Haemodialysis or Haemoperfusion in Severe Salicylate Poisoning?

1988 ◽  
Vol 7 (2) ◽  
pp. 161-163 ◽  
Author(s):  
D. Jacobsen ◽  
E. Wiik-Larsen ◽  
J.E. Bredesen
Keyword(s):  
Blood Flow ◽  
Plasma Levels ◽  
The Other ◽  
Blood Pump ◽  
Supportive Treatment ◽  
Acid Base ◽  
Electrolyte Disturbances ◽  
Salicylate Poisoning ◽  
Maximal Plasma ◽  
Theoretical Advantage

Two cases of severe salicylate poisoning with maximal plasma levels of 6.9 and 8.9 mmol/l are described. In addition to supportive treatment and forced alkaline diuresis, one case was treated with haemoperfusion and the other with haemodialysis. The use of the same blood pump and blood flow allowed us to compare directly the effect of these methods in removing salicylate. There was a non-significant higher dialysance (mean 86 ml/min, s.d. ± 8) than haemoperfusion clearance (mean 81 ml/min s.d. ± 17) at a blood flow of 200 ml/min. As haemodialysis offers the theoretical advantage of correcting acid-base and electrolyte disturbances, does not trap platelets and has a lower heparin requirement, the present comparison indicates that haemodialysis is preferable when extracorporal elimination is indicated in salicylate poisoning.

The Placental Transfer and Fetal Effects of Levobupivacaine, Racemic Bupivacaine, and Ropivacaine

1999 ◽  
Vol 90 (6) ◽  
pp. 1698-1703. ◽  
Author(s):  
Alan C. Santos ◽  
Barry Karpel ◽  
George Noble
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Local Anesthetics ◽  
Placental Transfer ◽  
Well Being ◽  
The Other ◽  
Uterine Blood Flow ◽  
Acid Base ◽  
Fetal Serum ◽  
Acid Base Status

Background The purposes of this study were to assess the effects of levobupivacaine on uterine blood flow and fetal well-being and to compare its placental transfer with that of bupivacaine and ropivacaine. Methods After a control period, pregnant ewes that were fitted with instruments for long-term monitoring were randomized to receive a two-step intravenous infusion of levobupivacaine, bupivacaine, or ropivacaine, in a blinded manner, for 1 h. Maternal and fetal hemodynamics were monitored during the study. Arterial blood samples were drawn at 30 and 60 min of infusion from the mother and fetus to determine the acid-base status (60 min only) and serum drug concentrations. The fetal brain, heart, liver, lungs, adrenal glands, and kidneys were obtained to measure tissue drug levels. Results Maternal blood pressure, central venous and intraamniotic pressures, acid-base status and uterine blood flow were unaffected by any drug infusion. In contrast to the other two local anesthetics, the infusion of bupivacaine was associated with a small but significant decrease in the ewe's heart rate. At the end of the study, the heart rate in the bupivacaine-treated animals was significantly less than in the animals treated with the other two drugs. All fetuses were in good condition at the start of study, and none of the local anesthetics affected fetal well-being. No significant differences were found among the three drugs in the maternal serum, fetal serum, fetal tissue concentrations, and tissue:serum concentration ratios. Conclusions Levobupivacaine was similar to bupivacaine and ropivacaine in causing no important hemodynamic changes in the pregnant ewe and fetus. There were no significant differences in the fetal serum and tissue levels of the drugs.

Experimental investigation of the influence of the hydraulic performance of an axial blood pump on intraventricular blood flow

2021 ◽  
pp. 039139882110130
Author(s):  
Guang-Mao Liu ◽  
Fu-Qing Jiang ◽  
Xiao-Han Yang ◽  
Run-Jie Wei ◽  
Sheng-Shou Hu
Keyword(s):  
Blood Flow ◽  
Particle Image ◽  
Swirling Flow ◽  
Blood Stasis ◽  
Systemic Circulation ◽  
Operating Conditions ◽  
Blood Pump ◽  
Image Velocimetry ◽  
Ct Data

