• Title/Summary/Keyword: Blood perfusion rate

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체외순환중 발생한 대량 공기전색에 대한 상공대정맥을 통한 일시적역관류 -치험 2예-

  • 이재성
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.543-548
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    • 1986
  • Massive air embolism during cardiopulmonary bypass is uncommon but serious and often lethal complication. Following this catastrophic event, the immediate institution of retrograde arterial blood perfusion via superior vena cava was made to remove air emboli from cerebral circulation. This method was performed by removing the arterial perfusion line from aortic cannula and connecting it to superior vena caval cannula. Then, retrograde perfusion at a flow rate of 2Umin via superior vena cava was carried out for 3 minutes. After air returning from the aortic cannula was identified, each line was connected to the cannulae primarily. In 2 cases who had massive air emboli due to air pumping into arterial line, the postoperative complete recovery resulted from this technique, which was used in conjunction with other therapy postoperatively.

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Experimental Studies on Extracorporeal Circulation by Sarns Heart-Lung Machine with Total Prime of Hartman's Solution (Sarns 심폐기의 혈희석 체외순환에 관한 실험적 연구)

  • 김근호
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.135-142
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    • 1975
  • Total body perfusion using Sarns Heart-Lung-Machine, five head pump motor system with Travenol disposable bubble oxygenator was attempted in the dogs by the hemodilution method with total prime of buffered Hartman`s solution under moderate hypothermia. The first of all, the functions of Sarns Heart-Lung-Machine and effects of the hemodilution perfusion by buffered Hartman`s solution was studied. At the same time the changes of pressure of artery and vein, gas contents of the blood, and influence on the blood pictures were observed before, during, and after perfusion in 1-2 days. Hemodilution rates were the ranges of 85.0ml/kg to 97.3ml/kg and perfusion flow rates were maintained with the average 80. 5ml/kg/min [the ranges of 73.3ml/kg/min to 92.8ml/kg/min]. Hypothermia was employed between $35^{\circ}C$ and $31^{\circ} of the esophageal temperature. The total body perfusion was continued for 50-60 minutes. In the total cardiopulmonary bypass, atriotomy, ventriculotomy, and atrioventriculotomy were performed respectively. Arterial pressure was ranged approximately between 50 mmHg and 140 mmHg, but generally, it was maintained over 75 mmHg. Venous pressure was measured between 3.8 cm$H_2O$ and 16.0 cm$H_2O$. Optimum oxygenation could be achieved when oxygen flow into the oxygenator was maintained approximately at 5. 5L/min. In this way, the $pO_2$, $pCO_2$, and oxygen saturation were measured before, during, and afterperfusion in 1-2 days. The $pCO_2$ ranged approximately between 26.0 mmHg and 38.5 mmHg, but generally, it was maintained in the average 30.9-32.5mmHg. The $pO_2$ was ranged between 73.0mmHg and 332.2 mmHg, but it was maintained in the average 103.0-219.0 mmHg. Oxygen saturation was measured over 95. 0% during and after extracorporeal circulation respectively. Erythrocyte count, hemoglobin, hematocrit, and leucocyte count were decreased to 49.2%, 49.0%, 49.4%, and 21. 1% of the preoperative value during extracorporeal circulation respectively and these reductions were not recovered until 1-2 days after perfusion. These. resulted from relatively high degree of hemodilution rate and operative bleeding during these experimental studies. The platelets count was also decreased about to 71% during perfusion, on the contrary, it was increased progressively after perfusion and in 1-21 days after perfusion, the value was returned to preoperative contro1 level. Three dogs were all recovered after extracorporeal circulation.

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A New Shock Index for Predicting Survival of Rats with Hemorrhagic Shock Using Perfusion and Lactate Concentration Ratio (흰쥐의 출혈성 쇼크에서 관류와 젖산 농도 비를 이용한 새로운 생존 예측 지표 개발)

