scholarly journals Study on Haemodynamic Response to Laryngoscopy and Intubation using McCOY and Macintosh Laryngoscopes: A Comparative Approach

2021 ◽  
pp. 320-324
Author(s):  
M. Barish
Keyword(s):  
Heart Rate ◽  
Macintosh Laryngoscope ◽  
Comparative Approach ◽  
Base Line ◽  
Hemodynamic Changes ◽  
Maximum Increase ◽  
Plasma Adrenaline ◽  
Arterial Blood ◽  
Group 2 ◽  
Group 1

Introduction: Laryngoscopy and endotracheal intubation are known to cause increase in arterial blood pressure, heart rate and may be associated with various dysarythmias. This study is done to compare the hemodynamic changes with McCOY laryngoscope and Macintosh laryngoscope in 120 patients who were divided into 2 groups. Methods: A positive correlation has been demonstrated between force exerted at laryngoscopy and patient's height, weight, body mass index (BMI) and presence of maxillary incisors but it was seen that effect of these factors on force exerted with the McCOY blade is not as important as with Macintosh blade. So this study was done to compare the hemodynamic response to laryngoscopy and intubation using McCOY and Macintosh laryngoscope in stress attenuation. Results: Maximum increase in heart rate from the baseline after laryngoscopy in group 2 and a least rise in heart rate from base line in group 1.Group 1 has 9 % increase in heart rate from basal value. Group 2 has 22 % increases in heart rate from basal value. Group 1 has 6 % increase in  Systolic BP from basal value Group 2 has 27 % increase in Systolic BP from basal value. Rise in Plasma adrenaline after laryngoscopy was not observed in Laryngoscopy with McCOY blade. Conclusion: McCOY laryngoscope produces significantly less in Hemodynamic parameters when compared with Macintosh blade.So this non­pharmacological intervention of McCOY blade can be utilized as a tool for obtunding hemodynamic responses to laryngoscopy and intubation

scholarly journals Evaluation of morpho-physiological characteristics of students living in northern conditions

2020 ◽  
pp. 116-123
Author(s):  
M. V. Osin ◽  
V. P. Maltsev
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular System ◽  
Physical Development ◽  
Hemodynamic Parameters ◽  
Development Indicators ◽  
Spring Period ◽  
Arterial Blood ◽  
Group 2 ◽  
Group 1

The study focused on the physical development indicators in younger teens aged 11–12 (Group 1) and 13–14 (Group 2) living in northern conditions (Surgut, Russia). The data was collected and processed in spring from February through March 2020. The physical development, the functional state of the cardiovascular system and the functional body reserves were assessed by anthropometric and hemodynamic indicators. It was found that the physical development was harmonious in the majority of examined teenagers. Among elder teenagers, more boys had good physical development, while more elder girls showed signs of asthenization. Hemodynamic parameters reflected the improved functioning of the cardiovascular system in relation to age. The integrative indicators of heart rate hemodynamics and arterial blood pressure were above the age-sex norm, which indicates stress on the vital systems. The adaptation reserves in teenagers of both groups were reduced during the spring period: 47–66 % of teenagers in Group 1 and 57–68 % of teenagers in Group 2 demonstrated unsatisfactory adaptation indicators.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Epidural Clonidine or Bupivacaine as the Sole Analgesic Agent during and after Abdominal Surgery 

1999 ◽  
Vol 90 (5) ◽  
pp. 1354-1362 ◽  
Author(s):  
Marc De Kock ◽  
Philippe Gautier ◽  
Athanassia Pavlopoulou ◽  
Marc Jonniaux ◽  
Patricia Lavand'homme
Keyword(s):  
High Dose ◽  
General Anesthetics ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Arterial Blood ◽  
Sedation Scores ◽  
Group 3 ◽  
Group 2 ◽  
High Doses ◽  
Group 1

