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1,920 results on '"Coronary perfusion pressure"'

102. Myocardial Adaptation to Acute Oxygen Shortage : A Kinetic Analysis

Author

Merati, Giampiero, Allibardi, Sonia, Marrazza, Giovanna, Mascini, Marco, Samaja, Michele, Nemoto, Edwin M., editor, LaManna, Joseph C., editor, Cooper, Christopher, editor, Delpy, David, editor, Groebe, Karlfried, editor, Hunt, Thomas K., editor, Keipert, Peter, editor, Mayevsky, Avrahim, editor, Pittman, Roland N., editor, Rumsey, William L., editor, Vaupel, Peter, editor, and Wilson, David F., editor

Published
1997
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121. Blood Pressure- and Coronary Perfusion Pressure-Targeted Cardiopulmonary Resuscitation Improves 24-Hour Survival From Ventricular Fibrillation Cardiac Arrest.

Author

Naim, Maryam Y., Sutton, Robert M., Friess, Stuart H., Bratinov, George, Bhalala, Utpal, Kilbaugh, Todd J., Lampe, Joshua W., Nadkarni, Vinay M., Becker, Lance B., and Berg, Robert A.

Subjects
*CARDIOPULMONARY resuscitation, *CARDIOPULMONARY system, *BLOOD pressure, *GUIDELINES, *VASOCONSTRICTORS, *THERAPEUTICS, *CORONARY circulation, *ANIMALS, *CARDIAC arrest, *STATISTICAL sampling, *SWINE, *VENTRICULAR fibrillation, *DISEASE complications, *PHYSIOLOGY
Abstract

Objectives: Treatment algorithms for cardiac arrest are rescuer centric and vary little from patient to patient. The objective of this study was to determine if cardiopulmonary resuscitation-targeted to arterial blood pressure and coronary perfusion pressure rather than optimal guideline care would improve 24-hour survival in a porcine model of ventricular fibrillation cardiac arrest.Data Sources: Preclinical animal laboratory using female 3-month-old swine.Study Selection: A randomized interventional study.Data Extraction: After induction of anesthesia and 7 minutes of untreated ventricular fibrillation, 16 female 3-month-old swine were randomized to 1) blood pressure care: titration of chest compression depth to a systolic blood pressure of 100 mm Hg and vasopressor dosing to maintain coronary perfusion pressure of greater than 20 mm Hg or 2) guideline care: chest compression depth targeted to 51 mm and standard guideline vasopressor dosing. Animals received manual cardiopulmonary resuscitation for 10 minutes before the first defibrillation attempt and standardized postresuscitation care for 24 hours.Data Synthesis: Twenty-four-hour survival was more likely with blood pressure care versus guideline care (0/8 vs 5/8; p < 0.03), and all survivors had normal neurologic examinations. Mean coronary perfusion pressure prior to defibrillation was significantly higher with blood pressure care (28 ± 3 vs 10 ± 6 mm Hg; p < 0.01). Chest compression depth was lower with blood pressure care (48 ± 0.4 vs 44 ± 0.5 mm Hg; p < 0.05), and the number of vasopressor doses was higher with blood pressure care (median, 3 [range, 1-7] vs 2 [range, 2-2]; p < 0.01).Conclusions: Individualized goal-directed hemodynamic resuscitation targeting systolic blood pressure of 100 mm Hg and coronary perfusion pressure of greater than 20 mm Hg improved 24-hour survival compared with guideline care in this model of ventricular fibrillation cardiac arrest. [ABSTRACT FROM AUTHOR]

Published
2016
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122. Effects of Shenfu injection on macrocirculation and microcirculation during cardiopulmonary resuscitation.

Author

Wu, Junyuan, Li, Chunsheng, and Yuan, Wei

Subjects
*BIOLOGICAL models, *BLOOD circulation, *CARDIOPULMONARY resuscitation, *HERBAL medicine, *INJECTIONS, *CHINESE medicine, *SWINE, *VEINS
Abstract

