• Title/Summary/Keyword: Red Blood Cell

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Carotid Vessel Wall MRI Findings in Acute Cerebral Infarction Caused by Polycythemia Vera: A Case Report (적혈구 증가증으로 인한 급성 뇌경색에서 경동맥 혈관벽 자기공명영상 소견: 증례 보고)

  • Jun Kyeong Park;Eun Ja Lee;Dong-Eog Kim;Hyun Jung Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.178-183
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    • 2022
  • Polycythemia vera (PV) is a rare myeloproliferative disease that causes elevated absolute red blood cell (RBC) mass due to uncontrolled RBC production. Moreover, this condition has been associated with a high risk of ischemic stroke and large vessel stenosis or occlusion, with many studies reporting cerebral infarction in PV patients. Despite these findings, there have been no reports on the vessel wall MRI (VW-MRI) findings of the narrowed vessels in PV-associated ischemic stroke patients. To the best of our knowledge, this is the first report in English regarding the carotid VW-MRI findings of a 30-year-old male diagnosed with PV after being hospitalized due to stroke.

Toxic Effects of Microplastic on Hematological Parameters, Plasma Components, and Antioxidant Responses in the Korean Rockfish Sebastes schlegelii (조피볼락(Sebastes schlegelii)의 혈액성상, 혈장성분 및 항산화 반응에 미치는 미세플라스틱의 독성 영향)

  • Jung-Hoon Kang;Ji Yeon Ko;Young-Bin Yu;Jae-Ho Choi;Ju-Hyeong Lee;Ju-Chan Kang
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.57 no.3
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    • pp.227-238
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    • 2024
  • This study aimed to evaluate the effects of polyethylene microplastic (PE-MPs) via measuring the growth performance, hematological parameters, and antioxidant responses in Korean rockfish Sebastes schlegelii exposed to waterborne polyethylene microplastic with dimensions of 22-71 ㎛. S. schlegelii (mean weight, 34.55±5.82 g; mean length, 12.59±0.79 cm) were exposed to PE-MPs at concentrations of 0, 400, 800, 1,600 and 3,200 ㎍/L for 10 and 20 days. PE-MPs significantly affected growth performance, hematological parameters, plasma components, and antioxidant responses in a concentration-dependent manner. At a concentration ≥1,600 ㎍/L, PE-MPs significantly decreased body weight gain and specific growth rate, and significantly increased the hepatosomatic index. Hematological parameters showed a significant decrease in total red blood cell count and hemoglobin levels. Plasma components showed a significant increase in glucose, aspartate aminotransferase, and alanine transaminase levels, whereas total protein, calcium, and magnesium levels significantly decreased. Exposure to ≥1,600 ㎍/L PE-MPs also induced reactive oxygen species generation in the gill and liver, significantly increasing superoxide dismutase and catalase activity. These findings suggest that exposure to ≥1,600 ㎍/L PE-MPs could significantly change growth performance, hematological parameters, plasma components, and antioxidant responses, resulting in physiological toxicity.

Efficacy of Tranexamic Acid during Primary Total Knee Arthroplasty: Comparative Study between Intravenous Use and Topical Use (일차 슬관절 전치환술 중 트라넥삼산의 정맥 내 투여와 국소 사용의 효과에 관한 비교 연구)

