scholarly journals Hemodynamic Parameters After Prone Positioning of COVID-19 Patients

2021 ◽  
Vol 17 (3) ◽  
pp. 32-41
Author(s):  
D. S. Shilin ◽  
K. G. Shapovalov
Keyword(s):  
Arterial Wall ◽  
Ventilatory Support ◽  
Lung Ventilation ◽  
Blood Flow Rate ◽  
Respiratory Support ◽  
Prone Positioning ◽  
Hemodynamic Changes ◽  
Hemodynamic Assessment ◽  
Central Hemodynamic ◽  
Wall Compliance

Aim of the study. To examine the effect of prone positioning on hemodynamics in patients with COVID-19.Materials and methods. The study enrolled 84 patients of both sexes with community-acquired multisegmental viral and bacterial pneumonia associated with COVID-19, who were divided into groups according to the type of respiratory support. The tests were performed using the integrated hardware and software system for noninvasive central hemodynamic assessment by volumetric compression oscillometry.Results. We found that the pulse blood pressure velocity decreased from 281 [242.0; 314.0] to 252 [209; 304] mm Hg/s in patients with severe COVID-19 on oxygen support (p=0.005); volume ejection rate decreased from 251 [200; 294] to 226 [186; 260] ml/s (P=0.03); actual/estimated normalized vascular resistance ratio dropped from 0.549 [0.400; 0.700] to 0.450 [0.300; 0.600] (P=0.002), while the arterial wall compliance increased from 1.37 [1.28; 1.67] to 1.45[1.10; 1.60] ml/mm Hg (P=0.009). Prone positioning of patients on noninvasive lung ventilation associated with a reduction of linear blood flow rate from 40.0 [34.0; 42.0] to 42.5 [42.5; 47.25] cm/s (7=0.04) and arterial wall compliance from 1.4 [1.24; 1.50] to 1.32 [1.14; 1.49] ml/mm Hg (7=0.03). Prone positioning of patients on invasive lung ventilation did not result in significant hemodynamic changes.Conclusion. The greatest hemodynamic changes during prone positioning were found in patients on oxygen respiratory support, whereas the least significant alterations were seen in patients on invasive ventilatory support.

scholarly journals Study of the Hemodynamics Effects of an Isolated Systolic Hypertension (ISH) Condition on Cerebral Aneurysms Models, Using FSI Simulations

2021 ◽  
Vol 11 (6) ◽  
pp. 2595
Author(s):  
José Barahona ◽  
Alvaro Valencia ◽  
María Torres
Keyword(s):  
Systolic Hypertension ◽  
Arterial Wall ◽  
Abrupt Change ◽  
Cerebral Aneurysms ◽  
Rupture Risk ◽  
Pressure Condition ◽  
Isolated Systolic Hypertension ◽  
Hemodynamic Changes ◽  
Physiological Conditions ◽  
Relative Residence Time

Hemodynamics is recognized as a relevant factor in the development and rupture of cerebral aneurysms, so further studies related to different physiological conditions in human represent an advance in understanding the pathology and rupture risk. In this paper, Fluid-structure interaction simulations (FSI) were carried out in six models of cerebral aneurysms, in order to study the hemodynamics effects of an isolated systolic hypertension (ISH) condition and compare it to a normal or normotensive pressure condition and a higher hypertension condition. Interestingly, the ISH condition showed, in general, the greatest hemodynamics changes, evidenced in the Time-Averaged Wall Shear Stress (TAWSS), Oscillatory Shear Index (OSI), and Relative Residence Time (RRT) parameters, with respect to a normal condition. These results could imply that a not high-pressure condition (ISH), characterized with a different shape and an abrupt change in its diastolic and systolic range may present more adverse hemodynamic changes compared to a higher-pressure condition (such as a hypertensive condition) and therefore have a greater incidence on the arterial wall remodeling and rupture risk.

scholarly journals VENTILATORY SUPPORT IN SARS-VOC-2 DURING INTENSIVE THERAPY

2020 ◽  
Author(s):  
Javier Eliecer Pereira Rodriguez ◽  
Juan Camilo Quintero Gomez ◽  
Otilio Lopez Florez ◽  
Sandra Sharon Waiss Skvirsky ◽  
Ximena Velasquez Badillo
Keyword(s):  
Mechanical Ventilation ◽  
Observational Studies ◽  
Intensive Therapy ◽  
Ventilatory Support ◽  
Cochrane Collaboration ◽  
Plateau Pressure ◽  
Lung Compliance ◽  
Respiratory Support ◽  
Pulmonary Vasodilators ◽  
Critical Patients

