• 제목/요약/키워드: hemodynamic changes

검색결과 216건 처리시간 0.038초

우측 성상 신경절 차단이 기관내 삽관에 따른 심혈관계 반응에 미치는 영향 (The Effect of Right Stellate Ganglion Block on Hemodynamics following Endotracheal Intubation)

  • 오수원;구길회
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.58-63
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    • 1997
  • Background : Endotracheal intubation is one of the methods most securely establishing airway. But accompanying hemodynamic responses are harmful to coronary or cerebral vascular disease patients. These hemodynamic responses are regarded as the results of sympathetic stimulation due to pharyngolaryngeal stimulation, and sympathetic blocking method-stellate ganglion block- may be obtundate these hemodynamic responses. Methods : 75 patients of ASA physical status I-II were selected. There were 40 patients normotensive (Group I), 35 patients hypertensive (Group II) Group I, steliate ganglion block was performed on 20 patients (Group I-S) the remainder had no procedure (Group I-O). Group II, 18 patients received SG3 (Group II-S), 17 patients had no procedure (Group II-O). SGB was performed with 1% lidocaine 8 ml on right stellate genglion after patient's consent. Blood pressure (IIP) and pulse rate(PR) were first measured in the pre-anesthesia room. Follow up BP and PR are checked immediately following SGB and every 5 minutes for subsequent 20 minutes, then after arrival at operatig room, then immediately after intubation and at 3, 5, 10, 15 and 20 minutes after incubation. Results : All group experienced significantly increased blood pressure and pulse rate upon arrival at the pre-anesthesetic and opeating rooms, as compared to when patients rates in the ward. After intubation and for subsequent 5 minutes, significant changes were measured. Patients then recovered to preblock value. In Group I, no statistical significance was recorded between subgroup I-S and I-O. However in Group II, there were significant differences between sub-group II-S and II-O. In evaluating pulse rate changes, there were no significant differences between Group I-S and I-O; nor II-S and II-O. Conclusion : The proper diagnosis of Stellate Ganglion Block had some measure of protective effect on hemodynamics following endotracheal intubation, especially in hypertensive patients.

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Monitoring Differences in Vaginal Hemodynamic and Temperature Response for Sexual Arousal by Different Anesthetic Agents Using an O ptical Probe

  • Jeong, Hyeryun;Seong, Myeongsu;Park, Kwangsung;Kim, Jae Gwan
    • Current Optics and Photonics
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    • 제4권1호
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    • pp.57-62
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    • 2020
  • The selection of anesthetic agent is important in preclinical studies, since each agent affects the systemic hemodynamics in different ways. For that reason, we hypothesized that different anesthetic agents will result in different vaginal hemodynamic response and temperature during sexual arousal, in an animal model. To validate the hypothesis, animal experiments were performed using female rats with two anesthetic agents widely used in preclinical studies: ketamine and isoflurane. Our previously developed near-infrared-spectroscopy-based probe was used to measure the changes of oxyhemoglobin (OHb), deoxyhemoglobin (RHb), and total hemoglobin (THb) concentrations along with temperature from the animal vaginal wall. As a control, saline was administered to both isoflurane- and ketamine-anesthetized animals, and did not show any significant changes in OHb, RHb, THb, or temperature. However, an administration of apomorphine (APO, 80 ㎍/kg) induced increases of OHb (63 ± 28 μM/DPF), RHb (35 ± 20 μM/DPF), and THb (98 ± 49 μM/DPF) in ketamine-anesthetized animals, while decreases of OHb (52 ± 76 μM/DPF) and THb (38 ± 30 μM/DPF) and an increase of RHb (28 ± 51 μM/DPF) were found in isoflurane-anesthetized animals. The vaginal temperature decreased from the baseline in both ketamine-(0.42℃) and isoflurane-(1.22℃)anesthetized animals. These results confirmed our hypothesis, and suggest that a preclinical study monitoring hemodynamic responses under anesthesia should employ an appropriate anesthetic agent for the study.