Background The rationale of this study was to compare high-dose epidural clonidine with a more commonly used agent, such as bupivacaine. This was performed to give a more objective idea of the relative analgesic potency of epidural clonidine. Methods Sixty patients undergoing intestinal surgery during propofol anesthesia were studied. At induction, the patients received epidurally a dose of 10 micrograms/kg [corrected] clonidine in 7 ml saline followed by an infusion of 6 micrograms [corrected] x kg(-1) x h(-1) (7 ml/h) (group 1, n = 20), a dose of 7 ml bupivacaine, 0.5%, followed by 7 ml/h bupivacaine, 0.25% (group 2, n = 20), or a dose of 7 ml bupivacaine, 0.25%, followed by 7 ml/h bupivacaine, 0.125% (group 3, n = 20). Intraoperatively, increases in arterial blood pressure or heart rate not responding to propofol (0.5 mg/kg) were treated with intravenous alfentanil (0.05 mg/kg). Additional doses of propofol were given to maintain an adequate bispectral index. The epidural infusions were maintained for 12 h. In cases of subjective visual analogue pain scores up to 5 cm at rest or up to 8 cm during coughing, the patients were given access to a patient-controlled analgesia device. Results During anesthesia, patients in group 1 required less propofol than those in groups 2 and 3 (78 [36-142] mg vs. 229 [184-252] mg and 362 [295-458] mg; P < 0.05) and less alfentanil than patients in group 3 (0 [0-0] mg vs. 11 [6-20] mg; P < 0.05). Analgesia lasted 380 min (range, 180-645 min) in group 1 versus 30 min (range, 25-40 min) in group 2 and 22 min (range, 12.5-42 min) in group 3 (P < 0.05). There was no suggestion of a hemodynamic difference among the three groups except for heart rates that were significantly reduced in patients in group 1. Sedation scores were significantly higher in this group during the first 2 h postoperatively. Conclusion Our results show that high doses of epidural clonidine potentiate general anesthetics and provide more efficient postoperative analgesia than the two bupivacaine dosage regimens investigated.

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.

scholarly journals Possibilities of cardioselective beta - blocker bisoprolol therapy in patients having coronary artery disease and bronchial asthma

2019 ◽  
Vol 91 (9) ◽  
pp. 26-31
Author(s):  
N Y Grigorieva ◽  
T P Ilyushina ◽  
E M Yashina
Keyword(s):  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Calcium Antagonist ◽  
Beta Blocker ◽  
Ventricular Extrasystoles ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim: to compare the antianginal and pulse slowing effects, the impact on the ectopic myocardial activity as well as the safety of the treatment with beta - adrenoblocker bisoprolol, calcium antagonist verapamil and the combination of bisoprolol with amlodipine in patients with stable angina (SA) and bronchial asthma (BA). Materials and methods. The study included 90 patients with SA II-III functional class (FC) having concomitant persistent asthma of moderate severity, controlled, without exacerbation. The patients were divided into three groups with 30 individuals in each one depending on the main antianginal drug prescribed. Group 1 patients received a cardio - selective beta - adrenergic blocker bisoprolol (Concor) at the dose of 5 mg/day, patients of group 2 were treated by a calcium antagonist verapamil at the dose of 240 mg/day, patients of group 3 received combined therapy with bisoprolol at the dose of 5 mg/day and amlodipine at the dose of 5 mg/day given as a fixed combination (Concor AM 5/5). All the patients were investigated by the methods of daily ECG monitoring and respiratory function study (RFS) in addition to physical examination at baseline and after 4 weeks of treatment. Results. After 4 weeks of treatment, patients of group 1 and group 3 did not complain of angina attacks and did not use nitroglycerin unlike patients of group 2. The achieved heart rate (HR) in group 1 patients was 68.6±8.5 beats/min, in group 2 - 74.3±5.6 beats/min, in group 3 - 67.3±4.8 beats/min. A significant decrease in the number of supraventricular and ventricular extrasystoles occurred in patients of group 1 and group 3 only. Thus, the pulse slowing, antianginal, antiischemic and antiarrhythmic effect of the calcium antagonist verapamil, even at the dose of 240 mg/day, is not always sufficient for the patients with SA II-III FC and concomitant BA, unlike therapy with the inclusion of beta - blocker bisoprolol. During the study there was no registered deterioration in the indices of bronchial patency according to the RFS data in the patients of all three groups. Conclusion. In patients with coronary artery disease and concomitant asthma, all three types of pulse slowing therapy do not have any negative effects on bronchial patency. Therapy with the inclusion of beta - blockers (bisoprolol or its combination with amlodipine), in contrast to verapamil, reliably reduces heart rate and the number of supraventricular and ventricular extrasystoles in addition to a good antianginal effect.

scholarly journals Acute Hemodynamic Changes Associated with Zumba and ZOCA Dance Exercises among Females of Selected Gyms in Lusaka, Zambia

2020 ◽  
Vol 2 (1) ◽  
pp. 84-91
Author(s):  
Chanda Grace Chisunka ◽  
◽  
Gibson Sijumbila ◽  
Fastone Goma ◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Hemodynamic Changes ◽  
Aerobic Dance ◽  
Arterial Blood ◽  
Effective Dynamic ◽  
Blood Pressure Monitors ◽  
Blood Pressures

