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Numerous studies have evaluated the effects of hemodynamic parameters on aneurysm formation. However, the reasons why aneurysms do not initiate in intracranial arteries are still unclear. This study aimed to investigate the influence of hemodynamic parameters, wall shear stress (WSS) and strain, on aneurysm formation by comparing between aneurysmal and non-aneurysmal arteries. Fifty-eight patients with paraclinoid aneurysms on one side were enrolled. Based on magnetic resonance angiography, each patient's left and right internal carotid arteries (ICAs) were reconstructed. For a patient having an aneurysm on one side, the ICA with the paraclinoid aneurysm was defined as the aneurysmal artery after eliminating the aneurysm, whereas the opposite ICA without aneurysm was defined as the non-aneurysmal artery. Computational fluid dynamics and fluid-structure interaction analyses were then performed for both aneurysmal and non-aneurysmal arteries. Finally, the relationship between high hemodynamic parameters and aneurysm location was investigated. For aneurysmal arteries, high WSS and strain locations were well-matched with the aneurysm formation site. Also, considerable correlations between high WSS and strain locations were observed. However, there was no significant relationship between high hemodynamic parameters and aneurysm formation for non-aneurysmal arteries. The findings are helpful for understanding aneurysm formation mechanism and encouraging further relevant research., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aims: The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position., Methods: This study was a non-randomized and non-controlled, quasi-experimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min., Results: It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (p < .05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles., Conclusions: It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°., (© 2024 Japan Academy of Nursing Science.)

Objective: To determine the effect of aromatherapy with thyme oil on disease symptoms, vital signs, and hemodynamic parameters in COVID-19 patients., Methods: We conducted the randomized controlled trial with 140 (experimental group=70, control group=70) COVID-19 patients. Patients admitted to the COVID-19 service of the Batman Training and Research Hospital were included in the sample between 31.01 - 31.08 2022. Patients in the experimental group inhaled thyme oil 3 times a day during 5 days. At the end of day 5, symptoms and hemodynamic parameters were measured as posttest. Vital signs were measured 3 times a day during 5 days. The control group only received routine treatment., Results: Thyme oil was found to be effective in relieving symptoms of shortness of breath, dizziness, secretion, diarrhea, weakness, loss of appetite, cough, headache and muscle joint pain. Although there was improvement in the symptoms of nausea-vomiting, runny nose and loss of taste-smell, the effect was not statistically significant. Thyme oil significantly decreased body temperature, pulse rate and respiratory rate (p<0.05), increased SPO 2 (p<0.05), and did not affect systolic and diastolic blood pressure (p>0.05). It had a significant effect on the regulation of pH, decreased CO 2 and increased O 2 significantly (p<0.05)., Conclusion: Thyme oil aromatherapy was effective in reducing symptoms, regulating vital signs and hemodynamic parameters. Accordingly, thyme oil is recommended as non-pharmacological treatment method in COVID-19 patients., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Evaluating fluid responsiveness with dynamic parameters is recommended for fluid management. However, in hemodynamically stable patients who are breathing spontaneously, accurately measuring stroke volume variation via echocardiography and passive leg raising is challenging due to subtle SV changes. This study aimed to identify normal SV changes in healthy volunteers and evaluate the precision of hemodynamic parameters in screening mild hypovolemia in patients. This prospective, repeated-measures, cross-sectional study screened 269 subjects via echocardiography. Initially, 45 healthy volunteers underwent a fluid challenge test, the outcomes of which served as criteria to screen 215 ICU patients. Among these patients, 53 underwent additional fluid challenge testing. Hemodynamic parameters, including medians of maximum velocity time integrals (VTImaxs), peak velocity of VTImax (PV), internal jugular vein diameters (IJVD), and area (IJVA) were repeatedly measured first at a 60° upper body elevation (UBE), second in a supine position, third at UBE, fourth in a supine position, and lastly in a supine position after fluid loading. The hemodynamic responses to the position changes were compared between 83 fluid non-responders and 15 fluid responders. Fluid responsiveness was defined as fluid-induced medians' change of VTImaxs (fluid-induced median VTImax change) ≥ 10%. None of the healthy volunteers showed the mean value of repeatedly measured medians of VTImaxs ≥ 7%, following either UBE position (UBE-induced median VTImax change) or fluid loading (fluid-induced median VTImax change). UBE-induced median VTImax and PV changes were significantly correlated with fluid responsiveness (p < 0.001, AUC 0.959; p < 0.001, AUC 0.804). The significant correlations were demonstrated via multivariable analysis using binary logistic regression (p = 0.001, OR 90.1) and the correlation coefficient (R 2  = 0.793) using linear regression analysis. UBE-induced median VTImax changes (≥ 11.8% and 7.98%) predicted fluid-induced median VTImax changes ≥ 10% and 7% (AUC 0.959 and 0.939). The collapsibility and variation of IJVD and IJVA showed no significant correlation. An increase in the mean value of medians of repeatedly measured VTImaxs transitioning from an UBE to a supine position, effectively screened mild hypovolemia and demonstrated a significant correlation with fluid responsiveness in spontaneously breathing patients maintaining hemodynamic stability., (© 2024. The Author(s).)

Purpose: To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models., Methods: Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential (ECAP) and displacement force (DF) for all three configurations., Results: The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain., Conclusions: The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model.

Purpose: To investigate the effect of sub-satisfactory stenting recanalization of severe vascular stenosis of the posterior circulation on cerebral hemodynamic perfusion., Materials and Methods: Patients with severe vascular stenosis of the posterior circulation who had undergone three-dimensional cerebral angiography before and after stenting were retrospectively enrolled. Computational fluid dynamic (CFD) analysis of hemodynamic parameters at the stenosis, perforating branch, and normal arterial segments proximal and distal to the stenosis were performed., Results: Sixty-two patients with basilar artery stenosis aged 60.9 ± 9.6 years were enrolled, and stent angioplasty resulted in the reduction of stenosis degree from 85.3 ± 7.2% before to 18.6 ± 6.4% after stenting. After stenting, at the proximal normal artery, the total pressures had significantly (P < 0.05) decreased, whereas all the other parameters (WSS, cell Reynolds number, velocity, vorticity, turbulence intensity, turbulence kinetic energy and dissipation rate) had significantly (P < 0.05) increased. At the stenosis, all hemodynamic parameters had significantly decreased. At the stenosis perforating branch, the WSS, cell Reynolds number, velocity, and vorticity were all significantly decreased, and the total pressure, turbulence intensity, kinetic energy, and dissipation rate were all significantly increased. At the distal normal artery, the total flow pressure (perfusion pressure) and velocity were both significantly (P < 0.05) increased, and the total pressure, WSS, cell Reynolds number, vorticity, turbulence intensity, kinetic energy, and dissipation rate were all significantly (P < 0.05) decreased. The hemodynamic parameters after stenting were closer to those after virtual stenosis repair at all measurements., Conclusion: Sub-satisfactory recanalization has significantly restored the stenosis and improved the hemodynamic parameters near the stenosis and at the root of the perforating branch, thus significantly improving the cerebral perfusion, similar to the changes of hemodynamic status and cerebral perfusion after virtual removal of the vascular stenosis. This may indicate the good effect of sub-satisfactory stenting recanalization of the vascular stenosis at the posterior circulation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Phthalic selenoanhydride (R-Se) solved in physiological buffer releases various reactive selenium species including H 2 Se. It is a potential compound for Se supplementation which exerts several biological effects, but its effect on the cardiovascular system is still unknown. Therefore, herein we aimed to study how R-Se affects rat hemodynamic parameters and vasoactive properties in isolated arteries. The right jugular vein of anesthetized Wistar male rats was cannulated for IV administration of R-Se. The arterial pulse waveform (APW) was detected by cannulation of the left carotid artery, enabling the evaluation of 35 parameters. R-Se (1-2 µmol kg -1 ), but not phthalic anhydride or phthalic thioanhydride, transiently modulated most of the APW parameters including a decrease in systolic and diastolic blood pressure, heart rate, dP/dt max relative level, or anacrotic/dicrotic notches, whereas systolic area, dP/dt min delay, dP/dt d delay, anacrotic notch relative level or its delay increased. R-Se (~10-100 µmol L -1 ) significantly decreased the tension of precontracted mesenteric, femoral, and renal arteries, whereas it showed a moderate vasorelaxation effect on thoracic aorta isolated from normotensive Wistar rats. The results imply that R-Se acts on vascular smooth muscle cells, which might underlie the effects of R-Se on the rat hemodynamic parameters.