The Usefulness of the Ivy Sign on Fluid-Attenuated Intensity Recovery Images in Improved Brain Hemodynamic Changes after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis in Adult Patients with Moyamoya Disease

  • Lee, Jung Keun;Yoon, Byul Hee;Chung, Seung Young;Park, Moon Sun;Kim, Seong Min;Lee, Do Sung
    • Journal of Korean Neurosurgical Society
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    • 제54권4호
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    • pp.302-308
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    • 2013
  • Objective : MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. Methods : We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. Results : Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. Conclusion : After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.

3차원 맥영상 검사로 살펴본 천왕보심단이 심혈관계에 미치는 영향 (Hemodynamic effects of Chunwangbosim-dan - A 3-dimensional radial pulse tonometry device study)

  • 강희정;권영상;구태훈;김경철
    • 대한융합한의학회지
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    • 제6권1호
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    • pp.5-20
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    • 2024
  • Objectives: This study was aimed to evaluate the hemodynamic feasibility using pulse parameters as a way to establish safe dose guidelines for Chunwangbosim-dan, and to provide a foundation for developing evidence-based guidelines for clinical use. Methods: Forty-one volunteers were recruited to participate in a study examining the changes in pulse wave characteristics following the ingestion of Chunwangbosim-dan, over a period of 2 weeks, and pulse wave measurements were taken before and after the administration. Pulse wave parameters were measured in this study using a 3-dimensional radial pulse tonometry device(DMP-Lifeplus). In addition, questionnaire, blood pressure, temperature, and body composition were also measured as secondary measures. Results: Fifteen minutes after administration of Chunwangbosim-dan, the non-adverse event group(non-AE) exhibited a statistically significant increase in several power and pressure-related parameters, including h1, h3, h4, h5, SA, PA and PW, while the adverse event group(AE) showed a trend of decreasing stroke volume and increasing Systemic Vascular Resistance Index(SVRI) and applied pressure. After 2 weeks of administration, non-adverse event group(non-AE) exhibited significant changes in standard deviation of pulse rate and HRV_LH ratio. Notably, there are significant differences between AE group and non-AE group in h4/h1, w/t, applied pressure, SV and pulse rate. Conclusion: These findings suggest that pulse parameters may be a useful way to establish safe dosing guidelines for Chunwangbosim-dan. Further research is needed to confirm these results and to develop evidence-based guidelines for clinical use.

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

  • 심은보;정찬일;최한고
    • 대한의용생체공학회:의공학회지
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    • 제22권5호
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    • pp.393-402
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    • 2001
  • 전체 심혈관계의 혈류역학적 특성을 분석할 수 있는 수치해석 방법을 개발하였다. 이는 12개의 요소들로 구성된 lumped parameter모델에 기초하고 있으며 인체의 신경계에 의한 자율조절기능을 모사하기 위해 주로 혈압의 단기적 조절을 위한.baroreflex system뿐 아니라 cardiopulmonary reflex 메커니즘가지도 구현하여 모델에 포함시켰다. 또한 교감 및 부교감 신경에 의한 자극-반응 전달을 구현함에 있어 생리학적 데이터에 기초한 방법을 사용하였다. 본 연구의 수치해석 코드를 검증하기 위하여 우선 보통 상태의 심혈관계에 대하여 혈류역학적 계산 결과를 기존의 참고문헌들에서의 값들과 비교 검토하였다. 심혈관계 모델의 혈류역학적 자극에 대한 반응 결과를 조사하기 위하여. 20% 출혈이 발생하는 경우와 LBNP(Lower Body Negative Pressure) 모사를 수행하였다. 두 경우 모두. 비교적 실험치와 잘 일cl하고 있음을 확인할 수 있었다. 특히 LBNP 수행 시, 외부압력의 크기가 커질수록 baroreflex만을 포함하고 있는 방법은 baroreflex와 cardiopulmonary reflex 모두를 포함하고 있는 방법에 비하여 다소 부정확한 결과를 보여주고 있는데. 이는 cardiopulmonary reflex 메커니즘의 중요성을 보여주고 있다.

