scholarly journals Predictors of hypotension during surgical management of femoral fractures in spinal anesthesia

2018 ◽  
Vol 71 (7-8) ◽  
pp. 235-240
Author(s):  
Milica Gojkovic ◽  
Arsen Uvelin ◽  
Milanka Tatic ◽  
Vladimir Vrsjakov ◽  
Dunja Mihajlovic ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Beta Blockers ◽  
Preoperative Evaluation ◽  
Femoral Fractures ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Elderly Age ◽  
The Mean

Introduction. Femoral fractures are the most common cause of morbidity and mortality in the elderly. The aim of this study was to establish the predictors of hypotension in the elderly patients with femoral fractures during surgery in spinal anesthesia. Material and Methods. This retrospective study included 454 patients and investigated the relationship between hypotension and predictive factors for the development of hypotension using binary logistic regression. A paired sample T-test for dependent variables was used to compare the mean arterial pressure before and after the surgical procedure. Three mean arterial pressure values were compared between subjects receiving bupivacaine and subjects who received levobupivacaine: preoperative, the lowest value during the surgery, and the mean arterial pressure at the end of the surgery. Results. The age of the subjects ranged from 20 to 93 years (mean = 71.56; standard deviation = 13.26, median = 74). The mean arterial pressure values during the preoperative evaluation (103.2 ? 14.7) were higher than the last mean arterial pressure during surgery (84.8 ? 13.6) and these differences were statistically significant (p < 0.001). The group of subjects who received levobupivacaine presented with higher values of median arterial pressure (73.99) than the group receiving bupivacaine (70.76). Conclusion. The predictors of hypotension during surgery of patients with femoral fractures in spinal anesthesia are elderly age and preoperative use of beta blockers.

scholarly journals Correlation between Calcium Phosphorus Product and Mean Arterial Pressure among Hemodialysis Patients with End Stage Renal Disease

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Muhammad Nadeem ◽  
Mansoor Abbas Qaisar ◽  
Ali Hassan Al Hakami ◽  
Fateh Sher Chattah ◽  
Muhammad Muzammil ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Calcium Phosphorus ◽  
The Mean ◽  
Stage Renal Disease ◽  
End Stage

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

scholarly journals Hubungan Mean Arterial Pressure (MAP) Dengan Preeklamsia Pada Ibu Hamil Di Puskesmas Bontobangun Kabupaten Bulukumba

2020 ◽  
Vol 5 (2) ◽  
pp. 138-145
Author(s):  
Ely Kurniati ◽  
Rusnawati
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pregnant Women ◽  
Sampling Method ◽  
Blood Pressure Measurement ◽  
Test Results ◽  
Historical Cohort ◽  
Measurement Results ◽  
History Of ◽  
The Mean

Preeclampsia complicates 4-7% of pregnancies and remains the leading cause of maternal and fetal morbidity and mortality worldwide. Despite improvements in health care over the last decade, preeclampsia remains the second most common cause of maternal mortality in Indonesia. This study aims to determine whether the mean arterial pressure (MAP) is related to the incidence of preeclampsia in pregnant women at the Bontobangun Puskesmas, Bulukumba district for the period 2018 to 2019. This research uses a descriptive-analytic approach with Historical Cohort Studies, namely by looking at the cohort book of the history of blood pressure measurement results for pregnant women at the Bontobangun Public Health Center, Bulukumba Regency for the period 2018 to 2019. Determining the sample using the sampling method taken by purposive sampling. 31 samples of pregnant women who experienced preeclampsia and 31 controls were pregnant women with normal conditions who had certain criteria (matching) with the sample. The results explained that from the paired T-test results, the value of α> 0.037 so that it is said that there is a relationship between mean artery pressure (MAP) and the incidence of preeclampsia in pregnant women at Bontobangun puskesmas for the period 2018-2019.

scholarly journals Comparison of Epidural and Spinal Anesthesia Techniques for Transurethral Resections