Aim of the study To examine the effects of Shenfu injection (SFI) on macrocirculation and microcirculation during ventricular fibrillation (VF) and cardiopulmonary resuscitation (CPR). Materials and methods Sixteen female Landrace pigs were used in this study. After anesthesia, coronary perfusion pressure (CPP) was measured, and then the abdominal cavity was opened to observe the mesenteric microcirculation with the aid of sidestream dark field imaging. Following the guidelines, we determined microvascular flow index, perfused vessel density and proportion of perfused vessels both for large (diameter>20 μm) and small (diameter<20 μm) microvessels. SFI (1 ml/kg) or saline was given by vein injection at 1 h before inducing VF. CPR was initiated after 4 min VF. Results The shocks and duration of CPR were less in the SFI group compared with saline group. As the occurrence of VF, the CPP suddenly dropped to near zero, and cannot be measured in the both groups. However, there was greater CPP during CPR and at 1 h after return of spontaneous circulation in the SFI group than saline group. Compared with saline, SFI significantly improved the microcirculation parameters of large and small microvessels during VF and CPR. Conclusions SFI can improve the microvascular blood flow and CPP during VF and CPR, and reduce the shocks and duration of CPR. [ABSTRACT FROM AUTHOR]

Published
2016
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123. Closed-loop controller for chest compressions based on coronary perfusion pressure: a computer simulation study.

Author

Wang, Chunfei, Zhang, Guang, Wu, Taihu, Zhan, Ningbo, and Wang, Yaling

Subjects
*CLOSED loop systems, *PERFUSION, *BIOMECHANICS, *FUZZY control systems, *PID controllers, *CORONARY circulation, *COMPUTER simulation, *LOGIC, *PRESSURE, *RESPIRATORY therapy, *CHEST (Anatomy), *PHYSIOLOGY
Abstract

High-quality cardiopulmonary resuscitation contributes to cardiac arrest survival. The traditional chest compression (CC) standard, which neglects individual differences, uses unified standards for compression depth and compression rate in practice. In this study, an effective and personalized CC method for automatic mechanical compression devices is provided. We rebuild Charles F. Babbs' human circulation model with a coronary perfusion pressure (CPP) simulation module and propose a closed-loop controller based on a fuzzy control algorithm for CCs, which adjusts the CC depth according to the CPP. Compared with a traditional proportion-integration-differentiation (PID) controller, the performance of the fuzzy controller is evaluated in computer simulation studies. The simulation results demonstrate that the fuzzy closed-loop controller results in shorter regulation time, fewer oscillations and smaller overshoot than traditional PID controllers and outperforms the traditional PID controller for CPP regulation and maintenance. [ABSTRACT FROM AUTHOR]

Published
2016
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138. Standard CPR versus interposed abdominal compression CPR in shunted single ventricle patients: comparison using a lumped parameter mathematical model

Author

Weiguang Yang, Carlos M. Mery, Daniel Stromberg, Michelle Mizrahi, Karen Carvalho, Alison L. Marsden, and Camille Immanuel

Subjects
medicine.medical_specialty, Cardiac output, Resuscitation, medicine.medical_treatment, Population, Internal medicine, Abdomen, medicine, Pressure, Humans, Cardiopulmonary resuscitation, education, Child, education.field_of_study, business.industry, Hemodynamics, General Medicine, Blood flow, Models, Theoretical, Cardiopulmonary Resuscitation, Blood pressure, Great vessels, Pediatrics, Perinatology and Child Health, Coronary perfusion pressure, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction:Cardiopulmonary resuscitation (CPR) in the shunted single-ventricle population is associated with poor outcomes. Interposed abdominal compression-cardiopulmonary resuscitation, or IAC-CPR, is an adjunct to standard CPR in which pressure is applied to the abdomen during the recoil phase of chest compressions.Methods:A lumped parameter model that represents heart chambers and blood vessels as resistors and capacitors was used to simulate blood flow in both Blalock-Taussig-Thomas and Sano circulations. For standard CPR, a prescribed external pressure waveform was applied to the heart chambers and great vessels to simulate chest compressions. IAC-CPR was modelled by adding phasic compression pressure to the abdominal aorta. Differential equations for the model were solved by a Runge-Kutta method.Results:In the Blalock-Taussig-Thomas model, mean pulmonary blood flow during IAC-CPR was 30% higher than during standard CPR; cardiac output increased 21%, diastolic blood pressure 16%, systolic blood pressure 8%, coronary perfusion pressure 17%, and coronary blood flow 17%. In the Sano model, pulmonary blood flow during IAC-CPR increased 150%, whereas cardiac output was improved by 13%, diastolic blood pressure 18%, systolic blood pressure 8%, coronary perfusion pressure 15%, and coronary blood flow 14%.Conclusions:In this model, IAC-CPR confers significant advantage over standard CPR with respect to pulmonary blood flow, cardiac output, blood pressure, coronary perfusion pressure, and coronary blood flow. These results support the notion that single-ventricle paediatric patients may benefit from adjunctive resuscitation techniques, and underscores the need for an in-vivo trial of IAC-CPR in children.