  • Choi, Jae-Lim;Nam, Ki-Chang;Kwon, Min-Kyung;Jang, Kyung-Hwan;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.48 no.4
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    • pp.1-9
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    • 2011
  • Hemorrhagic shock is a clinically widespread syndrome characterized by inadequate oxygenation and supply. It is important to diagnose hemorrhagic shock in its early stage for improving treatment effects and survival rate. However, an accurate diagnosis and treatment could be delayed in the early stage of hemorrhagic shock by evaluating only vital signs such as heart rate and blood pressure. There have been many studies for the early diagnosis of hemorrhagic shock, reporting that lactate concentration and perfusion were useful variables for tissue hypoxia and metabolic acidosis. In this study, we measured both perfusion using a laser Doppler flowmeter and lactate concentration from the volume controlled hemorrhagic shock using rats. We also proposed a new shock index which was calculated by dividing lactate concentration by perfusion for early diagnosis. As a result of the survival prediction by the proposed index with the receiver operating characteristic curve method, the sensitivity, specificity, and accuracy of survival were 90.0, 96.7 and 94.0%, respectively. The proposed index showed the fastest significant difference among the other parameters such as blood pressure and heart rate. It could offer early diagnosis and effective treatment for human hemorrhagic shock if it is applicable to humans.

Hepatic Arterial Perfusion Scintigraphy with Tc-99m-Macroaggregated Albumin in Hepatocellular Carcinoma (Tc-99m-MAA를 이용한 간세포암의 경동맥 관류스캔)

  • Kim, Gang-Deuk;Sohn, Kwang-Joon;Min, Kyung-Yoon;Kwon, Young-Mi;Kim, Chang-Guhn;Noh, Byung-Suk;Won, Jong-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.350-356
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    • 1994
  • Purpose : Hepatic arterial perfusion scintigraphy with Tc-99m-macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma(HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and usefullness of HAPS. Materials and Methods : HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4-5 mCi of MAA mixed with 2ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1ml/sec. We analysed 21 HCCs over 2cm in diameter(average diameter; 6.4cm) and 17 of 21 HCCs were over 4cm in diameter(Table 1). CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Results : Three different pattern of tumor perfusion were observed in 16 patients with HCC (Table 2). 1) diffuse increased perfusion in 16 of 21(76%)(Fig. 1) 2) increased peripheral perfusion in 4 of 21(19%) (Fig. 2) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16(56%)(Fig. 4). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16(13%). There was no accumulation of radioactivity on RBC-blood pool scan in all six patients with HCC examined (Fig. 1). Conclusion : HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

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Clinical study of blood flow and vascular reaction in Taeumin CVA patients using Transcranial Doppler (Transcranial Doppler를 이용(利用)한 태음인 중풍환자의 혈류속도(血流速度)와 혈관(血管) 반응성(反應性)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jong-Pil;Bae, Na-Young;Han, Kyung-Soo;Ahn, Taek-Won
    • Journal of Haehwa Medicine
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    • v.15 no.2
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    • pp.263-272
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    • 2006
  • Purpose Brain vessles have autoregulation function, so even when perfusion pressure drops, cerebral blood flow remain stable by vasodilation. Latest research on this reserve of cerebral vessels is being done using TCD, which measures the reserve of the vessels. We did a research comparing cerebral vessel and peripheral vessel reserve between Taeumin, who are more likely to suffer CVA, and the normal. We observed blood flow of Internal carotid artery siphon and radial indicis artery of the two group with TCD. Method We picked 20 people out of patients diagnosed as cerebral infarction at Cheon-An Oriental hospital of Daejeon University. They were diagnosed as Taeumin with QSCCII questionnaire and constitutional differentiation. Using TCD, we measured highest blood flow rate, mean blood flow and asymmetric counting blood flow of Internal carotid artery siphon and radial indicis artery at rest. And then we measured again after stimulating cerebral vessels, by triggering hypercapnia by self apnea and peripheral vessels by palm heating. Result At rest, mean blood flow rate of Internal carotid artery siphon showed significant decrease compared to control group. Blood flow rate of Internal carotid artery siphon after hypercapnia showed significant decline in highest blood flow rate and mean blood flow compared to control group. Cerebral vessel reaction after the hypercapnia induction showed great change in experiment group than the control group. Peripheral vessel reaction after palm heating showed significant decline in experiment group compared to control group. Conclusion In conclusion, measuring the alteration of blood flow used in diagnosing cerebral infarction, is more sensitive when vessel stimulation is done. Non-invasive TCD is effective especially in case of Taeumin who are more likely to suffer vascular disorder than others.