  • Lee, Hyun Ju;An, Ki Yong;Park, Ji Yeon;Chung, Young Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.142-149
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    • 2021
  • Purpose: This study examined the effectiveness of tranexamic acid in reducing postoperative blood loss in total knee arthroplasty by comparing the methods of administration between an intravenous group, topical group, and non-tranexamic acid group. Materials and Methods: This was a retrospective case series study of patients who underwent primary total knee arthroplasty from March 2017 to February 2019 performed by a single surgeon. The study population was divided into three groups according to the method of tranexamic acid administration (Group I: intravenous group, Group II: topical group, Group III: non-tranexamic acid group). To evaluate the effectiveness of tranexamic acids, the total amount of postoperative blood loss, postoperative hemoglobin loss, and volume of red blood cell transfusion in the three groups were compared. Results: The total amount of postoperative blood loss was lower in the tranexamic acid administered group than in the non-tranexamic acid group (1,366±866 ml). Among the administration methods, the intravenous group (987±449 ml) was significantly lower than the topical group (1,136±339 ml) (p=0.004). Postoperative hemoglobin loss was lower in the tranexamic acid group than the non-tranexamic acid group. Among the administration methods, the intravenous group was lower than the topical group. The transfusion rate was higher in the non-tranexamic acid group (5.7%) than the tranexamic administered group. The transfusion rate of the intravenous group was 1.4%, and no patient required a transfusion postoperatively in the topical group. The number of postoperative thromboembolic events, as a complication of tranexamic acid, was similar in the three groups. Conclusion: Tranexamic acid was effective in reducing postoperative blood loss after primary total knee arthroplasty compared to the non-tranexamic acid administered group. No significant difference in the complications induced by tranexamic acid was observed among the three groups.

Clinical Significance of Vascular Endothelial Growth Factor in Patients with Lung Cancer and Tuberculous Pleurisy (폐암 및 결핵성 흉막염에서 Vascular Endothelial Growth Factor의 임상적 의의)

  • Im, Byoung-Kook;Oh, Yoou-Jung;Sheen, Seung-Soo;Lee, Keu-Sung;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong;Choi, Jin-Hyuk;Lim, Ho-Young
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.171-181
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    • 2001
  • Background : Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a useful parameter related to the clinical features and prognosis of lung cancer and has been recently applied to a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. Methods : Using a sandwich enzyme-linked immunosorbent assay, the VEGF conoentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. Results : The serum VEGF levels in patients with lung cancer ($619.9{\pm}722.8pg/ml$) were significantly higher than those of healthy controls ($215.9{\pm}191.1pg/ml$), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion ($2,228.1{\pm}2,103.0pg/ml$) were significantly higher than those in the TB effusion ($897.6{\pm}978.8pg/ml$). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. Conclusion : The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.

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Changes of Haematological Constituents in the Nile tilapia, Oreochromis niloticus Exposed to HCB and PCBs (HCB와 PCBs에 노출된 나일틸라피아, Oreochromis niloticus의 혈액성분의 변화)

  • Cho Kyu Seok;Min Eun Young;Kang Ju Chan
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.35 no.2
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    • pp.110-114
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    • 2002
  • The study was carried out to investigate the changes of haematological constituents induced by dietary exposure of Hexachlorobenzene (HCB) and Polychlorinated biphenyls (PCBs) in nile tilapia, Oreochhromis niloticus. The nile tilapia were fed pellet with 0.05, 0.25 and 0.50 mg/kg body weight/day of HCB and PCBs for 30 days, respectively. HCB ($\ge$ 0.25 mg/kg) induced a significantly decreased the red blood cell count at 30 days, and the hemoglobin concentration and hematocrit value were significantly decreased after 20 days to 0.50 mg/kg. The diminution of red blood cell count, hemoglobin concentration and hamatocrit value by PCBs was found after 20 days at $\ge$0.25 mg/kg. The concentrations of calcium decreased significantly at 30 days at $\ge$0,25 mg/kg of PCBs-diet. However, magnesium and inorganic phosphorus did not show any noticeable changes in the range of 0.05$\~$o.50 mg/kg of HCB and PCBs compared to control group during the experimental period, The low concentration of total protein was observed at the last day of experiment to 0.50 mg/kg of HCB-diet, while total protein initiated to increase from 20 days at the 0.25 mg/kg of PCBs-diet. The glucose was significantly increased after 20 days at $\ge$0,25 mg/kg of HCB and PCBs, A significant increment GOT and GPT activities was noticed after 20 days at 0.50 mg/kg of HCB and PCBs, These results indicate that hematological and serum biochemical changes in the nile tilapia by dietary exposure to HCB and PCBs are affected at more than 0,25 mg/kg after 20 days.

