scholarly journals Modulation of Pulse Propagation and Blood Flow via Cuff Inflation—New Distal Insights

Sensors ◽  
2021 ◽  
Vol 21 (16) ◽  
pp. 5593
Author(s):  
Laura I. Bogatu ◽  
Simona Turco ◽  
Massimo Mischi ◽  
Lars Schmitt ◽  
Pierre Woerlee ◽  
...  
Keyword(s):  
Blood Flow ◽  
Critical Care ◽  
Pulse Propagation ◽  
Peripheral Resistance ◽  
Pulse Transit Time ◽  
Care Practice ◽  
Cuff Inflation ◽  
Compensatory Mechanisms ◽  
New Findings ◽  
Measurement Strategies

In standard critical care practice, cuff sphygmomanometry is widely used for intermittent blood pressure (BP) measurements. However, cuff devices offer ample possibility of modulating blood flow and pulse propagation along the artery. We explore underutilized arrangements of sensors involving cuff devices which could be of use in critical care to reveal additional information on compensatory mechanisms. In our previous work, we analyzed the response of the vasculature to occlusion perturbations by means of observations obtained non-invasively. In this study, our aim is to (1) acquire additional insights by means of invasive measurements and (2) based on these insights, further develop cuff-based measurement strategies. Invasive BP experimental data is collected downstream from the cuff in two patients monitored in the OR. It is found that highly dynamic processes occur in the distal arm during cuff inflation. Mean arterial pressure increases in the distal artery by 20 mmHg, leading to a decrease in pulse transit time by 20 ms. Previous characterizations neglected such distal vasculature effects. A model is developed to reproduce the observed behaviors and to provide a possible explanation of the factors that influence the distal arm mechanisms. We apply the new findings to further develop measurement strategies aimed at acquiring information on pulse arrival time vs. BP calibration, artery compliance, peripheral resistance, artery-vein interaction.

Ultrasound features of peripheral angiodistonic syndrome of the upper extremities in vibration disease

2020 ◽  
Vol 60 (11) ◽  
pp. 815-817
Author(s):  
Nadezhda I. Kuprina ◽  
Ekaterina V. Ulanovskaya ◽  
Olga A. Kochetova
Keyword(s):  
Blood Flow ◽  
Heart Defects ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Ulnar Artery ◽  
Upper Extremities ◽  
Disease Stage ◽  
Peripheral Blood Flow ◽  
Pronounced Increase ◽  
Vibration Disease

Introduction. Vibration disease (VD) is an example of the most common pathology due to the systematic exposure of the worker to intense vibration with sufficient work experience, the main manifestation of which is peripheral angiodystonic syndrome. The aim of study was to learn the features of peripheral blood flow in the arteries of the forearm in vibration disease using the ultrasound method. Materials and methods. The radial and ulnar arteries in patients with vibration disease were examined by ultrasound in B- and PW-mode. These materials present the results of an ultrasound assessment of the speed indicators of the main arteries of the forearm in vibration disease stages 1 and 2. The selection criteria for patients in the study ware the presence of pronounced clinical manifestations of angiodystonic syndrome in vibration disease, confirmed by instrumental research methods and data on the sanitary and hygienic characteristics of working conditions, the absence of cardiovascular chronic diseases (ischemic heart disease, heart defects, rhythm and conduction disturbances), rheumatic, oncological, infectious diseases, osteo-traumatic changes in the upper extremities. Results. The groups of patients with the established diagnosis of vibration disease of 1 and 2 degrees were studied. With vibration disease stage 1 a decrease in the pulse velocity of blood flow was observed in isolation on the ulnar artery and an increase in peripheral resistance (pulsation index and resistance index) in the radial and ulnar arteries symmetrically on both upper extremities. The second stage of vibration disease differed from the first by a more significant decrease in speed indicators both on the ulnar and radial arteries on both sides, symmetrically in combination with a more pronounced increase in peripheral resistance indicators on both main arteries of the forearm (pulsation index and resistance index). The revealed changes were determined with the same frequency in men and women. Conclusions. A significant decrease in speed indicators on the ulnar artery and an increase in peripheral resistance indicators are detected already at the initial stages of vibration disease. Thus, the method of ultrasound examination of the main arteries of the middle caliber of the upper extremities is currently the only available and objective method for examining the vascular system in vibration disease.