Introduction: The SARS-CoV-2 disease outbreak has now become a pandemic. Critical patients with COVID-19 require basic and advanced respiratory support. Therefore, the objective was to describe the ventilatory support strategies in SARS-CoV-2 during intensive therapy. Materials and methods: A systematic review of observational studies of the available scientific literature was performed in accordance with the recommendations of the Cochrane collaboration and the criteria of the PRISMA Declaration. Results: Fifteen observational studies were included that gave a study population of 4,081 patients. Mechanical ventilation is the main respiratory support treatment for critically ill patients, which should be administered as soon as normal oxygenation cannot be maintained, and despite the fact that there is no current consensus on the parameters of mechanical ventilation, the evidence collected suggests the use of Fio2 on average 50%, PEEP of 14 cmH2O, lung compliance of 29-37 ml per cm of water, driving pressure between 12-14 cm of water and a plateau pressure of 22-25 cm of water. Conclusions: IL-6 is shown as a possible marker of respiratory failure and a worse prognosis as well as obesity. In addition, the use of prone position, neuromuscular blockade, pulmonary vasodilators, ECMO, and mechanical ventilation based on the clinical conditions and needs of the patient with COVID-19 are strategies that could benefit patients entering intensive therapy for SARS-CoV- 2.

scholarly journals Perioperative Hemodynamic Changes During Video-Assisted Thoracoscopic Decortication for empyema

2017 ◽  
Vol 11 (1) ◽  
pp. 88-96
Author(s):  
Fang-Ting Chen ◽  
An-Hsun Chou ◽  
Chun-Yu Chen ◽  
Pei-Chi Ting ◽  
Ming-Wen Yang ◽  
...  
Keyword(s):  
Lung Ventilation ◽  
Lateral Decubitus Position ◽  
Time Interval ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Video Assisted ◽  
Lateral Decubitus ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background and Objective: Hemodynamic consequences during video-assisted thoracoscopic surgery (VATS) with decortication during empyema drainage are unclear. The aim of the study was to assess the perioperative hemodynamic changes decortication during empyema drainage. Methods: A prospective study enrolled 23 patients with empyema who underwent decortication. Hemodynamic parameters were continuously obtained at 15 time points: supine two lung ventilation after induction, lateral decubitus position and two lung ventilation, lateral decubitus position and one-lung ventilation, every 5 min after decortication upto 60 minutes and at the end of surgery. We divided patients into three groups according to microorganisms, group 1: patients with no growth of organism; group 2: patients with staphylococcus aureus and pseudomonas; group 3: patients with streptococcus, yeast and fungus, gram-positive bacilli, and mycobacterium tuberculosis. The hemodynamic variables were recorded by the third-generation Vigileo/FloTracTM system and variables for each time interval were compared with the baseline by Wilcoxon Signed Ranks Test. Results: In group 1, hemodynamic parameters showed no significant changes over time. However, in group 2 and 3, both CO and CI increased 10 to 15 minutes after decortication and remained elevated during the remainder of surgery. However, SVR and SVRI decreased 10 to 15 minutes after decortication in both groups, especially, with a more significant decrease noted in group 2 than group 3. Conclusion: Close perioperative hemodynamic monitoring during decortication in empyema patients is required because of potential hemodynamic disturbances especially patients with toxic microorganisms.

Prone Positioning of Patients With Acute Respiratory Distress Syndrome

2015 ◽  
Vol 35 (6) ◽  
pp. 29-37 ◽  
Author(s):  
Dawn M. Drahnak ◽  
Nicole Custer
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Pulmonary Ventilation ◽  
Ventilatory Support ◽  
Positive Outcomes ◽  
Prone Positioning ◽  
Intensive Care Nurses

Effectively treating critically ill patients with acute respiratory distress syndrome (ARDS) is a challenge for many intensive care nurses. Multiple disease processes and injuries contribute to the complexity of ARDS and often complicate therapy. As a means of supportive care for ARDS, practitioners resort to rescue therapies to improve oxygenation and salvage the patient. The pathophysiology of ARDS and the use of prone positioning to improve pulmonary ventilation and oxygenation in ARDS patients are described. Educating nursing and medical staff on the use of prone positioning allows ease of patient placement with an emphasis on safety of both patients and staff. Scrupulous assessment of patients coupled with judicious timing of prone positioning expedites weaning from ventilatory support and contributes to positive outcomes for patients.