Altered Expression of Peroxiredoxin and Thioredoxin in Septic Animal Model (패혈증 동물 모델에서 Peroxiredoxin 및 Thioredoxin의 발현 변화)

  • Kim, Hyung-Jung;Chae, Ho-Zoon;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.451-459
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    • 1999
  • Background : In sepsis, excessive generation of reactive oxygen species plays key roles in the pathogenesis of acute lung injury. The serum antioxidants such as catalase and MnSOD are elevated in sepsis and considered as predictors of acute respiratory distress syndrome(ARDS) and prognostic factors of sepsis. Peroxiredoxin(Prx) has recently been known as an unique and major intracellular antioxidant. In this study, we evaluated the expression of Prx I and Prx II in mouse monocyte-macrophage cells(RAW 267.7) after treatment of oxidative stress and endotoxin and measured the amount of Prx I, Prx II and thioredoxin(Trx) in peritoneal and bronchoalveolar lavage fluid of septic animal model. Methods : Using immunoblot analysis with specific antibodies against Prx I, Prx II and Trx, we evaluated the distribution of Prx I and Prx II in human neutrophil, alveolar macrophage and red blood cell. We evaluated the expression of Prx I and Prx II in mouse monocyte-macrophage cells after treatment of $5\;{\mu}M$ menadione and $1\;{\mu}g/ml$ lipopolysaccharide(LPS) and measured the amount of Prx I, Prx II and Trx in peritoneal lavage fluid of intraperitoneal septic animals(septic animal model induced with intraperitoneal 6 mg/Kg LPS injection) and those in bronchoalveolar lavage fluid of intraperitoneal septic animals and intravenous septic animals(septic animal model induced with intravenous 5 mg/Kg LPS injection) and compared with the severity of lung inflammation. Results : The distribution of Prx I and Prx II were so different among human neutrophil, alveolar macrophage and red blood cell. The expression of Prx I in mouse monocyte-macrophage cells was increased after treatment of $5\;{\mu}M$ menadione and $1\;{\mu}g/ml$ lipopolysaccharide but that of Prx II was not increased. The amount of Prx I, Prx II and Trx were increased in peritoneal lavage fluid of intraperitoneal septic animals but were not increased in bronchoalveolar lavage fluid of intraperitoneal and intravenous septic animals regardless of the severity of lung inflammation. Conclusion : As intracellular antioxidant, the expression of Prx I is increased in mouse monocyte-macrophage cells after treatment of oxidative stress and endotoxin. The amount of Prx I, Prx II and Trx are increased in local inflammatory site but not increased in injured lung of septic animal model.

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Experimental Study on Anti-inflammatory, Antitussive, and Expectoration Effects of Friltillariae Thunbergii Bulbus (절패모(浙貝母)의 항염 및 진해거담 효과에 대한 실험연구)

  • Kim, Jin Hoo;Yang, Won Kyung;Lee, Su Won;Lyu, Yee Ran;Kim, Seung Hyung;Park, Yang Chun
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.339-349
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    • 2020
  • Objective: This study aimed to evaluate anti-inflammatory and antitussive expectoration effects of Friltillariae Thunbergii Bulbus (FTB) in a mouse model. Materials and Methods: To evaluate the anti-inflammatory effects of the FTB, we conducted in vitro experiments using RAW264.7 cells. An MTT assay and enzyme-linked immunosorbent assay (ELISA) were carried out to examine the anti-inflammatory effects of FTB. The expectorant effect on phenol red secretion, the antitussive effect on cough induced by ammonia solution, and leukocyte increased inhibition effects in acute airway inflammation in the animal model were confirmed. Results: FTB did not show cytotoxicity in the experimental group at 10, 30, 50, 100, 300, or 500 ㎍/ml and significantly inhibited the increase of NO, TNF-α and IL-6 in the experimental groups at 30, 50, 100, 300, and 500 ㎍/ml concentrations. In sputum, cough, and acute airway inflammation animal models, FTB significantly increased phenol red secretion in the 400 mg/kg administration group. FTB significantly reduced the number of coughs and significantly increased cough delay time in both 200 and 400 mg/kg dose groups. FTB decreased the white blood cell count in BALF (bronchoalveolar lavage fluid) in the 400 mg/kg administration group. Conclusion: Our study revealed that FTB elicits antitussive and expectorant effects by inhibiting inflammatory cytokines, increasing sputum secretion, suppressing cough, and reducing inflammatory cells. We concluded that FTB is a highly promising agent for respiratory tract infection with therapeutic opportunities.