Blood flow inside the left ventricle (LV) is a concern for blood pump use and contributes to ventricle suction and thromboembolic events. However, few studies have examined blood flow inside the LV after a blood pump was implanted. In this study, in vitro experiments were conducted to emulate the intraventricular blood flow, such as blood flow velocity, the distribution of streamlines, vorticity and the standard deviation of velocity inside the LV during axial blood pump support. A silicone LV reconstructed from computerized tomography (CT) data of a heart failure patient was incorporated into a mock circulatory loop (MCL) to simulate human systemic circulation. Then, the blood flow inside the ventricle was examined by particle image velocimetry (PIV) equipment. The results showed that the operating conditions of the axial blood pump influenced flow patterns within the LV and areas of potential blood stasis, and the intraventricular swirling flow was altered with blood pump support. The presence of vorticity in the LV from the thoracic aorta to the heart apex can provide thorough washing of the LV cavity. The gradually extending stasis region in the central LV with increasing blood pump support is necessary to reduce the thrombosis potential in the LV.

scholarly journals Association of changes of retinal vessels diameter with ocular blood flow in eyes with diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshitaka Ueno ◽  
Takeshi Iwase ◽  
Kensuke Goto ◽  
Ryo Tomita ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Adaptive Optics ◽  
Laser Speckle ◽  
The Other ◽  
Systemic Hypertension ◽  
Laser Speckle Flowgraphy ◽  
Retinal Vessels ◽  
External Diameter ◽  
The Mean

AbstractWe investigated morphological changes of retinal arteries to determine their association with the blood flow and systemic variables in type 2 diabetes patients. The patients included 47 non-diabetic retinopathy eyes, 36 mild or moderate nonproliferative diabetic retinopathy (M-NPDR) eyes, 22 severe NPDR (S-NPDR) eyes, 32 PDR eyes, and 24 normal eyes as controls. The mean wall to lumen ratio (WLR) measured by adaptive optics camera was significantly higher in the PDR groups than in all of the other groups (all P < 0.001). However, the external diameter of the retinal vessels was not significantly different among the groups. The mean blur rate (MBR)-vessel determined by laser speckle flowgraphy was significantly lower in the PDR group than in the other groups (P < 0.001). The WLR was correlated with MBR-vessel (r = − 0.337, P < 0.001), duration of disease (r = 0.191, P = 0.042), stage of DM (r = 0.643, P < 0.001), systolic blood pressure (r = 0.166, P < 0.037), and presence of systemic hypertension (r = 0.443, P < 0.001). Multiple regression analysis demonstrated that MBR-vessel (β = − 0.389, P < 0.001), presence of systemic hypertension (β = 0.334, P = 0.001), and LDL (β = 0.199, P = 0.045) were independent factors significantly associated with the WLR. The increased retinal vessel wall thickness led to a narrowing of lumen diameter and a decrease in the blood flow in the PDR group.

THE EFFECT OF EXOGENOUS PROGESTAGEN ON THE LEVELS OF FREE OESTROGEN IN THE OVARIAN VEIN PLASMA OF THE EWE

1970 ◽  
Vol 48 (4) ◽  
pp. 485-496 ◽  
Author(s):  
J. F. SMITH ◽  
T. J. ROBINSON
Keyword(s):  
Plasma Levels ◽  
Similar Pattern ◽  
Peak Level ◽  
The Other ◽  
Ovarian Vein ◽  
Active Ovary ◽  
The Mean ◽  
Significant Change

SUMMARY The levels of free oestrogen (oestrone and oestradiol-17β) in plasma in the ovarian vein were determined in three groups, each of 27 ewes, at nine intervals at about the time of oestrus. One group had a normal oestrus while the other two had been treated for 16 days with intravaginal sponges containing either 10 or 30 mg of a synthetic progestagen (Cronolone, Searle). In untreated ewes, the mean level (corrected) of oestradiol-17β in plasma from the active ovary rose from 25·3 ng/100 ml at −48 h to a peak of 91·6 ng/100 ml at 0 h (onset of oestrus) and then fell. There was evidence of biphasic production. The mean level of oestrone was relatively high (13·0 ng/100 ml) at −48 h; it fell to 2·0 ng/100 ml between −36 and −24 h and then rose again to 9·4 ng/100 ml at + 12 h. There was no significant change, with time, in the plasma levels of either oestrogen from the non-active ovary. The total amounts of oestradiol-17β and of oestrone produced from both ovaries at an oestrous period were estimated to average 9·7 and 2·4 μg. In treated ewes, a similar pattern of production of oestradiol-17β was shown by the ewes treated with 30 mg Cronolone. That of ewes treated with 10 mg differed (P < 0·01). Peak level was reached at an earlier stage, relative to the onset of oestrus, and it declined more rapidly, the total amount of oestrogen produced (oestrone + oestradiol-17β) was less (10 mg Cronolone, 8·6 μg; 30 mg Cronolone, 12·1 μg; normal oestrus, 12·1 μg), and there was no biphasic production.