Background and Objectives: Stent implantation procedure should be carefully planned and adapted to the particular patient in order to minimize possible complications. Numerical simulations can provide useful quantitative data about the state of the artery after the implantation, as well as information about the benefits of the intervention from the hemodynamical point of view., Methods: In this paper, a numerical model for stent implantation is presented. This numerical model simulates the stent expansion, the interaction of the stent with arterial wall and the deformation of the arterial wall under the influence of the stent. FE method was used to perform CFD simulations and the effects of stenting were analyzed by comparing the hemodynamic parameters before and after stent implantation., Results: Clinical data for overall 34 patients was used for the simulations, and for 9 of them data from follow up examinations was used to validate the results of simulations of stent implantation., Conclusions: The good agreement of results (less than 4.1% of SD error for all the 9 validation cases) demonstrated the accuracy of the presented numerical model. The developed approach can be a valuable tool for the improvement of pre-operative planning and patient-specific treatment optimization., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be interpreted as a potential conflict of interest., (Copyright © 2021. Published by Elsevier B.V.)

Sweating during exercise is regulated by objective parameters, body weight, and endothelial function, among other factors. However, the relationship between vascular arterial stiffness and sweat volume in young adults remains unclear. This study aimed to identify hemodynamic parameters before exercise that can predict sweat volume during exercise, and post-exercise parameters that can be predicted by the sweat volume. Eighty-nine young healthy subjects (aged 21.9 ± 1.7 years, 51 males) were recruited to each perform a 3-km run on a treadmill. Demographic and anthropometric data were collected and hemodynamic data were obtained, including heart rate, blood pressure and pulse wave analysis using non-invasive tonometry. Sweat volume was defined as pre-exercise body weight minus post-exercise body weight. Post-exercise hemodynamic parameters were also collected. Sweat volume was significantly associated with gender, body surface area (BSA) (b = 0.288, p = 0.010), peripheral systolic blood pressure (SBP), peripheral and central pulse pressure (PP), and was inversely associated with augmentation index at an HR of 75 beats/min (AIx@HR75) (b = -0.005, p = 0.019) and ejection duration. While BSA appeared to predict central PP (B = 19.271, p ≤ 0.001), central PP plus AIx@HR75 further predicted sweat volume (B = 0.008, p = 0.025; B = -0.009, p = 0.003 respectively). Sweat volume was associated with peripheral SBP change (B = -17.560, p = 0.031). Sweat volume during a 3-km run appears to be influenced by hemodynamic parameters, including vascular arterial stiffness and central pulse pressure. Results of the present study suggest that vascular arterial stiffness likely regulates sweat volume during exercise., (© Journal of Sports Science and Medicine.)

This work is based on the hypothesis that it is possible to characterize the cardiovascular system just from the detailed shape of the arterial pulse waveform (APW). Since H 2 S, NO donor S-nitrosoglutathione (GSNO) and their H 2 S/GSNO products (SSNO - -mix) have numerous biological actions, we aimed to compare their effects on APW and to find characteristic "patterns" of their actions. The right jugular vein of anesthetized rats was cannulated for i.v. administration of the compounds. The left carotid artery was cannulated to detect APW. From APW, 35 hemodynamic parameters (HPs) were evaluated. H 2 S transiently influenced all 35 HPs and from their cross-relationships to systolic blood pressure "patterns" and direct/indirect signaling pathways of the H 2 S effect were proposed. The observed "patterns" were mostly different from the published ones for GSNO. Effect of SSNO - -mix (≤32 nmol kg -1 ) on blood pressure in the presence or absence of a nitric oxide synthase inhibitor (L-NAME) was minor in comparison to GSNO, suggesting that the formation of SSNO - -mix in blood diminished the hemodynamic effect of NO. The observed time-dependent changes of 35 HPs, their cross-relationships and non-hysteresis/hysteresis profiles may serve as "patterns" for the conditions of a transient decrease/increase of blood pressure caused by H 2 S.

Objectives: The impedance cardiography (ICG) technique measures the variation of impedance in the thorax due to the physical contractile activity of the heart. Twin pregnancy is characterized by greater maternal hemodynamic changes than a singleton pregnancy., Methods: In a study on 121 pregnant women in the last trimester we performed ICG, evaluating the following hemodynamic parameters: stroke volume, heart rate, cardiac output, ventricular ejection time, left ventricular ejection time, thoracic impedance, and systemic vascular resistance., Results: The study included singleton and twin pregnancies. Heart rate values in women with single fetus was lower than in those carrying twins (85 vs. 100 beats/min, p=0.021) as were the stroke volume values (64 vs. 83 mL, p=0.010) and the cardiac output (p<0.0001). Systemic vascular resistance decreased in twin pregnancies compared to singleton pregnancy (p=0.023)., Conclusions: ICG studies are rare, and the validation of their results is an ongoing process. However, the ICG technique is applicable in the third trimester of pregnancy and can yield important information regarding the hemodynamic profile of singleton and twin pregnancies, revealing maternal heart changes specific to twin pregnancies., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Many risk factors are associated with rupture of intracranial aneurysm. However, the prognostic effects hemodynamic factors on intracranial aneurysm rupture remains poorly understood. A meta-analysis was performed based on contemporary studies to evaluate the prognostic effect of hemodynamic parameters on rupture of intracranial aneurysm., Methods: The Cochrane Library, PubMed, Embase, and Web of Science were searched for cohort studies that analyzed hemodynamic parameters for intracranial aneurysm rupture prior to May 1, 2020. The standardized mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated to assess the effect of individual hemodynamic parameters on intracranial aneurysm rupture. The primary outcomes were difference in wall shear stress (WSS), oscillatory shear index (OSI) and low shear index (LSA) between ruptured and unruptured intracranial aneurysm. Two reviewers independently assessed the quality of the trials and the associated data. All statistical analyses were performed using standard statistical procedures in Review Manager 5.2., Results: A total of 15 studies including 779 patients with 900 aneurysms were identified for this meta-analysis. The pooled results indicated that the average WSS, OSI and LSA% had significant associations with rupture of intracranial aneurysm, with pooled SMDs of -0.36 (95% CI -0.57 to -0.15; P = 0.001), 0.37 (95% CI 0.19 to 0.55; P < 0.0001) and 0.57% (95% CI 0.18 to 0.95; P = 0.004), respectively. In addition, other hemodynamic parameters, including aneurysm size, aspect ratio, mean volume, undulation index, ellipticity index, nonsphericity index, number of vorticies, and relative residence time significant associations with intracranial aneurysm rupture. Multivariate analysis indicated that circumferential wall tension, angle btwn, irregular shape and size of aneurysms were independent risk factors of intracranial aneurysm rupture., Conclusions: This meta-analysis identified WSS, OSI and LSA% as influential hemodynamic parameters on rupture of intracranial aneurysm. The roles of other hemodynamic parameters and risk factors for intracranial aneurysm rupture need further assessments in future., (Copyright © 2021 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Measuring and monitoring hemodynamic parameters has brought many benefits in supporting diagnosis and treatment for cardiovascular patients. There are many advantages to measuring hemodynamic parameters by non-invasive technique based on impedance cardiography (ICG) such as simplicity, real-time and low cost. However, the electrode positions of this method are very difficult to implement in cases where the patient has to use multiple medical devices at the same time, especially for patients on active treatment and resuscitation. This paper presents the results of the study proposing new three locations of ICG electrodes to overcome the above limitation. Accordingly, we measured and evaluated 10 volunteers on the Niccomo device. The results show that all three positions of proposed electrode can be used to replace standard electrode position. In particular, the 1st proposed position, can be used to measure all five hemodynamic parameters HR, SV, LVET, Z o , CO and ICG waveforms, expressed by the average correlation and the relative average difference of five parameters, R 2 ¯ = 0.9641 and Mean ¯ = 3.31%. The 2nd proposed position can be used to measure four parameters HR, SV, LVET, CO and ICG waveforms shown by R 2 ¯ = 0.9091 and Mean ¯ = 8.67%. The 3rd proposed position can be used to measure three parameters HR, Z o and LVET, expressed by R 2 ¯ = 0.8485 and Mean ¯ = 9.26%.

