• Journal of Chest Surgery
• /
• v.17 no.3
• /
• pp.418-423
• /
• 1984

Appreciation of the large volume deficits which may occur in surgical or trauma patients due to blood loss has led to vigorous transfusion techniques designed to overt hypovolemic shock and ischemic damage to vital organs which may develop in minutes during the hypovolemic state. In a significant proportion of patients treated with massive rapid blood or fluid transfusion, hypervolemia occurs and life threatening pulmonary edema may develop. Especially, hypervolemia may occur during transfusion for preventing development of the so-called low output syndrome following cardiac surgery. However, the most effective indicator which reveals the adequate level of transfusion is not settled yet. The present study was aimed to compare the effectiveness of the indicators suggested thus far and to determine the most sensitive one. Eight dogs were experimentally studied in terms of left atrial pressure, pulmonary arterial systolic pressure, central venous pressure, mean systemic arterial pressure and heart rate before and after induced hypervolemia with infusion of 600ml heparinized homologous blood. Immediately after induced overtransfusion of the blood, pulmonary arterial systolic pressure increased 75.0%, in omparison with the control before transfusion, left atrial pressure 58.8%, central venous pressure 44.6%, and mean systemic arterial pressure 10.1%, one hour after transfusion, pulmonary arterial systolic pressure 40.0%, left atrial pressure 21.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, central venous pressure 14.5%, and mean systemic arterial pressure 3.2%, respectively. Heart rate showed no significant change throughout the experiment. These result suggested that the changes of the pulmonary arterial systolic pressure is the most sensitive indicator for detection of hypervolemia during blood transfusion.

• The Journal of Internal Korean Medicine
• /
• v.38 no.2
• /
• pp.110-117
• /
• 2017

Objective: This study was undertaken to examine the effect of Cortex Phellodendri on prostatic urethral pressure and mean arterial blood pressure of rabbits. Methods: To measure prostatic urethral pressure and mean arterial blood pressure, a Mikro-Tip catheter transducer was inserted and positioned in the prostatic urethra and left carotid artery. After a stabilizing period, phenylephrine ($1{\mu}/kg$) was intravenously administered two or three times to increase the urethral pressure and mean arterial blood pressure. Cortex Phellodendri (2.5 mg/kg and 5 mg/kg doses of Cortex Phellodendri extracted from 80% Ethanol) was administered intravenously, followed by phenylephrine, with no time interval between the doses. The urethral pressure and mean arterial blood pressure were then measured to determine whether they had stabilized. Results and Conclusion: Cortex Phellodendri appeared to inhibit phenylephrine-induced increases in prostatic urethral pressure and mean arterial blood pressure.

• The Korean Journal of Physiology
• /
• v.21 no.1
• /
• pp.13-22
• /
• 1987

Effects of synthetic atrial natriuretic peptide and furosemide on the cardiovascular and renal functions were examined in the freshwater turtle, Amyda japonica. Both atria and ventricle of turtle contained an immunoreactive atrial natriuretic peptide. Synthetic rat atrial natriuretic peptide (atriopeptin III) and turtle atrial extract caused a decrease in mean arterial blood pressure and the vasodepressor effect was dose-dependent. In hydrated turtles received either atriopeptin III or turtle atrial extract, no significant change in renal function was observed until 100 min except a slight natriuresis at 60 or 100 min after injection of 30 ug/kg atriopeptin III or atrial extract, respectively. However, furosemide, 2 mg/kg, caused marked diuresis, natriuresis and kaliuresis. In non-hydrated turtles, no significant change in renal function was observed until 6 hrs following injection of 30 ug/kg atriopeptin III. Plasma aldosterone decreased at 2 hr and increased at 24 hr after injection of atriopeptin III although plasma renin concentration did not change. But, furosemide caused persistent diuresis, natriuresis and kaliuresis. Additionally, plasma aldosterone and renin concentrations were significantly increased at 24 hrs after injection of furosemide. In conclusion, we suggest that the freshwater turtle may have an atrial natriuretic peptide in heart and vascular receptors for atrial natriuretic peptide, and that atrial natriuretic peptide is more important in the regulation of blood pressure rather than that of renal function in freshwater turtles. We also suggest that an increased plasma renin concentration caused by furosemide may not be due to the sodium concentration delivered to macula densa, but due to the dehydration caused by persistent diuresis and natriuresis.