Background: Dynamic exercises are known to elicit hemodynamic changes such as an increase in arterial blood pressure and heart rate. Zumba and ZOCA are part of a fast growing group of dance fitness programmes designed to provide a cardiovascular dynamic workout. Despite their growing popularity, very few studies have been done to provide knowledge regarding the hemodynamic changes associated with these exercises. Methods: Case study in which 27 females took part in either a Zumba or ZOCA class. Using digital blood pressure monitors, recordings of blood pressure and heart rate were taken, firstly, before commencement of the exercise, secondly, after 30 minutes after exercise and thirdly, at the end of the class.Results: Mean baseline blood pressures were 118 (SD = 14) mmHg and 77 (SD = 7) mmHg, systolic and diastolic blood pressures, respectively. After 30 minutes of dancing, mean systolic blood pressure increased to 130 (SD = 19) mmHg (p˂ 0.05) while diastolic blood pressureonly rose to an average of 80 (SD = 8) mmHg (p˃ 0.05). At the end of the class (after the cool down phase) mean systolic blood pressure reduced to 109 (SD = 13) mmHg (p˂0.05) while diastolic blood pressure reduced to 74(SD = 12) mmHg (p˂ 0.05). Conclusions: Zumba and ZOCA elicited significant hemodynamic changes that can be attributed to these exercises stimulating the cardiovascular regulatory mechanisms (e.g central command and exercise-pressor) sufficiently and hence resulting in autonomic adjustmentsthat were concurrent with effective dynamic exercise. Keywords: Blood Pressure, Heart Rate, Aerobic, Dance Exercise

scholarly journals Evaluation of the Accuracy of the Delta Life DL 1000 Oscillometric Monitor for Blood Pressure Measurement in Anesthetized Dogs of Different Weight Ranges

2020 ◽  
Vol 48 ◽  
Author(s):  
Bárbara Silva Correia ◽  
Eduardo Raposo Monteiro ◽  
João Victor Barbieri Ferronatto ◽  
Luciana Branquinho Queiroga ◽  
José Ricardo Herrera Becerra
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Pressure Measurement ◽  
Elective Surgery ◽  
Blood Pressure Measurement ◽  
Measurement Data ◽  
Arterial Blood ◽  
Anesthetized Dogs ◽  
Group 2 ◽  
Group 1

Background: Arterial blood pressure is one of the most commonly variables monitored during anesthetic procedures in veterinary patients. The most reliable method for measuring arterial blood pressure in dogs and cats is the direct (invasive) method. However, the oscillometric method is less complex and more practical for clinical routine in small animals. Nevertheless, oscillometric monitors present great variability in accuracy. The present study aimed to determine the accuracy of the Delta Life DL 1000 oscillometric monitor for measurement of systolic, mean and diastolic blood pressures (SAP, MAP and DAP, respectively) in anesthetized dogs of different weight ranges.Materials, Methods & Results: This study was approved by the Institutional Ethics Committee of Animal Use. Fifteen female dogs of different breeds, weighing 11.6 ± 10.0 kg and with a mean age of 48 ± 51 months were used. All animals were scheduled for elective surgery under general anesthesia in the Institution Veterinary Hospital. Dogs were anesthetized with morphine, propofol and isoflurane and had one 20 or 22 gauge catheter introduced into the dorsal pedal artery for continuous, invasive monitoring of SAP, MAP and DAP. A blood pressure cuff was positioned over the middle third of the radius and connected to Delta Life DL 1000 monitor. Oscillometric readings of SAP, MAP and DAP were registered every 5 minutes, and invasive values were simultaneously recorded. Values obtained with both methods were compared (invasive versus oscillometric) by use of the Bland Altman method to determine the bias, standard deviation of bias and 95% limits of agreement. The percentages of errors between the methods within 10 mmHg and within 20 mmHg were calculated. The results obtained were compared with the criteria from the American College of Veterinary Internal Medicine (ACVIM) for validation of indirect methods of arterial blood pressure measurement. Data were stratified into two groups according to the weight: < 10 kg (Group 1; n = 9); and ≥ 10 kg (Group 2; n = 6). In Group 1, 119 paired measurements were obtained, four of which classified as hypotension (SAP < 90 mmHg), 98 as normotension (SAP from 90 to 140mmHg) and 17 as hypertension (SAP > 140 mmHg). Bias (± SD) values in Group 1 were as follows: SAP, 5.2 ± 18.1 mmHg; MAP, -3.4 ± 17.2 mmHg; and DAP, 12.0 ± 17.5 mmHg. The percentages of errors within 10 mmHg were 40.3% for SAP; 45.4% for MAP and 28.6% for DAP. The percentages of errors within 20 mmHg were 72.3% for SAP, 84.0% for MAP and 68.1% for DAP. In Group 2, 66 paired measurements were obtained, nine of which classified as hypotension, 56 as normotension and one as hypertension. Bias (± SD) in Group 2 were as follows: SAP, 13.6 ± 14.3 mmHg; MAP, -1.1 ± 13.5 mmHg; and DAP, 8.2 ± 16.0 mmHg. The percentages of errors within 10 mmHg were 33.3% for SAP, 77.3% for MAP and 33.3% for DAP. The percentages of errors within 20 mmHg were 65.1% for SAP, 92.4% for MAP and 83.4% for DAP.Discussion: Based on the results of this study and reference criteria from the ACVIM, the Delta Life DL 1000 monitor had a poor accuracy for SAP, MAP and DAP and did not meet the criteria from the ACVIM in anesthetized dogs under 10 kg. Measurements of MAP in dogs ≥ 10 kg met the ACVIM criteria, but measurements of SAP and DAP did not. Based on the findings in this study, the DL 1000 oscillometric monitor is not recommended for blood pressure measurement in anesthetized dogs < 10 kg. In dogs ≥ 10 kg, measurements of MAP yielded acceptable values, but SAP and DAP measurements did not.