Impact of Washout Blades in a Multiple Disk Centrifugal Blood Pump

1999 ◽  
Author(s):  
Michelle J. Holmes ◽  
Gerald E. Miller
Keyword(s):  
Blood Flow ◽  
Flow Patterns ◽  
Blood Pump ◽  
Ventricular Assist ◽  
Centrifugal Blood Pump ◽  
Bridge To Transplant ◽  
Rotation Rates ◽  
Parallel Configuration ◽  
Output Characteristics ◽  
Blood Flow Patterns

Abstract A multiple disk, centrifugal blood pump (MDCP) for use as a ventricular assist device or as a bridge to transplant device has previously been designed and its output characteristics have been analyzed (Miller et al. 1990, 1993). The propelling mechanism of this device consists of six multiple disks assembled in a parallel configuration. Upon rotation these disks create centrifugal and shearing forces, which work to propel the fluid. This pump operates at lower rotation rates than other rotary blood pumps. The lower rotation rates reduce the chance for hemolysis, but may promote thrombosis formation due to stagnant blood flow. Previous flow visualization studies conducted by Miller et al. (1995) analyzed the blood flow patterns within the device. Results of this study indicated a region of flow stagnation between the last solid disk and the housing. In this investigation, further studies were performed that verified this recirculation. To provide washout of this region, eight, small Lexan blades were attached to the back of the last disk. Reevaluation of the flow patterns, following the blade attachment, revealed that the addition of the blades was successful in producing washout, thus reducing the possibility of thrombosis formation.

Changes in the tone of cerebral vessels in patients with bronchial asthma after glomectomy

1982 ◽  
Vol 63 (1) ◽  
pp. 56-56
Author(s):  
E. S. Karashurov ◽  
S. E. Karashurov
Keyword(s):  
Blood Flow ◽  
Bronchial Asthma ◽  
Cerebral Vessels ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
The Brain

Frequent complications of glomectomy are headaches and a mild, less-like state for several days or weeks after surgery, and sometimes hemi- and monoparesis. The reasons for these complications have not yet been revealed. In search of their explanation, we decided to study the volumetric blood flow of the brain and the acid-base state (ACS). Volumetric blood flow was studied by rheoencephalography (REG) in 43 patients, and acid base balance - in 100 patients (age from 22 to 67 years). The course of bronchial asthma before the operation in the examined patients was moderate and severe.

Acid-base and electrolyte disturbances in patients with diabetes mellitus

2018 ◽  
Vol 74 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Lissa Pipeleers ◽  
Karl Martin Wissing ◽  
Robert Hilbrands
Keyword(s):  
Diabetes Mellitus ◽  
Acid Base ◽  
Electrolyte Disturbances ◽  
Patients With Diabetes

scholarly journals Status Asthmaticus

2017 ◽  
Vol 15 (9-10) ◽  
pp. 269
Author(s):  
J.S Partana
Keyword(s):  
Body Weight ◽  
Status Asthmaticus ◽  
Fluid Administration ◽  
Acid Base Balance ◽  
Acid Base ◽  
Extreme Caution ◽  
Electrolyte Disturbances ◽  
Oxygen Administration ◽  
Base Balance ◽  
Normal Acid