Effects of Chamaeneron angustifolia Extract on Lipid Metabolism and Differentiation of 3T3-L1 Preadipocyte (Chamaeneron angustifolia 추출물이 3T3-L1 Preadipocyte의 지방대사 및 분화에 미치는 영향)

  • Seul Bi Lee;Moon-Yeol Choi;Mi Hyung Kim;So-Young Kim;Mi Ryeo Kim
    • The Korea Journal of Herbology
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    • v.39 no.4
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    • pp.29-35
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    • 2024
  • Objectives : Obesity is an imbalance between energy intake and consumption due to overeating and lack of exercise, and if it persists, it increases non-infectious diseases such as high blood pressure, diabetes, and hyperlipidemia. In this study, we tried to investigate the possibility of using Chamaeneron angustifolia (CA) as a material for anti-obesity by confirming the effect of inhibiting lipid differentiation. Methods : We measured the effects of CA extract on oil-red-o staining, cell cytotoxicity evaluation activity using 3T3-L1 cells. Additionally, we assessed fat decomposition and metabolism-related protein expression through Western blot analysis. Results : In this study, the anti-obesity effects of CA extract were experimentally assessed. Results showed significant inhibition of adipocyte differentiation and accumulation at concentrations of 0.05, 0.1, and 0.2 mg/ml of oil-red-o staining, with reductions of 80% or more. CA notably increased the phosphorylation of AMPK protein expression compared to the control group across all concentrations. Additionally, phosphorylation of ACC significantly increased at a concentration of 0.2 mg/ml compared to the control. PPAR-γ, which regulates adipogenesis, exhibited a significant decrease compared to the control, while protein expression of CPT-1, involved in fatty acid oxidation, showed a concentration-dependent increase across all groups. Therefore, CA extract demonstrates potential as a functional material for anti-obesity by increasing the expression of proteins related to fat decomposition and synthesis while decreasing others. Conclusions : These results suggest that CA may also be useful as an anti-obesity functional substance.

A Study on Nutritional Status of Young Children in Rural Korea (농촌영유아의 영양상태(營養狀態)에 관(關)한 조사연구(調査硏究))