The impact of exogenous constitutional obesity on the systemic circulation in COVID-19 patients

2021 ◽  
pp. 54-61
Author(s):  
Д.С. Шилин ◽  
К.Г. Шаповалов
Keyword(s):  
Body Weight ◽  
Vascular Wall ◽  
Systemic Circulation ◽  
Hemodynamic Changes ◽  
Normal Body ◽  
Bacterial Origin ◽  
Normal Body Weight ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Актуальность: ожирение является одной из самых распространенных в мире причин развития сопутствующих заболеваний. у человека. В настоящий момент проблема СOVID-19 приводит к развитию и обострению сердечно-сосудистой патологии, сопровождающейся изменениями гемодинамики. Цель исследования - оценка зависимости изменений гемодинамики у пациентов с COVID-19 от алиментарно-конституционального ожирения. Методика. Исследование выполнено у 73 пациентов обоего пола с внебольничной полисегментарной вирусно-бактериальной пневмонией на фоне СOVID-19. Пациенты были разделены на 3 группы по индексу массы тела. В 1-ю группу вошли пациенты без избытка массы тела, 2-ю составили пациенты с избыточной массой тела, 3-ю - с ожирением 1 степени. Использован комплекс аппаратно-программного неинвазивного исследования центральной гемодинамики методом объемной компрессионной осциллометрии «КАП ЦГ осм- «Глобус» (Россия). Результаты. У пациентов с СOVID-19, страдающих ожирением I степени (30,0 - 34,9 кг/м2). выявлено статистически значимое снижение сердечного индекса относительно лиц с нормальной массой тела (на 10,8%, p=0,010). Пациенты с избытком массы тела имели более высокое диастолическое давление (на 10,5%, p=0,011) Показатель периферического сосудистого сопротивления у пациентов с СOVID-19 без избыточной массы тела был на 16.5% ниже, чем у пациентов с ожирением 1 степени. Удельное периферическое сопротивление сосудов у пациентов 1-й группы было на 10.3% меньше, чем у пациентов с избыточной массой тела. Податливость сосудистой стенки у пациентов 1-й группы была ниже на 22.5%, чем у пациентов с СOVID-19 и ожирением 1 степени. Заключение. У пациентов с внебольничной полисегментарной вирусно-бактериальной пневмонией на фоне СOVID-19 при ожирении 1 степени и избыточной массе тела выявляются значимые изменения гемодинамики относительно больных с нормальной массой тела. Background: Obesity is one of the most common causes of comorbidities worldwide. During the COVID-19 pandemic, development and increasing severity of cardiovascular disorders associated with hemodynamic changes has become increasingly relevant. Aims: The study aimed to evaluate the hemodynamic changes in COVID-19 patients depending on the severity of their exogenous constitutional obesity. Methods. 73 male and female patients with community-acquired polysegmental pneumonia of viral and bacterial origin associated with COVID-19 were enrolled in the study. The patients were allocated to three groups depending on the value of their body mass index (BMI). Group 1 included patients with normal body weight; Group 2 included overweight patients, and Group 3 included patients with grade 1 obesity (BMI 30.0-34.9 kg/m2). The measurements were performed using a technique of volumetric compression oscillometry on a non-invasive hemodynamic monitoring system KAP CG osm (Globus, Russia). Results. COVID-19 patients with grade 1 obesity (BMI 30.0-34.9 kg/m2) demonstrated a statistically significant 10.8% decrease in the cardiac index compared to patients with normal body weight (p=0.010). Overweight patients had 10.5% higher diastolic blood pressure (p=0.011). Peripheral vascular resistance (PVR) in COVID-19 patients with normal body weight was 16.5% lower than in patients with grade 1 obesity. PVR adjusted for body surface area in patients with normal body weight was 10.3% lower than in overweight patients. The compliance of the vascular wall in Group 1 patients was 22.5% lower than in COVID-19 patients with grade 1 obesity. Conclusion. COVID-19 patients with community-acquired, polysegmental pneumonia of viral and bacterial origin demonstrate significant hemodynamic changes compared to patients with normal body weights.

