Arterial Hypotension
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2022 ◽  
Vol 8 (1) ◽  
pp. 154-159
A. Subanova

A study was carried out of women with arterial hypotension against the background of the development of the pathological state of the fetus and newborns born to women living in two different climatic regions of Osh city and in the highlands of Chon-Alay district of Osh region. In the pathogenesis of pregnancy complications caused by arterial hypotension, the leading importance is attached to vascular disorders and microcirculation disorders, leading to systemic hemodynamic changes in the body of a pregnant woman. It was found that in mountainous terrain, arterial hypotension and exogenous hypoxia affect the “mother–placenta–fetus–newborn” system, increasing the load on the respiratory, circulatory and hematopoietic organs of the mother, and also leads to impaired placental function.

T. S. T. S. Nurmatova ◽  

The study analyzed data from a representative sample of adolescents and young men, 1465 people involved in a one-stage epidemiological survey. The prevalence of arterial hypotension (AH) was 18.6% (among adolescents - 10.8% and among youth - 45.2%; P<0.001). The revealed results should be considered when developing and implementing preventive programs for adolescent and young populations living in the regions of Uzbekistan.

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Katharina Riedel ◽  
Marcus Thudium ◽  
Azize Boström ◽  
Johannes Schramm ◽  
Martin Soehle

Abstract Background Resection of cerebral arteriovenous malformations (AVM) is technically demanding because of size, eloquent location or diffuse nidus. Controlled arterial hypotension (CAH) could facilitate haemostasis. We performed a study to characterize the duration and degree of CAH and to investigate its association with blood loss and outcome. Methods We retrospectively analysed intraoperative arterial blood pressure of 56 patients that underwent AVM-resection performed by the same neurosurgeon between 2003 and 2012. Degree of CAH, AVM size, grading and neurological outcome were studied. Patients were divided into two groups, depending on whether CAH was performed (hypotension group) or not (control group). Results The hypotension group consisted of 28 patients, which presented with riskier to treat AVMs and a higher Spetzler-Martin grading. CAH was achieved by application of urapidil, increasing anaesthetic depth or a combination thereof. Systolic and mean arterial blood pressure were lowered to 82 ± 7 and 57 ± 7 mmHg, respectively, for a median duration of 58 min [25% percentile: 26 min.; 75% percentile: 107 min]. In the hypotension group, duration of surgery (4.4 ± 1.3 h) was significantly (p <  0.001) longer, and median blood loss (500 ml) was significantly (p = 0.002) higher than in the control group (3.3 ± 0.9 h and 200 ml, respectively). No case fatalities occurred. CAH was associated with a higher amount of postoperative neurological deficits. Conclusions Whether CAH caused neurological deficits or prevented worse outcomes could be clarified by a prospective randomised study, which is regarded as ethically problematic in the context of bleeding. CAH should only be used after strict indication and should be applied as mild and short as possible.

2021 ◽  
pp. 51-54
V. M. Baev ◽  
O. A. Igumnova ◽  
T. Yu. Agafonova

The aim of the work is to study the clinical and psychological manifestations of maladjustment of young female students with idiopathic arterial hypotension (IAH). Two groups, aged 18–35 years, were examined: 200 women with IAH with SBP level of 61–98 mm Hg, DBP – 59 mm Hg and less, and 130 women with normal blood pressure. The groups were compared by the frequency of complaints about health problems and the results of assessing mental performance, fatigue using the E. Kraepelin test. The studies were carried out as part of a preventive medical examination. A comparative analysis of complaints showed that women with IAH limit their physical activity due to a deterioration in subjective well-being – the appearance of shortness of breath, pain and discomfort in the chest and legs, dizziness, poor cold tolerance – chilliness of the hands and feet, episodes of involuntary urinary incontinence. With IAH, complaints of apathy, weakness and fatigue, and difficulty concentrating were more often recorded. Women with IAH under psychoemotional stress made more mistakes, and the proportion of women who made mistakes when performing a test was twice as high as in women with normal blood pressure. Thus, we can conclude that IAH in young women is characterized by more frequent complaints of health problems than in women with normal blood pressure, which is combined with a decrease in daily physical activity and cognitive impairment. IAH in female students can be regarded as a risk factor for psycho-emotional and social maladjustment, which negatively affects the effectiveness of learning in the higher education system.