Objectives: Functional gastrointestinal (GI) symptoms, such as IBS (irritable bowel syndrome), have been suggested to be associated with autonomic neuropathy. We therefore examined associations between hemodynamic indices of autonomic control, functional GI symptoms and stress in a population-based cohort. Methods and materials: The study included 2094 participants of the Malmö Offspring Study (mean age 40.6 ± 13.8 years, 53.9% women). 509 (24.3%) reported having GI symptoms the last 2 weeks, without having organic GI disease, and 347 subjects (16.6%) reported IBS. Office and ambulatory 24-h systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured. Associations between hemodynamic parameters and abdominal pain, diarrhea, constipation, bloating and flatulence, vomiting and nausea and psychological well-being according to the visual analog scale for IBS (VAS-IBS), and stress, were performed by Spearman's correlation test and linear regression models. Results: Subjects who reported GI symptoms had lower office supine and standing DBP and lower 24 h SBP and DBP compared with those without GI symptoms. Regarding specific symptoms, diarrhea was correlated with 24-h measurements of SBP (rs = 0.197), DBP (rs = 0.173) and heart rate (rs = 0.134). Subjects with the most severe diarrhea had higher 24-h SBP (125.2 vs. 119.0 mmHg; p  = .038), DBP (74.0 vs. 69.0 mmHg; p  = .033) and heart rate (74.5 vs 71.1 beats/minute; p  = .048), after adjustments for confounders, compared to the other. There were no associations between other GI symptoms, IBS, stress and hemodynamic alterations. Conclusion: Functional diarrhea was associated with hemodynamic indices of sympathetic activation, supporting a possible role of the autonomic nervous system in diarrhea.

Aim: Myocardial dysfunction and low cardiac index are common after out-of-hospital cardiac arrest (OHCA) as part of the post-cardiac arrest syndrome. This study investigates the association of cardiac index during targeted temperature management (TTM) with mortality., Methods: In the TTM-trial, which randomly allocated patients to TTM of 33 °C or 36 °C for 24 h, we prospectively and consecutively monitored 151 patients with protocolized measurements from pulmonary artery catheters (PAC) as a single site substudy. Cardiac index, heart rate and stroke volume were measured at 3 time-points during the 24 h TTM period and averaged. Uni- and multivariate Cox regression was used to assess association with mortality., Results: Of 151 patients, 50 (33%) were deceased after 180 days. Cardiac index during TTM was not significantly associated with mortality in univariate (HR: 0.84 [0.54-1.31], p = 0.59) or multivariate analyses (HR adjusted : 1.03 [0.57-1.83], p = 0.93). Cardiac index during TTM was also not significantly associated with non-neurological death (HR adjusted : 1.25 [0.43-3.59], p = 0.68). Higher heart rate (p = 0.03) and lower stroke volume (p = 0.04) were associated with increased mortality in univariate, but not multivariate analyses. No hemodynamic variables were associated with cerebral death, however, increasing lactate during TTM (HR adjusted : 2.15 [1.19-3.85], p = 0.01) and lower mean arterial pressure during TTM (HR adjusted : 0.89 [0.81-0.97], p = 0.008) were independently associated with non-neurological death., Conclusion: Cardiac index during TTM after resuscitation from OHCA is not associated with mortality. Future studies should investigate whether certain subgroups of patients could benefit from targeting higher goals for cardiac index., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Exercise capacity is a well-defined marker of outcome in congenital heart disease. We analyzed seventeen cardiovascular magnetic resonance (CMR) derived parameters and their correlation to exercise capacity in patients with Ebstein's anomaly (EA)., Methods: Fifty-four surgery free patients, age 5 to 69 years (median 30 years) prospectively underwent CMR examination and cardiopulmonary exercise testing (CPET). The following volume/flow parameters were compared with peak oxygen uptake as the percentage of normal (peakVO 2 %) using univariate and multivariate analysis: right and left ventricular ejection fraction (RVEF and LVEF), the indexed end-diastolic and end-systolic volumes (RVEDVi, RVESVi, LVEDVi, and LVESVi), the indexed stroke volumes (RVSVi and LVSVi), the total normalized right and left heart volumes; the total right to left heart volume ratio (R/L-ratio). The indexed antegrade flow (ante), indexed net flow (net) as well as cardiac index (CI) in the aorta (Ao) and pulmonary artery (PA) were used., Results: RVEF (R 2 0.2788), indexed flow PA net (R 2 0.2330), and PA ante (R 2 0.1912) showed the best correlation with peakVO 2 % (all p < 0.001) in the univariate model. Further significant correlation could also be demonstrated with CI-PA, LVEF, LVSVi, Aorta net, RVESVi, and Aorta ante. Multivariate analysis for RVEF and indexed net flow PA revealed a R 2 of 0.4350., Conclusion: Functional CMR parameters as RVEF and LVEF and flow data of cardiac forward flow correlate to peakVO 2 %. Evaluation of the indexed net flow in the pulmonary artery and the overall function of the right ventricle best predicts the maximal exercise capacity in patients with EA.

The chapter describes protocols and pitfalls in in vivo studies of drug effects on anesthetized rats. It focuses on the preparation of Na 2 S, Na 2 S 4 , and "SSNO - mix" solutions for rat intravenous administration, surgical preparation of jugular vein for drug administration, and preparation of carotid and tail arteries for recording of arterial pulse waveform (APW) at high resolution. It describes evaluation of ten hemodynamic parameters from APW and measurement of apparent pulse wave velocity.

The physiological processes that occur during the aging of insects are poorly understood. The aim of this study was to describe the changes in contractile activity and hemodynamic parameters of the heart that take place as the coleopteran beetle, Tenebrio molitor, ages. The frequency of heart contractions in beetles that had just undergone metamorphosis (median 24.7 beats/min) was significantly lower than the frequency of heart contractions in older beetles. In 56% of beetles that were < 1 week of age, a pattern of contractile activity with alternating periods of higher and lower contraction frequency was detected, suggesting that some posteclosion developmental processes occur during the first week of adulthood. All beetles that were 1 week of age showed a regular rhythm of heart contractions (median 72 beats/min). In older beetles, abnormalities such as heart arrhythmias or heart arrest were observed. The incidence of arrhythmia as well as the arrhythmicity index was highest in beetles that were 8-18 weeks old. The calculated stroke volume (SV) was also found to increase from eclosion to 12 weeks of age, and then decreased as adults aged further. Interestingly, cardiac output increased gradually, but the ejection fraction did not change significantly with age., (© 2018 Wiley Periodicals, Inc.)

