scholarly journals CHANGES IN SYSTEMIC AND REGIONAL HEMODYNAMICS DURING INTENSIVE MUSCULAR ACTIVITY (EXPERIMENTAL STUDY)

2019 ◽  
Vol 19 (3) ◽  
pp. 46-56
Author(s):  
M Balykin ◽  
H Karkobatov ◽  
Yu Shidakov ◽  
I Antipov
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Blood Flow Velocity ◽  
Blood Circulation ◽  
Oxygen Demand ◽  
Muscular Activity ◽  
Physical Exertion ◽  
Minute Volume ◽  
Visceral Organs ◽  
Regional Hemodynamics

Aim. The article deals with evaluating the changes in minute volume of blood circulation and the features of regional hemodynamics in somatic and visceral organs during intensive muscular activity. Materials and methods. Studies were conducted on outbred laboratory dogs (n = 16). At rest and at maximum physical exertion (running on a treadmill to failure), oxygen consumption (VO2), blood gas composition, the minute volume of respiration (VE) and blood circulation (Q) (according to Fick) were determined. The volumetric blood flow velocity in skeletal muscles and visceral organs (qt) was determined by introducing iodine-131-labeled microspheres into the heart cavity. Results. At maximum physical exertion, VO2 significantly increases by 11.7 times, Q – by 5.3 times. The volumetric blood flow velocity significantly (P ≤ 0.001) increases in locomotor (6.2–7.5 times) and respiratory (6.5–8.0 times) muscles. In postural muscles, blood flow does not change. In the myocardium, blood flow increases by 4.5 times and corresponds to changes in cardiac performance. In the adrenal gland, blood flow increases by 1.6 times (p ≤ 0.001), in the thyroid gland, it remains unchanged. In the kidney, blood flow decreases by 21.5%, in the liver by 23.0%, with an increase in the arterial fraction by 56.3% of organs. In organs of the splanchnic region (spleen, organs of the gastrointestinal tract), the volumetric blood flow velocity decreases by 44.9% (P ≤ 0.001). Conclusion. During extreme physical exertion, most of the cardiac output is distributed into the locomotor, respiratory muscles and organs involved in muscle activity, while reducing the volumetric blood flow in the visceral organs. It is postulated that against the background of high oxygen demand and arterial hypoxemia in the somatic and visceral organs, there are competitive relationships for blood flow and the prerequisites for the development of total tissue hypoxia.

Decrease of blood flow velocity in the middle cerebral artery after stellate ganglion block following aneurysmal subarachnoid hemorrhage: a potential vasospasm treatment?

2020 ◽  
Vol 133 (3) ◽  
pp. 773-779
Author(s):  
Christopher Wendel ◽  
Ricardo Scheibe ◽  
Sören Wagner ◽  
Wiebke Tangemann ◽  
Hans Henkes ◽  
...  
Keyword(s):  
Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Neurological Deficit ◽  
Blood Flow Velocity ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ganglion Block

OBJECTIVECerebral vasospasm (CV) is a delayed, sustained contraction of the cerebral arteries that tends to occur 3–14 days after aneurysmal subarachnoid hemorrhage (aSAH) from a ruptured aneurysm. Vasospasm potentially leads to delayed cerebral ischemia, and despite medical treatment, 1 of 3 patients suffer a persistent neurological deficit. Bedside transcranial Doppler (TCD) ultrasonography is used to indirectly detect CV through recognition of an increase in cerebral blood flow velocity (CBFV). The present study aimed to use TCD ultrasonography to monitor how CBFV changes on both the ipsi- and contralateral sides of the brain in the first 24 hours after patients have received a stellate ganglion block (SGB) to treat CV that persists despite maximum standard therapy.METHODSThe data were culled from records of patients treated between 2013 and 2017. Patients were included if an SGB was administered following aSAH, whose CBFV was ≥ 120 cm/sec and who had either a focal neurological deficit or reduced consciousness despite having received medical treatment and blood pressure management. The SGB was performed on the side where the highest CBFV had been recorded with 8–10 ml ropivacaine 0.2%. The patient’s CBFV was reassessed after 2 and 24 hours.RESULTSThirty-seven patients (male/female ratio 18:19), age 17–70 years (mean age 49.9 ± 11.1), who harbored 13 clipped and 22 coiled aneurysms (1 patient received both a coil and a clip, and 3 patients had 3 untreated aneurysms) had at least one SGB. Patients received up to 4 SGBs, and thus the study comprised a total of 76 SGBs.After the first SGB, CBFV decreased in 80.5% of patients after 2 hours, from a mean of 160.3 ± 28.2 cm/sec to 127.5 ± 34.3 cm/sec (p < 0.001), and it further decreased in 63.4% after 24 hours to 137.2 ± 38.2 cm/sec (p = 0.007). A similar significant effect was found for the subsequent SGB. Adding clonidine showed no significant effect on either the onset or the duration of the SGB. Contralateral middle cerebral artery (MCA) blood flow was not reduced by the SGB.CONCLUSIONSTo the authors’ knowledge, this is the largest study on the effects of administering an SGB to aSAH patients after aneurysm rupture. The data showed a significant reduction in ipsilateral CBFV (MCA 20.5%) after SGB, lasting in about two-thirds of cases for over 24 hours with no major complications resulting from the SGB.

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