• Title/Summary/Keyword: hemodynamic

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Autonomic dysfunction in patients with orthostatic dizziness

  • Hyung Lee;Hyun Ah Kim
    • Annals of Clinical Neurophysiology
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    • v.25 no.1
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    • pp.27-31
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    • 2023
  • Orthostatic dizziness is feeling dizzy or lightheaded when standing up. Hemodynamic orthostatic dizziness can be caused by autonomic dysfunction such as orthostatic hypotension or postural tachycardia syndrome. The interpretation of the autonomic function test results in patients with orthostatic dizziness is crucial for diagnosing and managing the underlying condition. The head-up tilt and Valsalva tests are especially important for evaluating adrenergic function in patients with hemodynamic orthostatic dizziness. However, it is important to note that autonomic function tests do not cover the entire diagnostic process, since their findings need to be considered along with the detailed history and physical examination results of the patient because various differential diagnoses exist for orthostatic dizziness. Ensuring appropriate treatment by interpreting the autonomic function test results can help to determine the improvement of and prevents falls from orthostatic dizziness.

Animal Experiment of the Pneumatic Ventrivular Assist Device (공압식 심실 보조기의 동물실험)

  • Park, Seong-Sik;Kim, Sam-hyun;Seo, Pil-won;Choi, Chang-hyu;Lee, Sang-hoon;Lee, Hyuk-soo;Hwang, Seung-ok;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1065-1077
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    • 1999
  • Background : Ventricular assist devices(VADs) are being used for patients in postcvardiotomy cardiogenic shock status bridge to cardiac transplant settings and in post-myocardial infarction cardiogenic shock. The VAD which was developed at the Deparment of medical engineering in Dankook University College of Medicine was a pneumatically driven device and can maintain pulsatile flow. The goal of this study is to develop animal experimental models using the VAD and to clarify the reliability and hemodynamic property adequacy of end organ perfusion durability and severity of thrombotic-hemolytic tendency of the device. Material and Method : The pneumatic VAD was applied to 8 adult female lambs, We examined some hemodynamic parameters such as arterial blood pressure pulmonary capillary wedge pressure(pcwp) pulmonary artery pressure(PAP) left atrial pressure hour urine output cardiac index VAD flow EKG to determine the reliability of the VAD and hemodynamic compatibility of the experimental animals within 24 hours of experiment. We also observed the end organ perfusion durability of the VAD and thrombotic-hemolytic property of the VAD after 24 hours of VAD insertion. Result: We could monitor all hemodynamic parameters including pcwp PAP cardiac index EKG, adn hour urine as true clinical settings. We observed that the reliability of the VAD was excellent and the hemodynamic property of the experimental animal and end organ perfusion were adequate within 24 hours of experiment. In four lambs surviving 24 hours after insertion the reliability of the VAD and end organ perfusion were excellent and no thrombotic-hemolytic tendency was noted. However after 15 days of experiment the diaphragm of the VAD was torn and it was recommende that the durability of the VAD should be extended. Conclusion : e conclude that the pneumatic VAD developed at Dankook University Biomedical Engineering has good hemodynamic property and low thromboembolic tendency and presents adequate end organ perfusion but we noted that the durability of the device should be expanded further. It will be possible to do more reliable experiment in the future according to the animal experimental method developed in this study especially with the heart failure models.

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Delayed sternal closure (미연성 흉골 봉합치험 1)

  • An, Byeong-Hui;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.308-310
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    • 1982
  • During the closure of the sternum, following the mitral valve replacement for mitral stenoinsufficiency, hemodynamic instability with cardiac tamponade was developed. After transfusion of massive diuretics and albumin for a few times, reclosure of the sternum was attempted with development of hemodynamic instability. And so we decided delayed sternal closure. After 72 hours of mitral valve replacement, delayed sternal closure was done with success, and so we report this case with literatures.