The therapy of status asthmaticus must be rational. Thus it is important to evaluate: 1. the severity and duration of an asthmatic attack. 2. the degree of dehydration. 3. whether infection plays a role. 4. all medication previously administered. 5. any possible complication.Treatment is as follows :Fluid and electrolyte therapy is important not only for the correction of dehydration and electrolyte disturbances but also for preventing inspissation of mucus in the bronchi. The best route of fluid administration is intravenous.Potassium iodide orally administered may be helpful as an expectorant.After hydration and normal acid-base balance have been established, epinephrine may be of benefit.Aminophylline is effective when administered intravenously. It should be used with extreme caution: the dose should not exceed 3 mg per kg of body weight, it should be given slowly and should not be given more frequently than every 8 hours.Corticosteroids should be administered, especially in cases who have received suppressive doses previously.Humidified oxygen administration is of the utmost importance.Antibiotics are recommended when infection is suspected.Management of complications.

scholarly journals Increased plasma angiotensin II in postural tachycardia syndrome (POTS) is related to reduced blood flow and blood volume

2006 ◽  
Vol 110 (2) ◽  
pp. 255-263 ◽  
Author(s):  
Julian M. Stewart ◽  
June L. Glover ◽  
Marvin S. Medow
Keyword(s):  
Blood Flow ◽  
Angiotensin Ii ◽  
Blood Volume ◽  
High Flow ◽  
The Other ◽  
Low Flow ◽  
Postural Tachycardia Syndrome ◽  
Peripheral Blood Flow ◽  
Ang Ii ◽  
Postural Tachycardia

POTS (postural tachycardia syndrome) is associated with low blood volume and reduced renin and aldosterone; however, the role of Ang (angiotensin) II has not been investigated. Previous studies have suggested that a subset of POTS patients with increased vasoconstriction related to decreased bioavailable NO (nitric oxide) have decreased blood volume. Ang II reduces bioavailable NO and is integral to the renin–Ang system. Thus, in the present study, we investigated the relationship between blood volume, Ang II, renin, aldosterone and peripheral blood flow in POTS patients. POTS was diagnosed by 70° upright tilt, and supine calf blood flow, measured by venous occlusion plethysmography, was used to subgroup POTS patients. A total of 23 POTS patients were partitioned; ten with low blood flow, eight with normal flow and five with high flow. There were ten healthy volunteers. Blood volume was measured by dye dilution. All biochemical measurements were performed whilst supine. Blood volume was decreased in low-flow POTS (2.14±0.12 litres/m2) compared with controls (2.76±0.20 litres/m2), but not in the other subgroups. PRA (plasma renin activity) was decreased in low-flow POTS compared with controls (0.49±0.12 compared with 0.90±0.18 ng of Ang I·ml−1·h−1 respectively), whereas plasma Ang II was increased (89±20 compared with 32±4 ng/l), but not in the other subgroups. PRA correlated with aldosterone (r=+0.71) in all subjects. PRA correlated negatively with blood volume (r=−0.72) in normal- and high-flow POTS, but positively (r=+0.65) in low-flow POTS. PRA correlated positively with Ang II (r=+0.76) in normal- and high-flow POTS, but negatively (r=−0.83) in low-flow POTS. Blood volume was negatively correlated with Ang II (r=−0.66) in normal- and high-flow POTS and in five low-flow POTS patients. The remaining five low-flow POTS patients had reduced blood volume and increased Ang II which was not correlated with blood volume. The data suggest that plasma Ang II is increased in low-flow POTS patients with hypovolaemia, which may contribute to local blood flow dysregulation and reduced NO bioavailability.

scholarly journals Blood Perfusion of the Kidney of Lophius Piscatorius L.

1953 ◽  
Vol 32 (2) ◽  
pp. 329-336 ◽  
Author(s):  
L. Brull ◽  
E. Nizet ◽  
E. B. Verney
Keyword(s):  
Blood Flow ◽  
Critical Level ◽  
Perfusion Pressure ◽  
Blood Perfusion ◽  
Urine Flow ◽  
The Other ◽  
Protein Nitrogen ◽  
Other Hand ◽  
Flow Through

Lophius kidneys perfused with the heparinized blood (venous) of the fish secrete urine in which total non-protein nitrogen is concentrated, magnesium highly concentrated, and chloride only slightly so or not at all. Oxygenation of the blood, or lowering the temperature of the perfusate from c. 20° to c. 5° C. does not appear to influence secretion. The blood flow through the kidneys increases with the perfusion pressure, the increase often becoming disproportionately large. The urine flow, on the other hand, above a certain critical level is largely independent of changes in perfusion pressure.

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