• The Korean Journal of Physiology and Pharmacology
• /
• v.21 no.6
• /
• pp.667-674
• /
• 2017

Angiotensin II (Ang II) is metabolized from N-terminal by aminopeptidases and from C-terminal by Ang converting enzyme (ACE) to generate several truncated angiotensin peptides (Angs). The truncated Angs have different biological effects but it remains unknown whether Ang-(4-8) is an active peptide. The present study was to investigate the effects of Ang-(4-8) on hemodynamics and atrial natriuretic peptide (ANP) secretion using isolated beating rat atria. Atrial stretch caused increases in atrial contractility by 60% and in ANP secretion by 70%. Ang-(4-8) (0.01, 0.1, and $1{\mu}M$) suppressed high stretch-induced ANP secretion in a dose-dependent manner. Ang-(4-8) ($0.1{\mu}M$)-induced suppression of ANP secretion was attenuated by the pretreatment with an antagonist of Ang type 1 receptor ($AT_1R$) but not by an antagonist of $AT_2R$ or $AT_4R$. Ang-(4-8)-induced suppression of ANP secretion was attenuated by the pretreatment with inhibitor of phospholipase (PLC), inositol triphosphate ($IP_3$) receptor, or nonspecific protein kinase C (PKC). The potency of Ang-(4-8) to inhibit ANP secretion was similar to Ang II. However, Ang-(4-8) $10{\mu}M$ caused an increased mean arterial pressure which was similar to that by 1 nM Ang II. Therefore, we suggest that Ang-(4-8) suppresses high stretch-induced ANP secretion through the $AT_1R$ and $PLC/IP_3/PKC$ pathway. Ang-(4-8) is a biologically active peptide which functions as an inhibition mechanism of ANP secretion and an increment of blood pressure.

• Journal of Chest Surgery
• /
• v.22 no.2
• /
• pp.179-190
• /
• 1989

The experimental study for extracorporeal preservation of the heart-lung preparation by autoperfusion system was performed in 10 dogs. Under intravenous Pentothal endotracheal anesthesia bilateral thoracotomies were performed. A 24F cannula connected to a plastic reservoir bag located 100 cm above the level of the heart was introduced into the aortic arch. Left subclavian, innominate artery, and descending aorta were ligated and divided. Both vena cavae were ligated and divided after the bag was half filled with blood. A 24F catheter inserted into right atrium and connected to the plastic bag in order to keep constant the preload. The thoracic trachea was intubated and the lungs were ventilated. The heart-lung preparations were removed en bloc and floated in a $34^{\circ}C$ bath of Hartmann solution. The preparations were observed for from 2 hours to 8 hours, with the average of 5.2 hours. Hemodynamic and hematologic variables were measured during preharvest and autoperfusion. The pH revealed severe respiratory alkalosis due to very low $PaCO_2$ during autoperfusion ; $PaO_2$ remained constant for 130-140 mmHg; $A-aDO_2$ increased markedly. The static inspiratory pressure [SIP] at late autoperfusion [6hr] increased significantly as compared with at early autoperfusion [2hr]. There was no difference between white blood cell counts from right atrium and those of left atrium. Heart rates remained constant for 110-120/min; cardiac outputs maintained to approximately 0.6L/min; mean aortic pressures, 75 mmHg; mean pulmonary arterial pressures, 15-18 mmHg; mean right atrial pressures, 9-13 mmHg; mean left atrial pressures, 12 mmHg lower than those of right atrium. Serum Na maintained with normal range during autoperfusion; K increased significantly; Ca decreased progressively. Hemoglobin and hematocrit decreased significantly during autoperfusion. The study demonstrated that stable hemodynamics could be maintained throughout the experiment and the preparation of the lung seemed to be inadequate, especially after 3-4 hours, such as high $A-aDO_2$, increased SIP, and scattered atelectasis and edema in their gross appearances.

• Journal of Korean Neurosurgical Society
• /
• v.64 no.6
• /
• pp.957-965
• /
• 2021

Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.