2018 ◽  
Vol 9 (1) ◽  
pp. 1-10
Author(s):  
Elif Copuroglu ◽  
Gonul Sagiroglu ◽  
Beliz Bilgili ◽  
Sevtap Hekimogl
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Epidural Anesthesia ◽  
Total Duration ◽  
Satisfaction Score ◽  
Patient Satisfaction Score ◽  
Group I ◽  
Anesthesia Group ◽  
Spinal Anesthesia Group

Purpose: Transurethral resections (TUR) are commonly performed for elderly population who have multiple comorbidities which can cause intraoperative and postoperative complications. The type of anesthesia has an impact on patient outcome. The aim of the study is to compare the effectiveness of epidural and spinal anesthesia techniques for TUR. Methods: A total of 158 elective TUR cases were evaluated. The patients were randomized into 2 groups: Epidural anesthesia was applied to Group I (n=82) and spinal anesthesia was applied to Group II (n=76). Both groups were compared for intraoperative hemodynamic parameters (mean arterial pressure, heart rate, peripheral oxygen saturations), total duration of hospital stay, perioperative complications, and satisfaction of the patients and surgeons. Results: The patients in the spinal anesthesia group experienced more frequent intraoperative hypotensive episodes during TUR (n=2 vs. n=10; p=0.026) and had lower mean arterial pressure values for the first 30 minutes of anesthesia compared to epidural anesthesia group. The postoperative duration of bed stay was longer in the spinal anesthesia group (402.96±49.61 min) than the epidural anesthesia group (205.91±28.27 min) (p<0.001). The patient satisfaction score was significantly higher in the epidural anesthesia group (2.54±0.63) than the spinal anesthesia group (2.23±1.22) (p=0.04) where as the surgeon satisfaction score were similar in both groups. Conclusion: Epidural anesthesia can be considered as an effective and safe technique for ambulatory interventions especially for elderly patients providing perioperative hemodynamic stability and postoperative early mobilization.

scholarly journals The Use of Biochemical and Biophysical Markers in Early Screening for Preeclampsia in Mongolia

2018 ◽  
Vol 6 (3) ◽  
pp. 57
Author(s):  
Urjindelger Tserensambuu ◽  
Ariunbold Chuluun-Erdene ◽  
Munkhtsetseg Janlav ◽  
Erkhembaatar Tudevdorj
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Maternal Serum ◽  
Operating Characteristics ◽  
Early Screening ◽  
Roc Curve Analysis ◽  
Detection Rates ◽  
The Mean

Preeclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality, particularly in developing countries. In Mongolia, preeclampsia and eclampsia have occurred among pregnancy complications at a rate of 25% in recent years. Recent studies in the literature have screened for preeclampsia by combining maternal factors with biomarkers. This study was conducted using prospective cohort research including 393 singleton pregnancies at 11–13+6 weeks. Maternal plasmas pregnancy-associated plasma protein-A (PAPP-A) and maternal serum placental growth factor (PlGF) were measured using Perkin Elmer time-resolved fluoroimmunoassay (DELFIA) kits, and the measurement of mean arterial pressure (MAP) was performed by automated devices and the uterine artery pulsatility index was measured by Doppler ultrasound. In the study population, there were 16.7% showing complicated preeclampsia. The receiver-operating characteristics (ROC) curve analysis showed a sensitivity of 71.21%, and a specificity of 75.54% when the mean arterial pressure cut-off was 89.5 mm; while a sensitivity of 33.36% and specificity of 77.68% were observed when the uterine artery mean pulsatility index (mPI) cut-off was 2.34; a sensitivity of 79.66% and specificity of 44.04% were observed when the PAPP-A cut-off was 529.1 mU/L; and a sensitivity of 74.58% and specificity of 46.6% were observed when the PlGF cut-off was 39.87 pg/mL. The detection rates following the combination of markers with the maternal history were as follows: 62.7% with mean arterial pressure, 69.5–82.9% with two markers 86.5% with three markers and 91.4% with four markers. In conclusion, the mean arterial pressure was highly sensitive and demonstrated its easy usage and cost-effectiveness as a predictive marker for the early screening of preeclampsia from other biomarkers.