2021 ◽  
Vol Publish Ahead of Print ◽  
Karuna Wongtangman ◽  
Luca J. Wachtendorf ◽  
Michael Blank ◽  
Stephanie D. Grabitz ◽  
Felix C. Linhardt ◽  

2021 ◽  
Vol 16 (7-8) ◽  
pp. 18-32
M.М. Pylypenko ◽  
M.V. Bondar

This article presents the main approaches to the pre-operative preparation of patients with severe acute bowel obstruction and emphasizes that this preparation should be limited in time and don’t delay the surgery. In severe bowel obstruction, in addition to a thorough assessment of vital functions and determination of leading physiologic disorders, it is extremely important to examine patients using specific scales which allow determining the risks of major complications. General anaesthesia usually is the method of choice for acute bowel obstruction; however, it could be supplemented by regional anaesthesia to improve intra- and postoperative pain relief. While preparing for general anaesthesia, first of all, it is necessary to determine the risks of difficult airway and complicated intubation, as well as regurgitation and aspiration of gastric contents, which allows you to purposefully approach the choice of intubation techniques and prevent the occurrence of these formidable complications. Sellick’s manoeuvre is no longer required in these patients, and instead of it during intubation, bimanual laryngoscopy can be used. Arterial hypotension is a common complication during induction of anaesthesia in severe bowel obstruction, and such patients should always be treated with infusion therapy, and their fluid and electrolyte disturbances should be corrected. At the same time, to prevent intestinal oedema and the development of intra-abdominal hypertension, infusion therapy should be limited both in time and in volume. If hypovolemia cannot be completely corrected, vasopressors should be given prophylactically to reduce the risk of significant arterial hypotension during rapid sequence induction.

2021 ◽  
Juan Victor Lorente Olazábal ◽  
Ignacio Jiménez ◽  
Javier Ripollés-Melchor ◽  
Alejandra Isabel Becerra ◽  
Wilbert Wesselink ◽  

Abstract Background: Intraoperative arterial hypotension is associated with poor postoperative outcomes. The Hypotension Prediction Index, developed from machine learning, predicts the occurrence of arterial hypotension from the analysis of the arterial pressure waveform. The use of this index can reduce the duration and severity of intraoperative hypotension in adults undergoing noncardiac surgery.Methods: We will conduct a multicenter, randomized, controlled trial (N=80) in high-risk surgical patients scheduled for elective major abdominal surgery. All participants will be randomly assigned to a control or intervention group. Hemodynamic management in the control group will be based on standard hemodynamic parameters. Hemodynamic management of patients in the intervention group will be based on functional hemodynamic parameters provided by the HemoSphere platform (Edwards Lifesciences Corp.), including dynamic arterial elastance, dP/dtmax and the Hypotension Prediction Index. Tissue oxygen saturation will be non-invasively and continuously recorded by using near-infrared spectroscopy technology. Biomarkers of acute kidney stress (cTIMP2 and IGFBP7) will be obtained before and after surgery. The primary outcome will be intraoperative time-weighted average of a mean arterial pressure < 65mmHg.Discussion: The aim of the study is to determine whether a goal-directed algorithm based on the prevention of arterial hypotension using the Hypotension Prediction Index reduces the duration and severity of intraoperative hypotension when compared with the recommended standard therapy and if this intraoperative strategy is associated with better tissue oxygenation and organ perfusion. Trial registration:, NCT04301102. Registered on March 10, 2020.

2021 ◽  
pp. 106-114
A. V. Sikorski ◽  
I. I. Savanovich ◽  
T. A. Sikorskaya ◽  
V. A. Pereverzev ◽  

The article presents the data on the characteristic features of lipoprotein metabolism and the level of vasoactive endothelial factors in children with primary and symptomatic arterial hypotension. Dyslipidemia in the first group of patients is characterized by an increase in low-density lipoprotein cholesterol, apolipoprotein B100, the atherogenicity coefficient, the ApoLP atherogenicity index, a high concentration of nitric oxide in case of low levels of high-density lipoprotein cholesterol and ApoLP A1. In children with chronic gastroduodenal pathology and symptomatic arterial hypotension, the above disorders of lipoprotein metabolism and endothelial function are accompanied by an increased content of total cholesterol and bradykinin. These data suggest that in children with primary and symptomatic arterial hypotension, conditions for the formation of the initial atherosclerotic process are created due to the predominance of the pro-atherogenic Apo B100 transporter protein over the anti-atherogenic Apo A1, as well as due to a significant increase in nitric oxide and endothelial dysfunction.

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