Objectives: Arterial stiffness has emerged as a surrogate marker of cardiovascular disease. We investigated the role of myocardial performance and hemodynamic parameters in arterial stiffness in patients with rheumatoid arthritis (RA), which is accompanied by excess cardiovascular risk., Design: Arterial stiffness was evaluated with pulse wave velocity (PWV) in RA patients and controls. Cardiac and hemodynamic characterization was based on impedance cardiography. Cardiovascular risk factors, inflammatory markers and disease-related parameters were assessed., Results: PWV (8.2 ± 2.1 vs 7.4 ± 1.4 m/s, p = .016) was higher among RA patients (n = 104) compared to controls (n = 52). In the RA group, PWV correlated with markers of cardiac contractibility (acceleration and velocity index), myocardial blood flow (cardiac output and stroke volume), preload (thoracic fluid content) and afterload (systemic vascular resistance) (p < .05 for all). PWV tended to increase with decreasing oxygen delivery to the myocardium (r = 0.055), as well as with shortening of the ejection duration of the left ventricle (p = .058). However, these associations no longer remained significant after adjustment for classical cardiovascular risk factors, inflammation and corticosteroid use, which were independently associated with PWV., Conclusions: Among patients with RA, arterial stiffness appears as the composite of cardiovascular risk factors and inflammation, while corticosteroid use emerges as an additional adverse factor.

Background: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery and is associated with poorer prognosis. This study attempted to evaluate whether hemodynamic parameters determined by a right heart catheter predict the occurrence of POAF., Hypothesis: We hypothesized that atrial fibrillation after cardiac surgery can be predicted by hemodynamic parameters determined by a right heart catheter., Methods: Between October 2015 and January 2017, 126 patients with preoperative sinus rhythm undergoing coronary artery bypass grafting and/or aortic valve replacement were enrolled in this study. Complete echocardiographic examination was performed preoperatively, and hemodynamic parameters were recorded via a right heart catheter before anesthesia induction. Postoperative telemetry strips and electrocardiogram were used to detect atrial fibrillation until discharge. Multivariate logistic regression was used to identify risk factors of POAF., Results: The overall incidence of POAF was 40/126 (31.7%). Multivariate logistic regression analysis determined that left atrial dimension (LAD) (adjusted odds ratio [OR]: 1.118, 95% confidence interval [CI]: 1.020-1.227, P = 0.018), pulmonary capillary wedge pressure (PCWP) (adjusted OR: 1.225, 95% CI: 1.082-1.387, P = 0.001), and pulmonary artery systolic pressure (PASP) (adjusted OR: 1.076, 95% CI: 1.019-1.137, P = 0.008) were significant predictors of POAF., Conclusions: The present study suggested that LAD, PCWP, and PASP were robust predictors of POAF. These parameters may indicate a patient's susceptibility toward developing POAF and help to identify patients who need preventive treatment., (© 2017 Wiley Periodicals, Inc.)

I conducted a prospective repeated-measure study in the general surgery intensive care unit to investigate the associations among acute postoperative pain, analgesic therapy, and hemodynamic parameters. I selected 33 patients and recorded 84 episodes of pain. I measured intensity of pain and hemodynamic parameters after patients were transferred from the postanesthesia care unit to the general surgery intensive care unit, immediately before analgesic therapy and at 15, 30, and 45 minutes after analgesic therapy. Acute pain increased systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP); pulse rate (PR); and arterial oxygen saturation. Fifteen minutes after analgesic therapy, SBP and PR decreased, and DBP, MAP, and oxygen saturation increased. Thirty minutes after therapy, SBP, MAP, and PR decreased, and DBP and oxygen saturation increased. Forty-five minutes after therapy, SBP, MAP, and PR decreased, and DBP and oxygen saturation increased. I saw no significant hemodynamic parameter changes during postoperative episodes of pain., (Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.)

Background: The sympathetic nervous system has an important role in generating pain. Various pathomechanisms are involved that respond well to the application of local anesthetics (LA), for example to the stellate ganglion block (SGB)., Objectives: We wanted to know more about the effects of SGB on cardiovascular parameters., Methods: We included 15 healthy volunteers; another 15 healthy volunteers as a control group (sham injection of LA). In order to produce a more precise SGB, we employed only a small volume of LA (3mL), a LA with a lower permeability (procaine 1%), and a modified injection technique. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and echocardiographic parameters were recorded before and after SGB. We also investigated whether there are side differences (left and right SBG)., Results: At baseline all parameters were within the normal range. After performing right and left SGB DBP significantly increased (on the right side from 68.73±8.61 to 73.53±11.10, p=0.015; on the left side from 70.66±13.01 to 77.93±10.40, p=0.003). In the control group no increase in DBP was observed. No side-specific differences were found, except a significant reduction in the maximum velocity of myocardial contraction during the systole with left-sided SGB., Conclusions: Even with our methods we could not prevent the simultaneous occurrence of a partial parasympatholytic effect. For this reason, the SGB has only minor hemodynamic effects, which is desirable as it enhances the safety of the SGB., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Impedance cardiography (ICG) is an inexpensive, noninvasive technique for estimating hemodynamic parameters. ICG can be used to obtain the ejection fraction of the left atrium and to monitor systolic time intervals. Traditional ICG technique does not enable unambiguous detection of the left ventricle ejection time (LVET) and the time relationships between specific marker points., Objective: This work aims to approbate a new approach for ICG signal processing using wavelet transform (WT) and to investigate the possibilities of this approach for determination of the parameters which are related to the stroke volume (SV), in particular LVET., Methods: Thoracic tetrapolar polyrheocardiography method for simultaneous registration of ECG, ICG and phonocardiograms has been used. A control group consisted of eight healthy men aged 20-25 years. In addition, four patients with essential hypertension participated in the study. Wavelet representation of the ICG data produced local maxima in a two dimensional distribution of the wavelet coefficient. Each extremum point was characterized by the amplitude, scale and time, which determine SV., Results: LVET was defined as the scale corresponding to the E-wave maximum related to the systolic phase of the cardiac cycle. Also, we defined the initial systolic time interval (ISTI) as the time interval between R peak in the ECG and E-wave maximum on the wavelet plane. During functional test LVET and ISTI values defined by WT demonstrated a proper hemodynamic response to loading for the control group and patients with essential hypertension., Conclusion: The proposed approach demonstrates the ability of ICG-WT technique for adequate assessment of SV parameters, including cardiac time intervals.

The purpose of this study is to investigate the hemodynamic parameters of blood flow in a balloon as a part of a new type of cardiac assist device named AVICENA, which is implanted into the descending aorta to improve the strength of pumping blood flow in a poor-performing left ventricle. Balloon is inflated and deflated during diastole and systole, respectively. The longitudinal velocity of blood flow during balloon inflation and deflation has been considered. Through these investigations, the result reveals that the balloon inflation causes the blood flow to accelerate through the balloon and compensates the blood flow velocity required for the normal circulation system. When the balloon deflates, a reverse flow is generated and improves the perfusion of coronary arteries. Furthermore, the inlet pressure and acting force on the aortic valve for the healthy, unhealthy, and assisted heart have been compared. Result indicates that the force acting on the aortic valve has been considerably reduced for the assisted heart compare to the unhealthy or unassisted heart., (© IMechE 2014.)

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

Aim: To evaluate how preoperative anxiety affects hemodynamic parameters in patients who were undergoing surgery and to evaluate for the rise in blood pressure and heart rate in patients with higher preoperative anxiety. Methodology: 60 patients were observed for the hemodynamic changes due to anxiety in preoperative period, before induction and after induction. The anxiety scores were analysed and tabulated. Result: Preoperative anxiety has a significant impact on heart rate, systolic blood pressure, diastolic blood pressure and SpO2 of the study participants. Conclusion: During pre-operative period there is no impact of anxiety on hemodynamic parameters. But before induction there was significant impact of anxiety on heart rate, systolic blood pressure, diastolic blood pressure and SpO2. [ABSTRACT FROM AUTHOR]

Computational fluid dynamics (CFD) has been utilized to calculate hemodynamic parameters in anterior communicating artery aneurysm (AComA), which is located at a junction between left and right A1 and A2 segments. However, complete or half circle of Willis (CoW) models are used indiscriminately. This study aims to suggest recommendations for determining suitable CoW model. Five patient-specific CoW models with AComA were used, and each model was divided into complete, left-half, and right-half models. After validating the CFD using a flow experiment, the hemodynamic parameters and flow patterns in five AComAs were compared. In four out of five cases, inflow from one A1 side had a dominant influence on the AComA, while both left and right A1 sides affected the AComA in the remaining case. Also, the average difference in time-averaged wall shear stress between the complete and half models for four cases was 4.6%, but it was 62% in the other case. The differences in the vascular resistances of left and right A1 and A2 segments greatly influenced the flow patterns in the AComA. These results may help to enhance clinicians' understanding of blood flow in the brain, leading to improvements in diagnosis and treatment of cerebral aneurysms. [ABSTRACT FROM AUTHOR]