  • Kim, Kyoung-Sik;Kim, Pang-Ji;Nam, Sang-Ok;Choi, Jung-Shin
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.1-28
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    • 1974
  • The writers have conducted the investigation to assess the nutritional status of young rural Korean children aged from 0 to 4 years old in August 1971. The survey areas were Kaejong-myon. Daeya-myon, Okku-gun, Jeonra-bukdo, Korea. These survey areas were typical agricultural plain areas. The total numbers of children examined were 2,706 comprising 1,394 male and 1,312 female. The weight, height, and chest circumference of children were measured and means and standard deviations. were calculated for each measurement. In addition, the nutritional status of each child was classified by the four levels of malnutrition and the Gomez classification, The examination of red blood cell count, haematocrit value, and intestinal parasite infection were carried out at the same time. In general, recent work tend to suggest that environmental influences, especially nutrition, are of great importance than genetic background or other biological factors for physical growth and development. Certainly the physical dimensions of the body are much influenced by nutrition, particularly in the rapidly growing period of early childhood. Selected body measurements can therefore give valuable information concerning protein-calory malnutrition. Growth can also be affected by bacterial, viral, and parasitic infection. For the field workers in a developing country, therefore, nutritional anthropometry appears to be of greatest value in the assessment of growth failure and undernutrition, principally from lack of protein and calories. In order to compare and evaluate the data obtained, the optimal data of growth from the off-spring of the true well-fed, medically and socially protected are needed. So-called 'Standards' that have been compiled for preschool children in Korea, however, are based on measurement of children from middle or lower socio-economic groups, who are, in fact, usually undernourished from six months of age onwards and continuously exposed to a succession of infective and parasitic diseases. So that, the Harvard Standards which is one of the international reference standards was used as the reference standards in this study. Findings of the survey were as follows: A. Anthropometric data: 1) Comparing the mean values for body weight obtained with the Korean standard weight of the same age, the rural Korean children were slightly haevier than the Korean standard values in both sexes. Comparing with the Japanese children values, the rural Korean children were slightly haevier in male and in the infant period of female but lighter in female of the period of 1 to 4 years old than Japanese children. 2) Comparing the mean values for height obtained with the Korean standard height of the same age, the rural Korean children were taller than the Korean standard values except the second half of infatn period in both sexes. Comparing with the Japanese children, the rural Korean children were slightly smaller than Japanese children except the first half of infant peroid in both sexes. 3) Mear values of chest circumference of rural Korean children obtained were less than the Korean standard values of the same ages in both sexes. B. Prevalence of Protein-Calory Malnutrition: Children examined were devided into two groups, i. e., infant(up to the first birthday) and toddler (1 to 4 fears old). 1) Percentages of four levels of malnutrition: a) When the nutrtional status of each child was classified (1) by body weight value, the percentages for male and female of children attained standard growth were 52.8%(infant 83.3%, toddler 44.4%) and 39.7% (infant 74.5%. toddler 30.5%), the first level of malnutrition were 31.9%(infant 13.7%, toddler 36.9%) and 31.7%(infant 15.3%, toddler 36,0%), the second level of malnutrition were 12.3%(infant 1.7%, toddler 15.3%) and 23.3% (infant 7.7%, fodder 27.5%), the third level of malnutrition were 2.7%(infant 0.7%, toddler 3.2%) and 4.6%(infant 1.8%, toddler 5.3%) the fourth level of malnutrition were 0.3% (infant 0.7%, toddler 0.2%) and 0.7% (0.7% for infant and toddler) respectively. (2) by height value, the percentages for male and female of children attained standard growth were 80.3% (infant 97.3%, toddler 75.6%) and 75.1% (infant 96.4%, toddler 69.5), the first level of malnutrition were 17.9% (infant 2.0%, toddler 22.3%) and 23.6% (infants 3.6%, toddler 28.8%), the second level of malnutrition were 1.2% (infant 0.3%, toddler 1.5%) and 1.1% (infant 0%, toddler 1.4%), the third level of malnutrition were 0.4%(infant 0.3%, toddler 0.5%) and 0.2%(infant 0%, toddler 0.3%), the fourth level of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 0% respectively. (3) by body weight in relation to height, the percentages for male and female of children attained standard growth were 87.9% (infant 77.6%, toddler 87.9%) and 78.2% (infant 77.4%, toddler 78.2%), the first level of malnutrition were 12.2% (infant 18.4%, toddler 10.6%) and 18.2% (infant 17.9%, toddler 18.3%), the second level of malnutrition were 1.9%(infant 3.3%, toddler 1.5%) and 3.0%(infant 3.3%, toddler 2.9%), the third level of malnutrition were 0.1%(infant 0%. toddler 0.1%) and 0.5% (infant 0%, toddler 0.6%), the fourth level of malnutrition were 0.1%(infant 0.7%, toddler 0%) and 0.3% (infant 1.5%, toddler 0%) respectively. b) When the nutritional status of each child according to the mother's age at perturition, i. e., young aged mother (up to 30 years old), middle aged mother (31 to 40 years old) and old aged mother (41 years or above) was classified (1) by body weight, among infants and toddlers, at each year of age, with increasing the mother's age, there was an increase in percentage of subjects underweight. This tendency of increasing percentage of underweight was more significant in the infant period than the toddler period. (2) by height value, no significant differences between each mother's age group were found. c) When the nutritional status of each child according to the birth rank, i. e., lower birth rank (first to third) and higher birth rank (fourth or above) was classified (1) by weight value, children of higher birth rank were slightly more often underweight than those of lower birth rank, but not significant. (2) by height value, no differences were found between children of lower and higher birth rank. 2) Gomez Classification: When the nutritional status of each child was classified a) by body weight value, the percentages for male and female of children. attained standard growth were 53.1% (infant 82.6%, toddler 44.9%) and 39.2% (infant 73.4%, toddler 30.1%), the first degree of malnutrition were 39.4% (infant 14.7%, toddler 46.2%) and 47.1% (infant 21.9%, toddler 53.8%), the second degree of malnutrition were 7.3%(infant 2.3%, toddler 8.6%) and 12.9% (infant 4.0%, toddler 15.2%). and the third degree of malnutrition were 0.2%. (infant 0.3%, toddler 0.2%) and 0.8% (infant 0.7%, toddler 0.9%) respectively. b) by height value, the percentages for male and female of children attained standard growth were 80.8% (infant 97.0%, toddler 76.3%) and 73.8%(infant 95.6%, toddler 68.0%), the first degree of malnutrition were 18.5% (infant 2.7%, toddler 22.9%) and 24.6% (infant 4.4%, toddler 30.0%), the second degree of malnutrition were 0.6%(infant 0.3%, toddler 0.7%) and 0.5% (infant 0.1%, toddler 0.7%), and the third degree of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 1.1% (infant 0%, toddler 1.3%) respectively. C. Results of clinical laboratory examination: 1) Red blood cells: The ranges of mean red blood cell counts for male and female were $3,538,000/mm^3\;to\;4,403,000/mm^3\;and\;3,576,000/mm^3\;to\;4,483,000/mm^3$ respectively. The lowest red cell counts were seen at the age of 0-3 months for male and 1-2 months for female. 2) Haematocrit value : The ranges of haematocrit value of male and female were 35.1% to 38.8% and 34.7% to 38.8% respectively. The lowest haematocrit values were seen at the age of 2-3 months for male and 1-2, months for female. 3) The prevalence rates of intestinal parasites for male and female children with Ascaris lumbricoides were 34.1% (infant 18.8%, toddler 38.1%) and 36.0%(infant 18.4%, toddler 40.7%), with Trichocephalus trichiuris were 6.8% (infant 2.9%, toddler 7.9%) and 9.0% (infant 3.0%, toddler 10.6%), with Hookworm were 0.3% (infant 0.5%, toddler 0.2%) and 0.3% (infant 0.5%, toddler 0.3%), with Clonorchis sinensis were 0.4%(infant 0%, toddler 0.5%) and 0.1%(infant 0%, toddler 0.1%) respectively.