scholarly journals In vivo femoropopliteal arterial wall compliance in subjects with and without lower limb vascular disease

1999 ◽  
Vol 30 (5) ◽  
pp. 936-945 ◽  
Author(s):  
Nigel R.M. Tai ◽  
Alberto Giudiceandrea ◽  
Henryk J. Salacinski ◽  
Alexander M. Seifalian ◽  
George Hamilton
Keyword(s):  
Vascular Disease ◽  
Lower Limb ◽  
Arterial Wall ◽  
Wall Compliance

Misinterpretation of the Functional Severity of Coronary Stenosis Due To Variability in Arterial Wall Compliance

2010 ◽  
Author(s):  
Bhaskar Chandra Konala ◽  
Ashish Das ◽  
Mohamed Effat ◽  
Arif Imran ◽  
Rupak K. Banerjee
Keyword(s):  
Arterial Wall ◽  
Coronary Intervention ◽  
Diagnostic Parameter ◽  
Carreau Model ◽  
Newtonian Viscosity ◽  
Coronary Stenoses ◽  
Wall Compliance ◽  
Wall Interaction ◽  
Stenotic Arteries ◽  
Parameter Values

Effect of arterial wall compliance on the invasive coronary diagnostic parameters for various severities of coronary stenoses was assessed. The Mooney-Rivlin model was used to define the non-linear properties of the arterial wall and the plaque regions. The non-Newtonian viscosity of blood was modeled using the Carreau model. A finite element method was employed to solve the pulsatile fluid (blood)-structure (arterial wall) interaction (FSI) equations. Variability in the diagnostic parameter values can occur near the cut-off value due to change in compliance of stenotic arteries between the range of 84% and 89% area stenosis. This may lead to misdiagnosis and might wrongly lead to postponement of coronary intervention.

Respiratory problems

2017 ◽  
Author(s):  
Sheila Adam ◽  
Sue Osborne ◽  
John Welch
Keyword(s):  
Nitric Oxide ◽  
Mechanical Ventilation ◽  
Respiratory Physiology ◽  
Respiratory Support ◽  
Holistic Care ◽  
Prone Positioning ◽  
Respiratory Problems ◽  
Anatomy And Physiology ◽  
Effective Care ◽  
Critical Care Admission

A requirement for respiratory support is the most frequent cause of critical care admission. Effective care requires an appreciation of the relevant anatomy and physiology, skills of physical assessment and use of monitoring, knowledge of a range of airway and breathing problems and the different challenges they present, and an understanding of the most appropriate means of airway management and respiratory support. This chapter details essential respiratory physiology and the advantages, disadvantages, and potential complications of different methods of monitoring and respiratory support, including holistic care of patients with artificial airways and various modes of mechanical ventilation, the use of nitric oxide, prone positioning and extra-corporeal devices, and management of the weaning patient.

scholarly journals Newer Modes of Mechanical Ventilatory Support

1986 ◽  
Vol 14 (3) ◽  
pp. 258-266 ◽  
Author(s):  
P. D. Cameron ◽  
T. E. Oh
Keyword(s):  
Ventilatory Support ◽  
Lung Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Minute Volume ◽  
Positive Pressure ◽  
High Frequency Ventilation ◽  
Volume Ventilation ◽  
Assisted Respiration ◽  
Frequency Ventilation ◽  
Flow Waveforms

Recent modes of ventilatory support aim to facilitate weaning and minimise the physiological disadvantages of intermittent positive pressure ventilation (IPPV). Intermittent mandatory ventilation (IMV) allows the patient to breathe spontaneously in between ventilator breaths. Mandatory minute volume ventilation (MMV) ensures that the patient always receives a preset minute volume, made up of both spontaneous and ventilator breaths. Pressure supported (assisted) respiration is augmentation of a spontaneous breath up to a preset pressure level, and is different from ‘triggering’, which is a patient-initiated ventilator breath. Other modes or refinements of IPPV include high frequency ventilation, expiratory retard, differential lung ventilation, inversed ratio ventilation, ‘sighs’, varied inspiratory flow waveforms and extracorporeal membrane oxygenation. While these techniques have useful applications in selective situations, IPPV remains the mainstay of managing respiratory failure for most patients.

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