Background: To compare efficacy between oral lignocaine viscous 2% and oral lignocaine spray 10% in attenuating the hemodynamic response for laryngoscopy & endotracheal intubation prior to general anaesthesia. Materials and Methods: This study was carried out in 60 patients belonging to ASA I& II, aged between 20 to50 years undergoing elective surgeries. The study will be conducted for a period of 1year in Department of Anaesthesia in Kurnool Medical College, Kurnool. Patients who had hypersensitivity to study drug, patients with severe renal, hepatic, respiratory, cardiac disease, neurological, psychiatric disorders, Difficult Airway-Cormack & Lehane grade 3 and 4 were excluded from the study. Divided in to two groups. Group V receives 10ml of 2% or a lignocaine viscous gargle for 5 minutes prior to induction. Group S receives five puffs of oral lignocaine spray 10% prior to induction. The values for HR, SBP, DBP, and MAP, SPO2 were obtained baseline, after induction, immediately after intubation and 1,3,5 and10 minutes after intubation and compared among the groups. Results: In the current study, after induction the mean HEART RATE starts increasing in group S and in group V mean heart rates tart decreasing after induction and slightly raised after immediately after intubation and gradually decreasing till 10 min after intubation. In group S immediately after intubation highest mean heart rate was observed, and start decreasing at 1 minute, 3 minute, 5minute and 10 minute after intubation but not reached baseline level, the mean heart rate between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). In group S mean SBP start increasing immediately after intubation and gradually start decreasing from 1 minute after intubation to 10 minutes after intubation. The mean SBP between two groups from 1 minute after induction to 10 minutes after intubation was significant. (p<0.05). In group V mean DBP start decreasing immediately after intubation and slightly increased immediately after intubation and gradually decreasing till 10 min after intubation. The mean DBP between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). The mean MAP starts increasing in group S till immediately after intubation and gradually start decreasing from 1 minute after intubation to 10 minutes after intubation but reached baseline level at 3minutes.However, in group V mean MAP start decreasing immediately after intubation and slightly increased immediately after intubation and gradually decreasing till 10 min after intubation. The mean MAP between two groups from after induction to 10 minutes after intubation was significant. (p<0.05). After induction the mean SPO2 starts increasing in both groups and reached to 100% in both groups. Conclusion: The study concluded that oral lignocaine viscous 2% was more effective in blunting the haemodynamic response to laryngoscopy and endotracheal intubation than lignocaine spray 10% No significant adverse events occurred during the study. [ABSTRACT FROM AUTHOR]

Wearable technologies face challenges due to signal instability, hindering their usage. Thus, it is crucial to comprehend the connection between dynamic patterns in photoplethysmography (PPG) signals and cardiovascular health. In our study, we collected 401 multimodal recordings from two public databases, evaluating hemodynamic conditions like blood pressure (BP), cardiac output (CO), vascular compliance (C), and peripheral resistance (R). Using irregular-resampling auto-spectral analysis (IRASA), we quantified chaotic components in PPG signals and employed different methods to measure the fractal dimension (FD) and entropy. Our findings revealed that in surgery patients, the power of chaotic components increased with vascular stiffness. As the intensity of CO fluctuations increased, there was a notable strengthening in the correlation between most complexity measures of PPG and these parameters. Interestingly, some conventional morphological features displayed a significant decrease in correlation, indicating a shift from a static to dynamic scenario. Healthy subjects exhibited a higher percentage of chaotic components, and the correlation between complexity measures and hemodynamics in this group tended to be more pronounced. Causal analysis showed that hemodynamic fluctuations are main influencers for FD changes, with observed feedback in most cases. In conclusion, understanding chaotic patterns in PPG signals is vital for assessing cardiovascular health, especially in individuals with unstable hemodynamics or during ambulatory testing. These insights can help overcome the challenges faced by wearable technologies and enhance their usage in real-world scenarios. [ABSTRACT FROM AUTHOR]

Background: Laryngoscopy and endotracheal intubation are stressful for patients, as these procedures can produce tachycardia, hypertension, and arrhythmias. Aim of work: The aim of the current study was to compare the effect of magnesium sulphate and two doses of dexmedetomidine on hemodynamic response to laryngoscopy and tracheal intubation. Patients and methods: This comparative prospective randomized controlled (single-blind) clinical study was carried out in Zagazig University hospitals on 80 patients during the period from May 2019 to February 2020. Patients were divided randomly into four groups each is 20 patients: Group Da: 20 Patients received dexmedetomidine 0.5mcg/kg in 20 ml normal saline intravenous infusion over 10 min. Group Db: 20 Patients received dexmedetomidine 1mcg/kg in 20 ml normal saline intravenous infusion. Group M: 20 Patients received magnesium sulphate 30mg/kg in 20 ml normal saline intravenous in fusion over 10 min. Group C: 20 Patients received 20 ml 0.9% in 20 ml normal saline intravenous infusion over 10 min. Results: The heart rate in Db group was statistically lower than other groups, Heart rate in the Da group were statistically significantly lower compared to group M and group C. Systolic blood pressure was statistically significantly lower in group Db compared to another group. Conclusions: Through this study, we can conclude that Dexmedetomidine 1mcg/kg is more effective than dexmedetomidine 0.5mcg/kg and magnesium sulphate 30mg/kg in decreasing the hemodynamic response to laryngoscopy and tracheal intubation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effect of cloth mask vs. N95 mask on cardiovascular and pulmonary parameters at rest and during physical activity in health-care providers. Materials and Methods: Hundred health-care providers (45 men and 55 women) were included in the study. The procedure comprised of pre-test and post-test outcome measures like hemodynamic parameters comprising of heart rate,[15] respiratory rate,[16] peak expiratory flow rate[7] and oxygen saturation[7] taken on first day with cloth mask and second day with an N95 mask consecutively. Outcome measures were measured during quite sitting and brisk walking on treadmill, which was a self-paced test. Subjects manually selected their comfortable speed while walking on the treadmill, when exhausted the test was terminated. Comparing values of the outcome measures we found the effect of N95 masks and cloth masks on hemodynamic parameters, oxygenation and peak expiratory flow rate during rest and physical activity. Results: This study resulted in favor of N95 masks (P < 0.05). The difference was significant, concluding a slight increase in the respiratory rate (P = 0.0009) and heart rate (P = 0.0001) while wearing a cloth mask in comparison with an N95 mask. Oxygen saturation and peak expiratory flow rate were significantly maintained during physical activity while wearing an N95 mask, compared to a cloth mask (P = 0.0001). Conclusion: N95 masks should be utilized by health-care providers as, they did not impair respiratory rate, heart rate, oxygenation, and peak expiratory flow rate at rest and during physical activity. In comparison with cloth masks, N95 masks were better in maintaining oxygen saturation and peak expiratory flow rate during physical activity. [ABSTRACT FROM AUTHOR]