Vascular Abnormalities and Pulmonary Hypertension in the Berkeley Sickle Mouse.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3185-3185
Author(s):  
David R. Archer ◽  
Shawn Elms ◽  
Joshua Boutwell ◽  
Jennifer Perry ◽  
Roy Sutliff
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Endothelial Dysfunction ◽  
Mouse Model ◽  
Arterial Pressure ◽  
Right Ventricular ◽  
The Mean

Abstract Clinically, pulmonary hypertension is a major risk factor for mortality in adults with sickle cell disease. Contributing factors probably include red cell hemolysis and vaso-occlusive injury with their associated oxidative and inflammatory stimuli. Previously, we have described RBC hemolysis and endothelial oxidative stress in the Berkeley sickle mouse model and extend those studies in this work to investigate cardiovascular and endothelial dysfunction. Eight to ten month old homozygous and hemizygous Berkeley sickle mice and C57BL/6 control mice were used for all aspects of these experiments. In vivo measurements of mean arterial pressure and right ventricular pressures were conducted in fully anesthetized mice using a pressure transducer inserted in the carotid and right ventricle respectively. Following in vivo readings hearts were excised for measurement of ventricular mass. The ascending aorta was removed and cut into 5 mm rings for in vitro studies of agonist- induced contractility and relaxation. The mean arterial pressure of the hemizygous sickle mice (70.6 ± 3.4) was significantly lower than the control mice (86.0 ± 3.1) and the mean arterial pressure of homozygous sickle mice (59.0 ± 2.2 mmHg) was significantly lower than the hemizygous and control mice (p≤0.05 and p≤0.001, respectively). The right ventricular pressure showed a trend that approached significance (p= 0.08) such that pressures in homozygous mice were ≥ than those in hemizygous which were ≥ than those in control mice. Increased basal cardiac output was suggested by significant left ventricular hypertrophy. In vitro examination of potassium chloride activation of voltage gated calcium channels showed no significant difference in sensitivity or maximal contraction. Similarly, there was no difference in sensitivity to the α1 agonist, phenylephrine. However, both hemi- and homozygous mice showed a significant reduction in maximal force of contraction (normalized to cross sectional area when compared to controls. Maximal acetylcholine induced relaxation of aortic rings was significantly reduced (p≤0.05) in homozygous sickle mice compared to controls. The same effect was not seen with sodium nitroprusside induced relaxation indicating that the acetylcholine effect was not due to effects on the smooth muscle but was endothelium-dependent. The Berkeley mouse model shows cardiac hypertrophy consistent with the increased cardiac output associated with chronic anemia and a reduced basal mean arterial blood pressure similar to that seen in humans. 8–10 month old mice have increased right ventricular pressure and RV mass indicative of pulmonary hypertension. Further endothelial dysfunction is characterized by a reduction in the maximal relaxation elicited by acetylcholine. Therefore, the Berkeley mouse is a good model for investigating sickle related endothelial dysfunction.

The role of hemodynamic factors on urinary calcium and magnesium excretion

1969 ◽  
Vol 47 (7) ◽  
pp. 619-626 ◽  
Author(s):  
A. Gonda ◽  
N. Wong ◽  
J. F. Seely ◽  
J. H. Dirks
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Divalent Cations ◽  
Fractional Excretion ◽  
Urinary Calcium ◽  
Sodium Reabsorption ◽  
Left Renal Artery ◽  
Renal Handling ◽  
The Mean ◽  
Calcium And Magnesium

The effects of unilateral vasodilatation and alterations in the mean arterial pressure upon the renal handling of calcium and magnesium were studied by clearance methods in dogs. Unilateral vasodilatation was produced by infusion of acetylcholine or bradykinin into the left renal artery, while arterial pressure was altered by aortic constriction, carotid occlusion and vagotomy, or by systemic infusion of angiotensin. Urinary electrolyte excretion was increased markedly by the infusion of each vasodilator and also varied directly with the mean arterial pressure, despite the absence of any significant changes in the filtered load. The fractional excretion of both calcium and magnesium correlated significantly with that of sodium. These results indicate that acute changes in renal hemodynamics modify the tubular reabsorption of divalent cations as well as alter sodium reabsorption.

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