assessed continuously during a sit-to-stand test (5 min baseline, 5 min of standing, and 5 min of recovery). This intervention was repeated on days 1, 2, 7, 14, and 21 of CDT, before and after MLD. Volume regulatory hormones were assessed in plasma samples. Results: A total number of 13 patients took part in this investigation. Resting diastolic blood pressure significantly decreased over three weeks of CDT (p = 0.048). No changes in baseline values were shown due to MLD. However, MLD led to a significant decrease in heart rate during orthostatic loading over all epochs on therapy day 14, as well as day 21. Volume regulatory hormones did not show changes over lymphedema therapy. Conclusion: We did not observe any signs of orthostatic hypotension at rest, as well as during to CDT, indicating that lymphedema patients do not display an elevated risk of orthostatic intolerance. Although baseline hemodynamics were not affected, MLD has shown to have potential beneficial effects on hemodynamic responses to a sit-to-stand test in patients undergoing lymphedema therapy.

Download Full-text

Heart in Acromegaly: The Echocardiographic Characteristics of Patients Diagnosed with Acromegaly in Various Stages of the Disease

International Journal of Endocrinology ◽

10.1155/2018/6935054 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Agata Popielarz-Grygalewicz ◽

Jakub S. Gąsior ◽

Aleksandra Konwicka ◽

Paweł Grygalewicz ◽

Maria Stelmachowska-Banaś ◽

...

Keyword(s):

Right Ventricular ◽

Healthy Volunteers ◽

Global Longitudinal Strain ◽

Interventricular Septum ◽

Left Ventricular ◽

Volume Index ◽

Control Group ◽

Glucose Metabolism Disorders ◽

Acromegalic Cardiomyopathy ◽

The Right

To determine whether the echocardiographic presentation allows for diagnosis of acromegalic cardiomyopathy. 140 patients with acromegaly underwent echocardiography as part of routine diagnostics. The results were compared with the control group comprising of 52 age- and sex-matched healthy volunteers. Patients with acromegaly presented with higher BMI, prevalence of arterial hypertension, and glucose metabolism disorders (i.e., diabetes and/or prediabetes). In patients with acromegaly, the following findings were detected: increased left atrial volume index, increased interventricular septum thickness, increased posterior wall thickness, and increased left ventricular mass index, accompanied by reduced diastolic function measured by the following parameters: E’med., E/E’, and E/A. Additionally, they presented with abnormal right ventricular systolic pressure. All patients had normal systolic function measured by ejection fraction. However, the values of global longitudinal strain were slightly lower in patients than in the control group; the difference was statistically significant. There were no statistically significant differences in the size of the right and left ventricle, thickness of the right ventricular free wall, and indexed diameter of the ascending aorta between patients with acromegaly and healthy volunteers. None of 140 patients presented systolic dysfunction, which is the last phase of the so-called acromegalic cardiomyopathy. Some abnormal echocardiographic parameters found in acromegalic patients may be caused by concomitant diseases and not elevated levels of GH or IGF-1 alone. The potential role of demographic parameters like age, sex, and/or BMI requires further research.

Download Full-text

Performance of a capnodynamic method estimating cardiac output during respiratory failure - before and after lung recruitment

Journal of Clinical Monitoring and Computing ◽

10.1007/s10877-019-00421-w ◽

2019 ◽

Vol 34 (6) ◽

pp. 1199-1207

Author(s):

Thorir Svavar Sigmundsson ◽

Tomas Öhman ◽

Magnus Hallbäck ◽

Eider Redondo ◽

Fernando Suarez Sipmann ◽

...

Keyword(s):

Cardiac Output ◽

Respiratory Failure ◽

Reference Method ◽

Hemodynamic Instability ◽

Lung Lavage ◽

Lung Recruitment ◽

Recruitment Manoeuvre ◽

Percentage Error ◽

Before And After ◽

The Right

AbstractRespiratory failure may cause hemodynamic instability with strain on the right ventricle. The capnodynamic method continuously calculates cardiac output (CO) based on effective pulmonary blood flow (COEPBF) and could provide CO monitoring complementary to mechanical ventilation during surgery and intensive care. The aim of the current study was to evaluate the ability of a revised capnodynamic method, based on short expiratory holds (COEPBFexp), to estimate CO during acute respiratory failure (LI) with high shunt fractions before and after compliance-based lung recruitment. Ten pigs were submitted to lung lavage and subsequent ventilator-induced lung injury. COEPBFexp, without any shunt correction, was compared to a reference method for CO, an ultrasonic flow probe placed around the pulmonary artery trunk (COTS) at (1) baseline in healthy lungs with PEEP 5 cmH2O (HLP5), (2) LI with PEEP 5 cmH2O (LIP5) and (3) LI after lung recruitment and PEEP adjustment (LIPadj). CO changes were enforced during LIP5 and LIPadj to estimate trending. LI resulted in changes in shunt fraction from 0.1 (0.03) to 0.36 (0.1) and restored to 0.09 (0.04) after recruitment manoeuvre. Bias (levels of agreement) and percentage error between COEPBFexp and COTS changed from 0.5 (− 0.5 to 1.5) L/min and 30% at HLP5 to − 0.6 (− 2.3 to 1.1) L/min and 39% during LIP5 and finally 1.1 (− 0.3 to 2.5) L/min and 38% at LIPadj. Concordance during CO changes improved from 87 to 100% after lung recruitment and PEEP adjustment. COEPBFexp could possibly be used for continuous CO monitoring and trending in hemodynamically unstable patients with increased shunt and after recruitment manoeuvre.

Download Full-text