Direct laryngoscopy and endotracheal intubation is a noxious stimuli and induce sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life-threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. The aim is to study the effects of intravenous labetalol and lignocaine on haemodynamic responses to laryngoscopy and endotracheal intubation. Materials and methods: It is a cross-sectional and randomized controlled study with two study groups was planned. 70 patients were randomly assigned to one of two groups: those receiving Labetalol 0.25 mg/kg (n=35) or those receiving lignocaine 1mg/kg (n=35). The parameters assessed are heart rate, systolic BP, diastolic BP and Mean arterial pressure. Baseline parameters were recorded at the time of induction, post-intubation immediately and 1, 3, 5, 10 minutes later. Results: In the current study, at the time of induction, the mean heart rate was 65.97±5.22 per min in group LB whereas the mean heart rate was 76.66±8.49 per min in group LG which was statistically significant (P value <0.001). There was significantly reduced systolic blood pressure at 1min after intubation, 3min after intubation, 5min after intubation, and 10min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Significantly reduced diastolic blood pressure at 1 min after intubation, 3 min after intubation, 5 min after intubation, and 10 min after intubation in patients of group LB when compared with patients of group LG (P value <0.05). Conclusions: It was concluded in the present study that intravenous labetalol of dosage 0.25 mg/kg before laryngoscopy and endotracheal intubation was efficient in attenuating the hemodynamic parameters. [ABSTRACT FROM AUTHOR]

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Background: The aim of this study is to present the first United Arab Emirates pulmonary hypertension registry of patients' clinical characteristics, hemodynamic parameters and treatment outcomes. Method: This is a retrospective study describing all the adult patients who underwent a right heart catheterization for evaluation of pulmonary hypertension (PH) between January 2015 and December 2021 in a tertiary referral center in Abu Dhabi, United Arab Emirates. Results: A total of 164 consecutive patients were diagnosed with PH during the five years of the study. Eighty-three patients (50.6%) were World Symposium PH Group 1-PH; nineteen patients (11.6%) were Group 2-PH due to left heart disease; twenty-three patients (14.0%) were Group 3-PH due to chronic lung disease; thirty-four patients (20.7%) were Group 4-PH due to chronic thromboembolic lung disease, and five patients (3.0%) were Group 5-PH. Among Group 1-PH, twenty-five (30%) had idiopathic, twenty-seven (33%) had connective tissue disease, twenty-six (31%) had congenital heart disease, and five patients (6%) had porto-pulmonary hypertension. The median follow-up was 55.6 months. Most of the patients were started on dual then sequentially escalated to triple combination therapy. The 1-, 3- and 5-year cumulative probabilities of survival for Group 1-PH were 86% (95% CI, 75–92%), 69% (95% CI, 54–80%) and 69% (95% CI, 54–80%). Conclusions: This is the first registry of Group 1-PH from a single tertiary referral center in the UAE. Our cohort was younger with a higher percentage of patients with congenital heart disease compared to cohorts from Western countries but similar to registries from other Asian countries. Mortality is comparable to other major registries. Adopting the new guideline recommendations and improving the availability and adherence to medications are likely to play a significant role in improving outcomes in the future. [ABSTRACT FROM AUTHOR]

Reducing maternal morbidity and mortality has been a challenge for low and middle-income countries, especially in the setting of hypertensive disorders of pregnancy. Improved strategies for treating obstetric patients with resistant hypertension are needed. We sought to explore whether hemodynamic parameters may be used to identify patients that develop resistant hypertension in pregnancy. Retrospective cohort study among pregnant patients with gestational hypertension or preeclampsia that experienced severe blood pressure elevations. Hemodynamic variables were evaluated, including cardiac output (CO), and total peripheral resistance (TPR). The primary endpoint was resistant hypertension. An exploratory logistic regression was performed to evaluate the association between the hemodynamic profile and the development of resistant hypertension. Adverse maternal and fetal outcomes were additionally described according to the presence of resistant hypertension. Fifty-seven patients with severe pregnancy hypertension were included, of whom 34 developed resistant hypertension (59.7%). The resistant hypertension group, in comparison to those without resistant hypertension, presented with a hypodynamic profile characterized by reduced CO < 5 L/min (41.2% vs. 8.7%, p: 0.007), and increased TPR > 1400 dyn-s/cm5 (64.7% vs. 39.1%, p: 0.057). Logistic regression analysis revealed an association between a hypodynamic profile and resistant hypertension (OR 3.252, 95% CI 1.079–9.804; p = 0.035). Newborns of the resistant hypertension group had more frequent low birth weight (<2500 g), low Apgar scores, ICU admissions, and acute respiratory distress syndrome. Patients experiencing hypertensive crisis during pregnancy and exhibiting a hypodynamic profile (TPR ≥1400 dyn·s/cm5 and CO ≤ 5 L/min) developed higher rates of resistant hypertension. [ABSTRACT FROM AUTHOR]

Background: Emergence from general anesthesia and tracheal extubation may be associated with tremendous physiological and metabolic stress in patients which could be major concern for the anesthesiologist in patients especially with neurosurgical patients. Aims and Objectives: The study was designed to find a novel method to achieving a smooth extubation in neurosurgery by compare the respiratory complications and hemodynamic stress response between conventional awake extubation of an endotracheal tube (ETT) and that following exchange extubation of ETT using a laryngeal mask airway (LMA) in craniotomy surgeries. Materials and Methods: A total of 60 patients of American Society of Anesthesiologists physical status I and II between ages 18 and 60 years undergoing neurosurgery were evaluated for respiratory events such as bucking, coughing, desaturation, and hemodynamic changes due to sympathetic stimulation such as tachycardia, hypertension, and any other complications that have occurred in any of the two extubation methods. Results: In Group A, 86.67% patients have shown significant events of bucking and coughing while desaturation events were comparable between two groups. Manipulation events, that is, chin lift and jaw thrust had to perform in 66.67% and 21.67%, respectively, in patients of Group A compared to only 03.33% patients in Group L. (P<0.05). In Group A, 97.33% patients shown tachycardia compared to 30% in Group L where only 30%. Similarly, mean arterial pressure after extubation found to be significantly high in 63.33% of the patients in Group A with 63.33% as compared to13.33% of patients in Group L (P<0.05). Conclusion: ETT/LMA exchange is the most effective technique for achieving the clinical endpoints of the study, that is, prevention of emergence hypertension and respiratory complications compared to awake extubation methods. The exchange of ETT with LMA in deeper plane of anesthesia significantly reduces emergence related the hemodynamic and respiratory unwonted events. [ABSTRACT FROM AUTHOR]

Purpose: Diabetic nephropathy (DN) is a serious microvascular complication in those with type 2 diabetes mellitus (T2DM). Evidence confirms that serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the T2DM stage are proposed as prognostic markers for DN development, but it is unclear how they affect renal podocyte-associated nephrin and WT-1 expression. In the presence of podocyte injury, glomerular vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS) and hemodynamic parameters are dysregulated. The current research aimed to clarify the relationship of TNF-α and IL-1β with podocyte injury by altering VEGF/eNOS expression and hemodynamic parameters. Methods: A high-fat diet/streptozotocin-induced DN rat model was established. Serum TNF-α and IL-1β levels were tracked in the pre-T2DM, T2DM and DN stages. In the DN stage, the mRNA and protein expression levels of renal TNF-α, IL-1β, VEGF, eNOS, nephrin and WT-1 were studied. Renal hemodynamic parameters, including peak systolic velocity, end-diastolic flow velocity and mean velocity were measured with a color Doppler ultrasound technique. Results: Compared to those in the normal control (CTL) group, serum TNF-α and IL-1β levels increased significantly in the pre-T2DM stage (obesity, insulin resistance and hyperlipidemia), T2DM stage (hyperglycemia) and DN stage (abnormal renal functions) (all: P < 0.05) in the DN group. Serum TNF-α and IL-1β levels in the T2DM stage were significantly higher than those in the pre-T2DM stage (two: P < 0.05). Compared to the CTL group, renal nephrin, WT-1, TNF-α, IL-1β, eNOS and VEGF expression and hemodynamic parameters in the DN stage all showed significant differences separately (all: P < 0.05). Conclusion: Increased serum and renal TNF-α and IL-1β levels played important roles in reducing renal nephrin and WT-1 expression levels, which may be related to the fact that the former affected renal VEGF/eNOS expression and blood flow parameters in the DN rats. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are one of the leading members of non-communicable diseases. An early diagnosis is essential for effective treatment, to reduce hospitalization time and health care costs. Nowadays, an exercise stress test on an ergometer is used to identify CVDs. To improve the accuracy of diagnostics, the hemodynamic status and parameters of a person can be investigated. For hemodynamic management, thoracic electrical bioimpedance has recently been used. This technique offers beat-to-beat stroke volume calculation but suffers from an artifact-sensitive signal that makes such measurements difficult during movement. We propose a new method based on a gated recurrent unit (GRU) neural network and the ECG signal to improve the measurement of bioimpedance signals, reduce artifacts and calculate hemodynamic parameters. We conducted a study with 23 subjects. The new approach is compared to ensemble averaging, scaled Fourier linear combiner, adaptive filter, and simple neural networks. The GRU neural network performs better with single artifact events than shallow neural networks (mean error −0.0244, mean square error 0.0181 for normalized stroke volume). The GRU network is superior to other algorithms using time-correlated data for the exercise stress test. [ABSTRACT FROM AUTHOR]

The article highlights a study aimed to assess the effects of inhalation aromatherapy with Rosa damascena on stress, anxiety, and hemodynamic parameters of patients undergoing coronary angiography. It discusses that Coronary arteries angiography is used commonly for diagnosing cardiovascular diseases and could lead to stress, anxiety and consequently hemodynamic changes in patients.