RATIONALIZATION FOR THE DIFFERENTIAL DIAGNOSIS OF OVARIAN CANCER AND CHRONIC SALPINGOOPHORITIS IN THE PARAMETERS OF DISINTEGRATION AND NETWORK MODELING CHANGES OF BLOOD FLOW IN UTERINE AND OVARIAN ARTERIES AND VEINS

2017 ◽  
Vol 63 (5) ◽  
pp. 766-769
Author(s):  
Nikolay Agarkov ◽  
Pavel Tkachenko ◽  
Dmitriy Kicha ◽  
Vitaliy Aksenov ◽  
Aleksandr Ivanov ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Blood Flow ◽  
Diagnostic Criteria ◽  
Peripheral Resistance ◽  
Resistance Index ◽  
Diagnostic Process ◽  
Venous Outflow ◽  
Flow Changes ◽  
Arteries And Veins ◽  
Selection Of

Analysis of ultrasonic blood flow changes in uterine and ovarian arteries and veins in 92 patients with ovarian cancer and 87 patients with chronic salpingoophoritis has allowed to identify the leading differential diagnostic criteria, which include minimum diastolic blood flow velocity, resistance index, while fast hyperemia, the index of venous outflow diastolic index and index of peripheral resistance. Based on a selection of leading differential diagnostic criteria for ovarian cancer and chronic salpingoophoritis developed a network model of differentiation of these groups of patients, streamlining the differential diagnostic process

Diastolic pressure and peripheral resistance during stellate ganglion stimulation

1963 ◽  
Vol 204 (1) ◽  
pp. 71-72 ◽  
Author(s):  
Edward D. Freis ◽  
Jay N. Cohn ◽  
Thomas E. Liptak ◽  
Aristide G. B. Kovach
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Total Peripheral Resistance ◽  
Diastolic Pressure ◽  
Stellate Ganglion ◽  
Peripheral Resistance ◽  
Resistance Vessels ◽  
Left Stellate Ganglion ◽  
Increased Blood Flow

The mechanism of the diastolic pressure elevation occurring during left stellate ganglion stimulation was investigated. The cardiac output rose considerably, the heart rate remained essentially unchanged, and the total peripheral resistance fell moderately. The diastolic rise appeared to be due to increased blood flow rather than to any active changes in resistance vessels.

Applications of 3D printing in critical care medicine: A scoping review

2021 ◽  
pp. 0310057X2097665
Author(s):  
Natasha Abeysekera ◽  
Kirsty A Whitmore ◽  
Ashvini Abeysekera ◽  
George Pang ◽  
Kevin B Laupland
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
A Priori ◽  
Three Dimensional ◽  
Critical Care Medicine ◽  
Future Research ◽  
Care Practice ◽  
Three Dimensional Printing ◽  
Wide Range ◽  
Dimensional Printing

Although a wide range of medical applications for three-dimensional printing technology have been recognised, little has been described about its utility in critical care medicine. The aim of this review was to identify three-dimensional printing applications related to critical care practice. A scoping review of the literature was conducted via a systematic search of three databases. A priori specified themes included airway management, procedural support, and simulation and medical education. The search identified 1544 articles, of which 65 were included. Ranging across many applications, most were published since 2016 in non – critical care discipline-specific journals. Most studies related to the application of three-dimensional printed models of simulation and reported good fidelity; however, several studies reported that the models poorly represented human tissue characteristics. Randomised controlled trials found some models were equivalent to commercial airway-related skills trainers. Several studies relating to the use of three-dimensional printing model simulations for spinal and neuraxial procedures reported a high degree of realism, including ultrasonography applications three-dimensional printing technologies. This scoping review identified several novel applications for three-dimensional printing in critical care medicine. Three-dimensional printing technologies have been under-utilised in critical care and provide opportunities for future research.