scholarly journals Glycopenia - induced sympathoadrenal activation in diabetes mellitus and uncontrolled arterial hypertension: an observational study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Abimbola Abobarin-Adeagbo ◽  
Andreas Wienke ◽  
Matthias Girndt ◽  
Rainer U. Pliquett
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Insulin Dose ◽  
Hypertensive Crisis ◽  
Plasma Norepinephrine ◽  
Arterial Blood ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Diabetes Patients

Abstract Background Aim of this study is to investigate a possible association of hypoglycemic episodes and arterial hypertension. We hypothesize that hospitalized insulin-treated diabetes patients with hypertensive crisis have more hypoglycemic episodes than their counterparts without hypertensive crisis on admission. Methods In a prospective, observational cohort study, 65 insulin-treated diabetes patients (type 1, type 2, type 3c) were included in Group 1, when a hypertensive crisis was present, as control patients in Group 2 without hypertensive crisis or hypoglycemia, in Group 3, when a symptomatic hypoglycemia was present on admission. All patients were subjected to open-label continuous glucose monitoring, 24-h blood-pressure- and Holter electrocardiogram recordings, and to laboratory tests including plasma catecholamines. Results 53 patients, thereof 19 Group-1, 19 Group-2, 15 Group-3 patients, completed this study. Group-1 patients had the highest maximum systolic blood pressure, a higher daily cumulative insulin dose at admission, a higher body-mass index, and a higher plasma norepinephrine than control patients of Group 2. Group-3 patients had more documented hypoglycemic episodes (0.8 ± 0.5 per 24 h) than Group-2 patients (0.2 ± 0.3 per 24 h), however, they were not different to the ones in Group-1 patients (0.4 ± 0.4 per 24 h). Plasma norepinephrine and mean arterial blood pressure were higher Group-1 and Group-3 patients than in control patients of Group 2. At discharge, the daily cumulative insulin dose was reduced in Group-1 (− 18.4 ± 24.9 units) and in Group-3 patients (− 18.6 ± 22.7 units), but remained unchanged in Group-2 control patients (− 2.9 ± 15.6 units). Conclusions An association between hypoglycemic events and uncontrolled hypertension was found in this study.

Effect of sympathetic blockade on diurnal variation of hemodynamic patterns

1989 ◽  
Vol 256 (3) ◽  
pp. R778-R785 ◽  
Author(s):  
M. I. Talan ◽  
B. T. Engel
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Output ◽  
Stroke Volume ◽  
Total Peripheral Resistance ◽  
Peripheral Resistance ◽  
Base Line ◽  
Sympathetic Blockade ◽  
Selective Blockade ◽  
Arterial Blood

Heart rate, stroke volume, and intra-arterial blood pressure were monitored continuously in each of four monkeys, 18 consecutive h/day for several weeks. The mean heart rate, stroke volume, cardiac output, systolic and diastolic blood pressure, and total peripheral resistance were calculated for each minute and reduced to hourly means. After base-line data were collected for approximately 20 days, observation was continued for equal periods of time under conditions of alpha-sympathetic blockade, beta-sympathetic blockade, and double sympathetic blockade. This was achieved by intra-arterial infusion of prazosin, atenolol, or a combination of both in concentration sufficient for at least 75% reduction of response to injection of agonists. The results confirmed previous findings of a diurnal pattern characterized by a fall in cardiac output and a rise in total peripheral resistance throughout the night. This pattern was not eliminated by selective blockade, of alpha- or beta-sympathetic receptors or by double sympathetic blockade; in fact, it was exacerbated by sympathetic blockade, indicating that the sympathetic nervous system attenuates these events. Because these findings indicate that blood volume redistribution is probably not the mechanism mediating the observed effects, we have hypothesized that a diurnal loss in plasma volume may mediate the fall in cardiac output and that the rise in total peripheral resistance reflects a homeostatic regulation of arterial pressure.

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