The task to develop a mechanism for predicting the hemodynamic parameters values based on non-invasive hydrocuff technology of a pulse wave signal fixation is described in this study. The advantages and disadvantages of existing methods of recording the ripple curve are noted in the published materials. This study proposes a new hydrocuff method for hemodynamic parameters and blood pressure values measuring. A block diagram of the device being developed is presented. Algorithms for processing the pulse wave contour are presented. A neural network applying necessity for the multiparametric feature space formation is substantiated. The pulse wave contours obtained using hydrocuff technology of oscillation formation for various age groups are presented. According to preliminary estimates, by the moment of the dicrotic surge formation, it is possible to judge the ratio of the heart and blood vessels work, which makes it possible to form an expanded feature space of significant parameters based on neural network classifiers. This study presents the characteristics accounted for creating a database for training a neural network. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the effects of deep and superficial endotracheal suctioning on hemodynamic parameters and pain level in mechanically ventilated neurosurgical patients. Patients and Methods: This prospective, randomized, controlled experimental study was conducted on 37 patients who underwent deep endotracheal suctioning and 37 patients who underwent superficial endotracheal suctioning using open endotracheal suctioning system. The arterial blood pressure, heart rate, body temperature, respiratory rate, oxygen saturation levels and pain status of the patient were compared before and after endotracheal suctioning at 1 min, 5 min and 30 min. Results: There was no statistically significant difference between the effects of deep and superficial endotracheal suctioning methods (p> 0.05). However, there was less change in systolic and diastolic arterial blood pressure and heart rates in patients who underwent superficial endotracheal suctioning before and 30 min after endotracheal suctioning (p> 0.05). Conclusion: Superficial endotracheal suctioning caused fewer changes in hemodynamic parameters and pain levels of patients compared to deep endotracheal suctioning. For this reason, nurses should first prefer the superficial endotracheal suctioning method during the suctioning practices of neurosurgery patients. [ABSTRACT FROM AUTHOR]

(1) Background: The purpose of this prospective study was to determine the changes in primary hemodynamic parameters and oxygen saturation in systemically healthy patients during the surgical procedure involving crown lengthening. (2) Methods: A total of 44 patients who required a crown-lengthening procedure in a single tooth in the maxillary arch were included in this study. Heart rate (HR), blood pressure (BP) and oxygen saturation (SpO2) were measured in all the subjects at three different intervals: before injecting the anesthetic (T1), after the anesthetic injection (T2) and after the procedure (T3). Descriptive statistics were computed, and observations were recorded as mean and standard deviation (SD). Analysis of variance (ANOVA) was used to compare the mean observation within parameters at different time intervals. (3) Results: All primary hemodynamic parameters were increased in the T2 phase over T1 and decreased in the T3 phase over T2. However, SpO2 decreased in both the T2 and T3 phases compared to the initial T1 phase. No significant differences were observed among the primary hemodynamic variables. However, SpO2 showed a significant difference (p = 0.013) among the T1, T2 and T3 phases. (4) Conclusions: Further study with larger sample size is required in order to analyze the accurate hemodynamic alterations. [ABSTRACT FROM AUTHOR]

Objective(s): Exposures to particulate matter (PM) have been related to increased risk for cardiovascular health effects and can promote cardiac ischemia and oxidative stress. Crocin has strong antioxidant properties and stress-reducing effects. Therefore, this study considered the effect of crocin on cardiovascular parameters in rats exposed to PM10. Materials and Methods: Forty Wistar rats (male, 250–300 g) were grouped as control, receiving normal saline and crocin, receiving PM10, receiving PM10+Crocin. Instillation of PM10 into the trachea was done. Forty-eight hours after exposure to the normal saline or PM, the heart was separated. Hemodynamic and electrophysiological factors were measured. The levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase activity (CAT), malondialdehyde (MDA), xanthine oxidase, were evaluated by kits. Results: The voltage of the QRS complex was significantly reduced and PR and QTc intervals increased in PM10 groups. Hemodynamic parameters before ischemia and in the ischemic-reperfusion stage, in the PM10 group, showed a significant decrease. In the ischemic hearts of the PM10 group, a significant decline in the activity of CAT, SOD, and GPx, and a significant increase in MDA and XOX enzymes activity were observed, and crocin improved all of these factors. Conclusion: Cardiac ischemia causes abnormal hemodynamic factors of the heart, which are exacerbated by PM10 and further reduce the heart’s contractile strength. Increased oxidative stress due to PM10 is probably one of the important reasons for these changes. This study suggests that the use of antioxidants such as crocin improves the cardiovascular adverse effects of myocardial ischemia and PM10 exposure. [ABSTRACT FROM AUTHOR]

Open chest surgery in rodents requires assisted breathing and the most common approach for ventilation is via an endotracheal tube. Even with well-trained operators the endotracheal intubation is technically challenging and may lead to prolonged procedures and endotracheal intubation complications. Nose cone ventilation is a simpler procedure compared to endotracheal intubation and has the potential to improve animal welfare by reducing procedure time and endotracheal intubation associated complications. Rats are obligate nose breathers, and therefore replacing intubation with air supply from a nose cone would be an advantage and a more natural way of breathing. Here, we compared the values for several blood gases, blood pressure and heart rate from rats that were nose cone ventilated with rats that underwent endotracheal intubation at 12 timepoints equally distributed across three surgical stages: baseline, open chest and closed chest. Throughout the monitoring period the hemodynamic and blood gas values for both methods of ventilation were within published, normal ranges for the rat and were biologically equivalent (equivalence test p value ≤ 0.05). Our data showed that nose cone ventilation-maintained blood gases and hemodynamic homeostasis equivalent to endotracheal intubation. Nose cone ventilation can be recommended as an alternative to endotracheal intubation in rat experiments where investigators require airway control. [ABSTRACT FROM AUTHOR]

Objective(s): Exposures to particulate matter (PM) have been related to increased risk for cardiovascular health effects and can promote cardiac ischemia and oxidative stress. Crocin has strong antioxidant properties and stress-reducing effects. Therefore, this study considered the effect of crocin on cardiovascular parameters in rats exposed to PM10. Materials and Methods: Forty Wistar rats (male, 250–300 g) were grouped as control, receiving normal saline and crocin, receiving PM10, receiving PM10+Crocin. Instillation of PM10 into the trachea was done. Forty-eight hours after exposure to the normal saline or PM, the heart was separated. Hemodynamic and electrophysiological factors were measured. The levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase activity (CAT), malondialdehyde (MDA), xanthine oxidase, were evaluated by kits. Results: The voltage of the QRS complex was significantly reduced and PR and QTc intervals increased in PM10 groups. Hemodynamic parameters before ischemia and in the ischemic-reperfusion stage, in the PM10 group, showed a significant decrease. In the ischemic hearts of the PM10 group, a significant decline in the activity of CAT, SOD, and GPx, and a significant increase in MDA and XOX enzymes activity were observed, and crocin improved all of these factors. Conclusion: Cardiac ischemia causes abnormal hemodynamic factors of the heart, which are exacerbated by PM10 and further reduce the heart’s contractile strength. Increased oxidative stress due to PM10 is probably one of the important reasons for these changes. This study suggests that the use of antioxidants such as crocin improves the cardiovascular adverse effects of myocardial ischemia and PM10 exposure. [ABSTRACT FROM AUTHOR]