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Efficacy of minimal invasive cardiac output and ScVO2 monitoring during controlled hypotension for double-jaw surgery

  • Kim, Seokkon;Song, Jaegyok;Ji, Sungmi;Kwon, Min A;Nam, Dajeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.353-360
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    • 2019
  • Background: Controlled hypotension (CH) provides a better surgical environment and reduces operative time. However, there are some risks related to organ hypoperfusion. The EV1000/FloTrac system can provide continuous cardiac output monitoring without the insertion of pulmonary arterial catheter. The present study investigated the efficacy of this device in double jaw surgery under CH. Methods: We retrospectively reviewed the medical records of patients who underwent double jaw surgery between 2010 and 2015. Patients were administered conventional general anesthesia with desflurane; CH was performed with remifentanil infusion and monitored with an invasive radial arterial pressure monitor or the EV1000/FloTrac system. We allocated the patients into two groups, namely an A-line group and an EV1000 group, according to the monitoring methods used, and the study variables were compared. Results: Eighty-five patients were reviewed. The A-line group reported a higher number of failed CH (P = 0.005). A significant correlation was found between preoperative hemoglobin and intraoperative packed red blood cell transfusion (r = 0.525; P < 0.001). In the EV1000 group, the mean arterial pressure (MAP) was significantly lower 2 h after CH (P = 0.014), and the cardiac index significantly decreased 1 h after CH (P = 0.001) and 2 h after CH (P = 0.007). Moreover, venous oxygen saturation (ScVO2) decreased significantly at both 1 h (P = 0.002) and 2 h after CH (P = 0.029); however, these values were within normal limits. Conclusion: The EV1000 group reported a lower failure rate of CH than the A-line group. However, EV1000/FloTrac monitoring did not present with any specific advantage over the conventional arterial line monitoring when CH was performed with the same protocol and same mean blood pressure. Preoperative anemia treatment will be helpful to decrease intraoperative transfusion. Furthermore, ScVO2 monitoring did not present with sufficient benefits over the risk and cost.