Published
2021

139. Effects of Add-On Left Ventricular Assist Device to Extracorporeal Membrane Oxygenation During Refractory Cardiac Arrest in a Porcine Model

Author

Arve Mongstad, Atle Solholm, Grete Slettom, Lodve Stangeland, Jan Erik Nordrehaug, Tom Roar Omdal, Ketil Grong, Vegard Tuseth, Rune Haaverstad, Malte Urban, Tore Wentzel-Larsen, Liqun Zhang, and Erik J S Packer

Subjects
Cardiac function curve, medicine.medical_specialty, Swine, medicine.medical_treatment, Biomedical Engineering, Biophysics, Hemodynamics, Bioengineering, Return of spontaneous circulation, Biomaterials, Extracorporeal Membrane Oxygenation, Internal medicine, medicine, Extracorporeal membrane oxygenation, Animals, Humans, Extracorporeal cardiopulmonary resuscitation, business.industry, General Medicine, Cardiopulmonary Resuscitation, Heart Arrest, Ventricular assist device, Coronary perfusion pressure, Ventricular pressure, Cardiology, Heart-Assist Devices, business
Abstract

This study evaluated the effects of extracorporeal membrane oxygenation (ECMO) in combination with a percutaneous adjunctive left ventricular assist device (LVAD) in a porcine model during 60 minutes of refractory cardiac arrest (CA). Twenty-four anesthetized swine were randomly allocated into three groups given different modes of circulatory assist: group 1: ECMO 72 ml/kg/min and LVAD; group 2: ECMO 36 ml/kg/min and LVAD; and group 3: ECMO 72 ml/kg/min. During CA and extracorporeal cardiopulmonary resuscitation (ECPR), mean left ventricular pressure (mLVP) was lower in group 1 (p = 0.013) and in group 2 (p = 0.003) versus group 3. Mean aortic pressure (mAP) and coronary perfusion pressure (CPP) were higher in group 1 compared with the other groups. In group 3, mean pulmonary artery flow (mPAf) was lower versus group 1 (p = 0.003) and group 2 (p = 0.039). If the return of spontaneous circulation (ROSC) was achieved after defibrillation, up to 180 minutes of unsupported observation followed. All subjects in groups 1 and 3, and 5 subjects in group 2 had ROSC. All subjects in group 1, five in group 2 and four in group 3 had sustained cardiac function after 3 hours of spontaneous circulation. Subjects that did not achieve ROSC or maintained cardiac function post-ROSC had lower mAP (p < 0.001), CPP (p= 0.002), and mPAf (p = 0.004) during CA and ECPR. Add-on LVAD may improve hemodynamics compared with ECMO alone during refractory CA but could not substitute reduced ECMO flow. Increased mAP and CPP could be related to ROSC rate and sustained cardiac function. Increased mLVP was related to poor post-ROSC cardiac function.

Published
2021

150. Investigators from University of North Texas Health Science Center Zero in on Life Science (Oxygen-sensing Pathways Below Autoregulatory Threshold Act To Sustain Myocardial Oxygen Delivery During Reductions In Perfusion Pressure).

Abstract

Keywords: Fort Worth; State:Texas; United States; North and Central America; Life Science; Chalcogens; Coronary Perfusion Pressure; Diagnostics and Screening; Health and Medicine; Perfusion EN Fort Worth State:Texas United States North and Central America Life Science Chalcogens Coronary Perfusion Pressure Diagnostics and Screening Health and Medicine Perfusion 2314 2314 1 05/08/23 20230512 NES 230512 2023 MAY 12 (NewsRx) -- By a News Reporter-Staff News Editor at Health & Medicine Week -- Investigators discuss new findings in Life Science. Fort Worth, State:Texas, United States, North and Central America, Life Science, Chalcogens, Diagnostics and Screening, Health and Medicine, Perfusion, Coronary Perfusion Pressure. [Extracted from the article]

Published
2023

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