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Clinical Experience with Intraaortic Balloon pump - Report of 31 cases - (IABP 치험 [31례 보고)

  • 최준영
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.706-709
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    • 1987
  • From December 1981 to June 1987, thirty one patients suffering from low output syndrome after cardiac operation received cardiac assist with intraaortic balloon pump. Fifteen patients survived [survival rate 48.4%]. After receiving assist with IABP, urine output increased, heart rate and central venous pressure decreased, reflecting improved myocardial performance. Poor preoperative hemodynamic and functional status resulted in poor survival despite of assist with IABP. Poor pre-IABP hemodynamic status also resulted in high mortality after assist with IABP. Our experience suggests that IABP should be introduced early in the course of worsening to get good result.

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Traumatic tension enterothorax in New Zealand: a case report

  • Monique Mahadik;Ashok Gunawardene;Aleisha Sutherland;Damien Ah Yen
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.258-260
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    • 2023
  • Traumatic rupture of the right hemidiaphragm occurred following a high-velocity motor vehicle collision in the case presented herein. The resulting herniation of small bowel loops into the thorax resulted in hemodynamic and respiratory compromise due to pressure effects on the right heart and major vessels. The patient's hemodynamic status improved with reduction of enterothorax, and the diaphragmatic defect was repaired. We discuss the available literature and learning points from this rare case.

Computational Study on the Hemodynamics of Cardiovascular System Including Short-term Auto-regulation Functions (단기적 자율조절기능을 포함하는 심혈관계 혈류역학 모델링에 관한 수치적 연구)

  • 심은보;정찬일;최한고
    • Journal of Biomedical Engineering Research
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    • v.22 no.5
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    • pp.393-402
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    • 2001
  • A computational model representative of cardiovascular circulation was built using 12 standard lumped compartments. Especially, both the baroreceptor reflex and the cardiopulmonary reflex control model were implemented to explain the auto-regulation of cardiovascular system. Another important aspect of this model is to utilize the impulse-response curve of the nerve system in transferring the impulse error signals to autonomous nerve system. For the verification of this model, we have computed the normal hemodynamic conditions and compared those with the clinical data. Then. hemodynamic shock of 20% hemorrhage to cardiovascular system was simulated to test the effects of the control system model. The results of these two simulations were well matched with the experimental ones. The steady state LBNP simulation was also performed. The transient changes of hemodynamic variables due to ramp increase of bias pressure of LBNP showed good agreement with the physiological experiments. Numerical solution using only the baroreflex model showed relatively a larger deviation from the experimental data. compared with the one using the control model haying both the baroreflex and the cardiopulmonary reflex systems, which shows an important role of the cardiopulmonary reflex system for the simulation of the hemodynamic behavior of the cardiovascular system .

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Pulmonary Hemodynamic Alterations Following Radical Hilar Stripping (폐문부박리가 폐혈류 역학에 미치는 영향)

  • Kwack, Moon Sub;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.20-26
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    • 1976
  • Author has performed experimental study on hemodynamic changes of lung following radical hilar stripping and contralateral pulmonary artery ligation. In view of hemodynamic changes in group 1 (right pulmonary artery ligation only) and group 2(left hilar stripping+right pulmonary artery ligation). group 2 showed remarkable decrease rate in oxygen uptake (P<0.001) and total pulmonary blood flow(P<0.001), and the more increase rate in mean pulmonary artery pressure(P<0.02) and total pulmonary vascular resistance (P<0.001). Meanwhile, the decrease percent of left lung vascular resistance was lower than group 1(P<0.001). The hemodynamic changes in group 1 returned to control range two weeks later. In the group 2, two dogs were expired as a result of atelectasis and pulmonary hypertension. Among allying 8 dogs, five months after operation, follow up studies performed in two dogs, which showed normal pulmonary hemodynamics similar to preoperative data. The altered blood gas values and decreased oxygen uptake are more remarkable in denervated lung, which may due to pulmonary hypertension and partly retained more secretion in bronchial trees than usual. Important factors of raising pulmonary vascular resistance and pulmonary artery pressure are considered as the increased blood flow to remaining left lung and dysfunction of pulmonary vascular bed to accept the increased blood flow after denervation. Loss of nerve innervation had a influence, to some extent, to the decrease of oxygen uptake and the increase of pulmonary vascular resistance and pulmonary artery pressure. There can be little question that denervation does impair the pulmonary hemodynamics, however, intact pulmonary nerve innervation is not absolutely essential for survival of the animal.