Sexual dimorphism in regional blood flow responses to vasopressin in conscious rats

1997 ◽  
Vol 273 (3) ◽  
pp. R1126-R1131 ◽  
Author(s):  
Y. X. Wang ◽  
J. T. Crofton ◽  
S. L. Bealer ◽  
L. Share
Keyword(s):  
Blood Flow ◽  
Vascular Resistance ◽  
Regional Blood Flow ◽  
Pressor Response ◽  
Peripheral Resistance ◽  
Female Rats ◽  
Sexually Dimorphic ◽  
Arterial Blood ◽  
Vasoconstrictor Response ◽  
Renal Vascular

The greater pressor response to vasopressin in male than in nonestrous female rats results from a greater increase in total peripheral resistance in males. The present study was performed to identify the vascular beds that contribute to this difference. Mean arterial blood pressure (MABP) and changes in blood flow in the mesenteric and renal arteries and terminal aorta were measured in conscious male and nonestrous female rats 3 h after surgery. Graded intravenous infusions of vasopressin induced greater increases in MABP and mesenteric vascular resistance and a greater decrease in mesenteric blood flow in males. Vasopressin also increased renal vascular resistance to a greater extent in males. Because renal blood flow remained unchanged, this difference may be due to autoregulation. The vasopressin-induced reduction in blood flow and increased resistance in the hindquarters were moderate and did not differ between sexes. Thus the greater vasoconstrictor response to vasopressin in the mesenteric vascular bed of male than nonestrous females contributed importantly to the sexually dimorphic pressor response to vasopressin in these experiments.

Control of Blood Pressure and the Distribution of Blood Flow

1991 ◽  
Vol 7 (S1) ◽  
pp. 79-84 ◽  
Author(s):  
Hans T. Versmold
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cardiac Output ◽  
Peripheral Resistance ◽  
Systemic Blood Pressure ◽  
Adrenergic Innervation ◽  
Systemic Blood ◽  
Low Cardiac Output ◽  
Neurohumoral Control ◽  
The Brain

Systemic blood pressure (BP) is the product of cardiac output and total peripheral resistance. Cardiac output is controlled by the heart rate, myocardial contractility, preload, and afterload. Vascular resistance (vascular hindrance × viscosity) is under local autoregulation and general neurohumoral control through sympathetic adrenergic innervation and circulating catecholamines. Sympathetic innovation predominates in organs receivingflowin excess of their metabolic demands (skin, splanchnic organs, kidney), while innervation is poor and autoregulation predominates in the brain and heart. The distribution of blood flow depends on the relative resistances of the organ circulations. During stress (hypoxia, low cardiac output), a raise in adrenergic tone and in circulating catecholamines leads to preferential vasoconstriction in highly innervated organs, so that blood flow is directed to the brain and heart. Catecholamines also control the levels of the vasoconstrictors renin, angiotensin II, and vasopressin. These general principles also apply to the neonate.

Advances in critical care for the older patient

2013 ◽  
Vol 23 (2) ◽  
pp. 118-130 ◽  
Author(s):  
Diane Monkhouse
Keyword(s):  
Quality Of Life ◽  
Critical Care ◽  
Critical Illness ◽  
General Population ◽  
Acute Illness ◽  
Limited Resources ◽  
Care Practice ◽  
Older Patient ◽  
Life Sustaining Treatment

SummaryAs the proportion of elderly people in the general population increases, so does the number admitted to critical care. In caring for an older patient, the intensivist has to balance the complexities of an acute illness, pre-existing co-morbidities and patient preference for life-sustaining treatment with the chances of survival, quality of life after critical illness and rationing of expensive, limited resources. This remains one of the most challenging areas of critical care practice.

scholarly journals Effects of acetylcholine and nitric oxide on forearm blood flow at rest and after a single muscle contraction