Background: Refractory septic shock can cause severe morbidities and mortalities in children. Resuscitation based on hemodynamics is important in children with critical illness. Thus, this study aimed to identify the hemodynamics of refractory septic shock associated with poor prognosis at an early stage to allow for timely interventions. Methods: We evaluated children with refractory septic shock admitted to a pediatric intensive care unit (PICU) and monitored their hemodynamics using a pulse index continuous cardiac output (PiCCO) system. The serial cardiac index (CI), systemic vascular resistance index (SVRI), and vasoactive–inotropic score (VIS) were recorded during the first 72 h after PICU admission. Results: Thirty-three children with refractory septic shock were enrolled. The SVRI and VIS were both associated with fatality from septic shock. The non-survivors had lower serial SVRI and higher VIS (both p < 0.05). Based on the area under the ROC curve, the SVRI was the predictor during the early resuscitative stage (first 36 h) in pediatric refractory septic shock. Conclusions: Both SVRI and VIS are predictors of mortality in children with refractory septic shock, and the SVRI is the powerful predictor of mortality in the early resuscitative stage. A low serial SVRI may allow for the early awareness of disease severity and strategies for adjusting vasoactive–inotropic agents to increase the SVRI. [ABSTRACT FROM AUTHOR]

Background and Aims: General anesthesia induces endocrine, immunologic, and metabolic responses. Anesthetic drugs affect endocrine system by changing the level of stress hormones and hemodynamic of the patient. The purpose of this study was to compare the effects of propofol and isoflurane on hemodynamic parameters and stress-induced hormones in laparoscopic cholecystectomy (LC) surgery. Material and Methods: Seventy patients of elective LC were included in this study. Patients were randomly divided into two equal groups of 35 patients; group P received propofol (70–120 μg/kg/min) and group I received isoflurane (mac: 1.28%) as anesthesia maintenance. The following parameters were monitored, checked, and recorded from preanesthesia period to 10 min after PACU entry according to a planned method: hemodynamic parameters (heart rate and mean atrial pressure), level of blood sugar, and serum epinephrine level. Results: Heart rate and mean atrial pressure changes did not show significant differences between the two groups in all stage (P > 0.05), but isoflurane group tolerated lower fluctuating changes. Blood glucose and serum epinephrine level rise in the isoflurane group were significantly higher than the propofol group (P < 0.05). Conclusion: Maintenance anesthesia by inhalation gas base on isoflurane has not shown a significant difference with total intravenous anesthesia base on propofol on hemodynamic parameter. However, propofol has a consistent effect on decreasing stress hormone and suggested for LC surgery. [ABSTRACT FROM AUTHOR]

The present study was conducted in 12 clinical cases presented to Veterinary Clinical Complex, Veterinary College, KVAFSU, Bidar for the treatment of various surgical affections in cattle. The cattle were randomly divided into two groups consisting of six animals in each group. The group-I animals were administered guaifenesin at the dose rate of 50 mg/ kg body weight intravenously as 5% solution in normal saline along with ketamine at the dose rate of 3 mg/kg body weight intravenously as drip form and maintained with isoflurane (1-2%). The animals of group-II were administered with preanaesthetic dexmedetomidine hydrochloride (2.5 µg/kg, IV) after 5 minutes followed by guaifenesin at the dose rate of 50 mg/ kg body weight intravenously as 5 % solution in normal saline along with ketamine at the dose rate of 3 mg/kg body weight intravenously as drip form and maintained with isoflurane (1-2%). Hematobiochemical parameters like haemoglobin, packed cell volume, total erythrocyte count and total leukocyte count decreased significantly at a maximum depth of anaesthesia in both groups. Alanine transaminase, aspartate transaminase, serum creatinine, Serum urea nitrogen levels increased significantly at a maximum depth of anaesthesia in both groups. However, biochemical values were decreased towards normal at 120 minutes of post-induction. In the present study both the anaesthetic protocols provided a satisfactory surgical plane of anaesthesia in cattle. However, guaifenesin and ketamine drip with dexmedetomidine under isoflurane combination was ideal to perform major surgeries in cattle without any complications. [ABSTRACT FROM AUTHOR]

Background: Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. Aim of work: The aim of the current study was to compare the attenuation of the hemodynamic response to laryngeoscopy and tracheal intubation with magnesium sulfate versus two Doses of Dexmedetomidine. Patients and methods: This comparative prospective randomized controlled (single-blind) clinical study was carried out in Zagazig University hospitals on 80 patients during the period from May 2019 to February 2020. Patients were divided randomly into four groups each is 20 patients: Group Da: 20 Patients received dexmedetomidine 0.5mcg/kg. Group Db: 20 Patients were received dexmedetomidine 1mcg/kg in 20 ml normal saline intravenous infusion. Group M: 20 Patients were received magnesium sulfate 30mg/kg. Group C: 20 Patients were received 20ml 0.9% normal saline intravenous. Results: Heart rate in Db group were statistically significant lower than other groups, Heart rate in Da group were statistically significant lower compared to group M and group C. Systolic blood pressure were statistically significant lower in group Db compared to other group. Conclusion: Through this study, we can conclude that Dexmedetomidine 1mcg/kg is more effective than dexmedetomidine 0.5mcg/kg and magnesium sulfate 30mg/kg in decrease the hemodynamic response to laryngeoscopy and tracheal intubation. However, Dexmedetomidine 0.5 mcg/kg was better than 30 mg/kg magnesium sulphate in decrease HR while the magnesium sulfate 30 mg/kg was better than Dexmedetomidine 0.5mcg/kg in decrease the rise in SBP and DBP to tracheal intubation. [ABSTRACT FROM AUTHOR]

Introduction: Few data exist on the effects of increasing norepinephrine doses or increasing arterial CO2 (PaCO2) on hemodynamics and cerebral oxygenation in comatose out-of-hospital cardiac arrest (OHCA) patients.Methods: We prospectively studied 10 resuscitated OHCA-patients undergoing targeted temperature management (36C°). The trial consisted of 5 phases with 20 minutes steady state in-between: Phase 1-4 were increasing doses of norepinephrine to reach targets of mean arterial pressure (MAP). First 65, second 75, third 85, fourth 65 mmHg again. In the fifth phase, MAP was constant while PaCO2 was increased to 6.5-7.3 kPa to increase cardiac output. Primary outcome was cerebral near-infrared spectroscopy (NIRS). Secondary outcomes were hemodynamic variables from Swan-Ganz catheters and blood samples from the radial artery and jugular bulb.Results: To reach a MAP at 85 mmHg, norepinephrine was increased from 0.11±0.02 to 0.18±0.02 µg/kg/min (P < 0.001). Norepinephrine uptitration significantly increased systemic vascular resistance (SVR) and pulmonary vascular resistance, without affecting cardiac output, heart rate or cerebral oxygenation. Increasing PaCO2, resulted in a significant increase in cardiac output and cerebral NIRS, but arterial-venous cerebral oxygen-uptake decreased. Norepinephrine demand to keep MAP at 65 mmHg was unaffected by increasing PaCO2.Conclusions: A short-term increase in MAP with norepinephrine in resuscitated comatose cardiac arrest-patients is associated with increased SVR and pulmonary vascular resistance without affecting cardiac output or cerebral NIRS. Increased cardiac output caused by an increase in PaCO2 increased cerebral NIRS, but not cerebral oxygen uptake. [ABSTRACT FROM AUTHOR]