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

  • 서상호;박준길;노형운;이병권;권혁문
    • 대한기계학회논문집B
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    • 제34권10호
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    • pp.893-899
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    • 2010
  • 박동유동조건에서 관상동맥 내의 유동특성과 혈류역학적 인자 분포를 선행연구에서 수행하여 혈류역학이 관상동맥 내의 협착현상과 연관관계가 있음을 밝혔다. 동맥경화증의 호발부위인 관상동맥 분지부에서 혈류역학적 변수를 분석하여 동맥경화증의 발생기전을 규명하는 것이 본 연구의 목적이다. 동맥경화증에 의한 협착현상은 혈액과 혈관벽 사이의 생화학 반응뿐 아니라 유동박리나 벽전단응력과 같은 혈류역학적 인자와도 관계 있음을 확인하였다. 관상동맥 분지부의 분지각이 증가할수록 분지부 단면에서의 재순환영역의 크기가 증가하고 교란유동이 발생하게 된다. 이 재순환영역이 관상동맥에서 동맥경화의 시작점으로 의심되는 영역이라 할 수 있다.

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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    • 제62권2호
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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.

폐고혈압을 동반한 심실중격결손증의 술후 혈류역학 변화 (Postoperative Hemodynamic Changes of VSD with Pulmonary Hypertension)

  • 문승호;민용일;오봉석
    • Journal of Chest Surgery
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    • 제26권2호
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    • pp.122-128
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    • 1993
  • This series compromised 31 patients with pulmonary hypertension of 282 patients of ventricular septal defect(VSD) who underwent operation at the department of Thoracic and Cardiovascular Surgery in Chonnam University Hospital, from January, 1986 to December, 1991. Pulmonary hypertension was noted in 59 of 280 cases of VSD. Of them, 31 cases underwent cardiac catheterization on postoperative 8th to 77th month. Age at operation was ranged from 10 months to 29 years (mean 9.13 years). 17 patients were male and 14 patients were female. Results of follow-up studies were as follows: Cardiothoracic ratio was decreased from 0.59${\pm}$0.04 to 0.54${\pm}$0.03 (p=NS). Postoperative systolic pulmonary arterial pressure (PAPs), mean pulmonary arterial pressure (PAPm), and systolic right ventricular pressure (RVPs) were decreased significantly (p<0.001). And also Rp/Rs was decreased from 0.37${\pm}$0.21 to 0.14${\pm}$0.06 (p<0.02). However, systemic arterial pressure (SAP), right atrial pressure (RAP), and pulmonary capillary wedge pressure (PCWP) were changed insignificantly. There were significant relations of follow-up period with the decrement of PAP(p<0.005). In contrary, ther were no relations between the decrement of PAP and the age at operation. These data suggested that the long-term hemodynamic changes remained to be determined in some of the patients, even though they Were asymptomatic, with pulmonary hypertension.

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동맥관개존증의 술후 심전도변화에 관한 임상적 연구 (A Clinical Study on Postoperative Changes of Electrocardiographic Findings in Patients with PDA)

  • 이신영;김근호
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.43-49
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    • 1986
  • At the Department of Thoracic and Cardiovascular Surgery, Hanyang university, from 1976 to 1984, 102 patients operated for isolated patent ductus arteriosus were studied. The correlation between the degree of left ventricular hypertrophy [LVH] and hemodynamic data, and postoperative changes of electrocardiographic findings were evaluated. The following results were obtained; [1] Of 102 patients with isolated patent ductus arteriosus, 78 patients [76.5%] were found to have LVH by EKG, preoperatively. [2] The patients with LVH had higher incidence of respiratory infection [79.4%] compared to patients without LVH. [3] Frequent physical findings in the patients with LVH were precordial bulging and P2 accentuation on auscultation. The typical continuous machinery murmur was not different in two group with or without LVH. [4] 66.1% of patients with LVH showed more than 56% of cardiothoracic ratio [CTR] on simple chest X-ray. 56.5% of patients without LVH showed less than 50% of CTR. [5] In the patients found to have LVH by EKG, the correlation between values of Svl+Rv6 and Qp/Qs in hemodynamic data was correlation coefficient 0.57 and between CTR and Qp/Qs was correlation coefficient 0.51. [6] In patent ductus arteriosus with LVH following surgery, the values of Svl+Rv6 was changed from preoperative 153.6$\pm$42.78% to 107.7$\pm$19.58% within 3 months and to 80.4$\pm$12.22%, which is within normal range of Svl+Rv6 on EKC, after 6 months.

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