1998 ◽  
Vol 85 (6) ◽  
pp. 2249-2254 ◽  
Author(s):  
R. W. Brock ◽  
M. E. Tschakovsky ◽  
J. K. Shoemaker ◽  
J. R. Halliwill ◽  
M. J. Joyner ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Muscle Contraction ◽  
Forearm Blood Flow ◽  
Mechanical Effect ◽  
Voluntary Contraction ◽  
Single Muscle ◽  
Cuff Inflation ◽  
S Period ◽  
Echo Doppler Ultrasound

We tested the hypothesis that ACh or nitric oxide (NO) might be involved in the vasodilation that accompanies a single contraction of the forearm. Eight adults (3 women and 5 men) completed single 1-s-duration contractions of the forearm to raise and lower a weight equivalent to ∼20% maximal voluntary contraction through a distance of 5 cm. In a second protocol, each subject had a cuff, placed completely about the forearm, inflated to 120 mmHg for a 1-s period, then released as a simulation of the mechanical effect of muscle contraction. Three conditions were studied, always in this order: 1) control, with intra-arterial infusion of saline; 2) after muscarinic blockade with atropine; and 3) after NO synthase inhibition with N G-monomethyl-l-arginine (l-NMMA) plus atropine. Forearm blood flow (FBF), measured by combined pulsed and echo Doppler ultrasound, was reduced at rest with l-NMMA-atropine compared with the other two conditions. After the single contraction, there were no effects of atropine, butl-NMMA reduced the peak FBF and the total postcontraction hyperemia. After the single cuff inflation, atropine had no effects, whereasl-NMMA caused changes similar to those seen after contraction, reducing the peak FBF and the total hyperemia. The observation thatl-NMMA reduced FBF in response to both cuff inflation and a brief contraction indicates that NO from the vascular endothelium might modulate the basal level of vascular tone and the mechanical component of the hyperemia with exercise. It is unlikely that ACh and NO from the endothelium are involved in the dilator response to a single muscle contraction.

Oxygen transport to exercising leg in chronic hypoxia

1988 ◽  
Vol 65 (6) ◽  
pp. 2592-2597 ◽  
Author(s):  
P. R. Bender ◽  
B. M. Groves ◽  
R. E. McCullough ◽  
R. G. McCullough ◽  
S. Y. Huang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Sea Level ◽  
Chronic Hypoxia ◽  
Peripheral Resistance ◽  
Hemoglobin Concentration ◽  
Barometric Pressure ◽  
Ambient Air ◽  
Leg Blood Flow ◽  
State Cycle ◽  
O2 Delivery

Residence at high altitude could be accompanied by adaptations that alter the mechanisms of O2 delivery to exercising muscle. Seven sea level resident males, aged 22 +/- 1 yr, performed moderate to near-maximal steady-state cycle exercise at sea level in normoxia [inspired PO2 (PIO2) 150 Torr] and acute hypobaric hypoxia (barometric pressure, 445 Torr; PIO2, 83 Torr), and after 18 days' residence on Pikes Peak (4,300 m) while breathing ambient air (PIO2, 86 Torr) and air similar to that at sea level (35% O2, PIO2, 144 Torr). In both hypoxia and normoxia, after acclimatization the femoral arterial-iliac venous O2 content difference, hemoglobin concentration, and arterial O2 content, were higher than before acclimatization, but the venous PO2 (PVO2) was unchanged. Thermodilution leg blood flow was lower but calculated arterial O2 delivery and leg VO2 similar in hypoxia after vs. before acclimatization. Mean arterial pressure (MAP) and total peripheral resistance in hypoxia were greater after, than before, acclimatization. We concluded that acclimatization did not increase O2 delivery but rather maintained delivery via increased arterial oxygenation and decreased leg blood flow. The maintenance of PVO2 and the higher MAP after acclimatization suggested matching of O2 delivery to tissue O2 demands, with vasoconstriction possibly contributing to the decreased flow.

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