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Atherogenic Risk Stratification According to Changes in the Geometrical Shape of the Coronary Artery (관상동맥의 기하학적 형상변화에 따른 동맥경화 위험도)

  • Suh, Sang-Ho;Park, Jun-Gil;Roh, Hyung-Woon;Lee, Byung-Kwon;Kwon, Hyuck-Moon
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.34 no.10
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    • pp.893-899
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    • 2010
  • A previous study showed that hemodynamics is correlated with stenosis in the coronary artery. The flow characteristics and the distributions of the hemodynamic wall parameters in the coronary artery are investigated under physiological flow condition. The present study also aims to establish the mechanism of the generation of atherosclerosis by analyzing the hemodynamic variables in the coronary artery where atherosclerosis frequently occurs. The stenosis phenomena due to atherosclerosis are related to not only the biochemical reaction between blood and blood vessels but also the hemodynamic factors sush as flow separation and oscillatory wall shear stress. As the bifurcated angle increases, the size of the recirculation area that appears in the cross section increases and disturbed flow is observed in this area. We speculate that this area is the starting point of atherosclerosis in the coronary artery.

Patient-Specific Computational Fluid Dynamics in Ruptured Posterior Communicating Aneurysms Using Measured Non-Newtonian Viscosity : A Preliminary Study

  • Lee, Ui Yun;Jung, Jinmu;Kwak, Hyo Sung;Lee, Dong Hwan;Chung, Gyung Ho;Park, Jung Soo;Koh, Eun Jeong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.183-192
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    • 2019
  • Objective : The objective of this study was to analyze patient-specific blood flow in ruptured aneurysms using obtained non-Newtonian viscosity and to observe associated hemodynamic features and morphological effects. Methods : Five patients with acute subarachnoid hemorrhage caused by ruptured posterior communicating artery aneurysms were included in the study. Patients' blood samples were measured immediately after enrollment. Computational fluid dynamics (CFD) was conducted to evaluate viscosity distributions and wall shear stress (WSS) distributions using a patient-specific geometric model and shear-thinning viscosity properties. Results : Substantial viscosity change was found at the dome of the aneurysms studied when applying non-Newtonian blood viscosity measured at peak-systole and end-diastole. The maximal WSS of the non-Newtonian model on an aneurysm at peak-systole was approximately 16% lower compared to Newtonian fluid, and most of the hemodynamic features of Newtonian flow at the aneurysms were higher, except for minimal WSS value. However, the differences between the Newtonian and non-Newtonian flow were not statistically significant. Rupture point of an aneurysm showed low WSS regardless of Newtonian or non-Newtonian CFD analyses. Conclusion : By using measured non-Newtonian viscosity and geometry on patient-specific CFD analysis, morphologic differences in hemodynamic features, such as changes in whole blood viscosity and WSS, were observed. Therefore, measured non-Newtonian viscosity might be possibly useful to obtain patient-specific hemodynamic and morphologic result.

EFFEECTS OF NON-NEWTONIAN FLUID MODEL ON HEMODYNAMICS IN CEREBRAL SACCULAR ANEURYSMS (낭상 뇌동맥류 혈류유동에서 비뉴우토니안 유체 모델의 영향)

  • Park, J.S.;Lee, S.W.
    • Journal of computational fluids engineering
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    • v.16 no.2
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    • pp.81-87
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    • 2011
  • The importance of shear thinning non-Newtonian blood rheology on the hemodynamic characteristics of idealized cerebral saccular aneurysms were investigated by carrying out CFD simulations assuming two different non-Newtonian rheology models (Carreau and Ballyk models). To explore effects of vessel curvature, a straight and a curved vessel geometry were considered. The wall shear stress(WSS), relative residence time(RRT) and velocity distribution were compared at the different phases of cardiac cycle. As expected, blood entered the aneurysm at the distal neck and created large vortex in both aneurysms, but with higher momentum on the curved vessel. Hemodynamic characteristics such as WSS, and RRT exhibited only minor effects by choice of different rheological models although Ballyk model produced relatively higher effects. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the hemodynamic characteristics, in particular, WSS-based parameters, considering the current accuracy level of medical image of cerebral aneurysm.