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Effect of Cimetidine on the Hepatic Blood flow -On the Basis of Pharmacokinetics of Indocvanine Green in Rats- (시메티딘이 간혈류량에 미치는 영향 - Rat에 있어서 Indocyanine Green의 체내 동태를 중심으로 -)

  • Lee, Yong-Bok;Koh, Ik-Bae
    • Korean Journal of Clinical Pharmacy
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    • v.3 no.2
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    • pp.163-168
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    • 1993
  • The influence of cimetidine pretreatment(100mg/kg, single i.p.) on the hepatic blood flow was investigated using pharmacokinetic parameters of indocyanine green(ICG) in the rat on the basis of hepacc perfusion-limited model. ICG(1mg/kg) was respectively administered via femoral and portal vein to the control and to the cimetidine-pretreated rats. The rate constant K12, K20 and the systemic clearance(CLt) of ICG were significantly(p<0.05) decreased ill the cimetidine-pretrea-to(B rats, but no significant diffirences were observed in hematocrit and liver weight. The biliary excretion rates of ICG were also decreased regardless of the route of administration in the cimetidine-pretreated rats. And also the hepatic blood flow in rats was decreased about $16\%$ by cimetidine. It may be concluded that the decreased hepatic blood flow with cimetidine mainly contributed to the decreased hepatic uptake and the decreased systemic clearance of ICG.

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Arterial Spin Labeling Magnetic Resonance Imaging in Healthy Adults: Mathematical Model Fitting to Assess Age-Related Perfusion Pattern

  • Ying Hu;Rongbo Liu;Fabao Gao
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1194-1202
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    • 2021
  • Objective: To investigate the age-dependent changes in regional cerebral blood flow (CBF) in healthy adults by fitting mathematical models to imaging data. Materials and Methods: In this prospective study, 90 healthy adults underwent pseudo-continuous arterial spin labeling imaging of the brain. Regional CBF values were extracted from the arterial spin labeling images of each subject. Multivariable regression with the Akaike information criterion, link test, and F test (Ramsey's regression equation specification error test) was performed for 7 models in every brain region to determine the best mathematical model for fitting the relationship between CBF and age. Results: Of all 87 brain regions, 68 brain regions were best fitted by cubic models, 9 brain regions were best fitted by quadratic models, and 10 brain regions were best fitted by linear models. In most brain regions (global gray matter and the other 65 brain regions), CBF decreased nonlinearly with aging, and the rate of CBF reduction decreased with aging, gradually approaching 0 after approximately 60. CBF in some regions of the frontal, parietal, and occipital lobes increased nonlinearly with aging before age 30, approximately, and decreased nonlinearly with aging for the rest of life. Conclusion: In adults, the age-related perfusion patterns in most brain regions were best fitted by the cubic models, and age-dependent CBF changes were nonlinear.

Enhancement of scu-PA Production from Human Kidney Cells by a Novel Bioreactor (인간 신장세포로부터 새로운 배양공법에 의한 scu-PA의 생산성 향상)

  • 최석규;강재구이진하이현용
    • KSBB Journal
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    • v.5 no.4
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    • pp.391-396
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    • 1990
  • 4.0$\times$10-3 (IU/cells/day) of maximum specific scu-PA production, which was higher than those by a 75$\textrm{cm}^2$ T-flask and conventional perfusion systems, was maintained by tube-type bioreactor at 0.35 (1/h) of perfusion rate corresponding to 0.15 (dynes/$\textrm{cm}^2$) of shear stress. The production of scu-PA is also increased as shear stress was slowly increased, which is similar to natural human blood circulation. The tube reactor proves that there may be no limitation of oxygen supply by showing 1.0 (1/h) of oxygen transfer coefficient at steady state and this system yields much lower shear stress of 0.3(dynes/$\textrm{cm}^2$) than that of 5-8(dynes/$\textrm{cm}^2$) by conventional agitation systems.

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Vascular Augmentation in Renal Transplantation: Supercharging and Turbocharging

  • Jeong, Euicheol C.;Hwang, Seung Hwan;Eo, Su Rak
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.238-242
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    • 2017
  • The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap. Supercharging uses a distant source of the vessels, while turbocharging uses vascular sources within the same flap territory. These technical concepts can also be applied in renal transplantation, and in this report, we describe 2 patients who underwent procedures using supercharging and turbocharging. In one case, the ipsilateral deep inferior epigastric artery was transposed to the accessory renal artery (supercharging), and in the other case, the accessory renal artery was anastomosed to the corresponding main renal artery with a vascular graft (turbocharging). The transplanted kidneys showed good perfusion and proper function. No cases of renal failure, hypertension, rejection, or urologic complications were observed. These microsurgical techniques can be safely utilized for renal transplantation with donor kidneys that have multiple arteries with a lower complication rate and better outcome.