• Journal of Chest Surgery
• /
• v.22 no.4
• /
• pp.601-608
• /
• 1989

We sought the relationship between the pulmonary artery development and cardiac performance from the analysis of the 36 cyanotic congenital heart disease patients [mainly TOF] who were operated and indwelled the pulmonary artery and left atrial pressure monitoring catheters for the postoperative care at the department of Thoracic and Cardiovascular Surgery SNUH in 1988. They were pre-evaluated of the pulmonary artery index from the cineangiographic films and post-operatively, calculated the cardiac index from the arterial and mixed venous blood gas and also measured the mean left atrial pressure and total inotropic supporting amount after operation. The post-operative cardiac indices were 3.46 * 1.03 1/min/M2 [immediate postoperative], 3.31 [ 1.08 [postoperative 6 hrs], 3.29 [ 1.01 [12 hrs], 3.54 * 1.02 [24 hrs], 3.92 * 1.14 [48 hrs], respectively. We divided the patients the group A and group B from the size of the pulmonary artery index, that is, group A was below 200 mm2/M2 and group B above 200 mm2/M2 of the pulmonary artery index. The cardiac indices and left atrial pressure between the group A and B were not different in the view of the statistical significance but the total post-operative inotropic amount of group A was more than group B and it was significant statistically. We concluded that the smaller the pulmonary artery index is, the more postoperative supportive treatment [for example, inotropics] for the enhancement of cardiac performance is needed, and indirectly, which means that the pulmonary artery index was correlated with the postoperative cardiac performance in cyanotic congenital heart disease.

• Journal of Chest Surgery
• /
• v.21 no.2
• /
• pp.246-253
• /
• 1988

An in vitro model providing with a recirculating perfusion apparatus using an isolated canine heart and its autogenous blood, which was prepared for study of myocardial protection method. This apparatus was easily used by quick connect system and maintained well heart function for about 2 hours. The Langendorff perfusion was initiated for a 10 minute period by introducing perfusate at 37` into the aorta from aortic reservoir located 100 cm above the heart. The isolated perfused working canine heart model was a left heart preparation in which oxygenated perfusion medium [at 37K] entered the cannulated left atrium at a constant flow rate [900ml/ min] under 20 mmHg overflow system and was spontaneously ejected[no electrical pacing] via an cannula against a hydrostatic pressure of 80 cm H2O. During this working period, various indices of cardiac function were measured. The cardiac functions were stable for over 2 hours with perfusion of Krebs-Henseleit solution and autologous blood[1:1] mixture in volume and maintained heart rate ]]3-122/bpm peak systolic pressure 109-113 mmHg, cardiac output 900 ml / min and left atrial mean pressure 8-9 mmHg. In this model, the efficiency of myocardia] protection could be easily measured by means of functional, enzymatic, biochemical and ultrastructural assessment. And also, we believe this model to be a useful assessment screening model of recovery state after long duration of myocardial preservation of donor heart without difficult transplantation procedures.

• Journal of Veterinary Science
• /
• v.22 no.5
• /
• pp.60.1-60.9
• /
• 2021

Background: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. Objectives: To establish the normal echocardiographic parameters for Maltese dogs. Methods: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. Results: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. Conclusion: This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

• Journal of Chest Surgery
• /
• v.28 no.12
• /
• pp.1096-1106
• /
• 1995

We experienced 7 cases of left single lung transplantation in 14 mongrel dogs and analyzed graft lung function by hemodynamics, blood gas analysis, chest X-ray, biopsy and perfusion lung scan. We performed right pulmonary artery cuff[PA cuff for analysis of graft lung function in 3 cases. The donor lungs were flushed with modified Euro-Collins solution[n=3 or low potassium dextran glucose solution[n=4 and preserved for 4 to 5 hours[n=4 or 24 hours[n=3 at 10o C and implanted to the dogs with similar weight . Assessment of left graft lung was done by occluding the right pulmonary artery for 10 minutes using PA cuff. Assessment for graft lung function was done immediately after an operation and after 3 days, 7days and 3 weeks postoperatively. Four dogs survived for 3days, 7days[2 cases and 3 weeks respectively. Other three dogs expired within 3 hours of reperfusion. Immediate perfusion scans of left lung in four survived dogs after reperfusion were 42.1%, 36% , 11% and 5.9% respectively, and another dog with 4.8% perfusion to left lung was dead due to left atrial thrombi after 3 hours reperfusion. In one case among three acute rejections follow-up perfusion scan was done on 3rd and 11th postoperative day and the result decreased from 36% perfusion immediate postoperatively to 21% and 15% respectively. Three expired dogs postoperatively couldn`t tolerate occlusion of right pulmonary artery with above 40 mmHg of mean pulmonary artery pressure. On the other hand, three survival dogs postoperatively tolerated occlusion of right pulmonay artery with less than 30 mmHg of mean pulmonary artery pressure. and one dog couldn`t tolerate same procedure immediate postopertively but in 2 hours reperfusion later tolerated with 29 mmHg of mean pulmonary artery pressure.In conclusion we couldn`t compare the effect of two flushing solutions but low potassium dextran glucose solution showed relatively safe preservation effect in cases with preservation of more than 20 hours. Also canine left single lung transplantation model with PA cuff indicated useful method for the assessment of graft lung function with effect of lung preservation.