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1.
Rev Assoc Med Bras (1992) ; 66(9): 1180-1186, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027442

RESUMO

INTRODUCTION: The vascular evaluation of the erectile function through Color Duplex-Doppler Ultrasound (CDDU) of the penis can benefit the therapeutic decision-making process. Unfortunately, there is no standard procedure for CDDU conduction, a fact that results in high result-interpretation variability. OBJECTIVE: The aims of this review are to promote greater standardization during CDDU of the penis and discuss the fundamental principles for its accurate conduction. METHODS: CDDU is initially conducted with the penis in the flaccid state; the whole penis must be assessed (images at B mode) with a high-frequency linear transducer (7.5-18 MHz). Intracavernous injection of vasodilating agents (prostaglandin E1, papaverine, phentolamine) is performed to induce a rigid erection. Serial measurements at different times should be taken during the CDDU session and penile rigidity must be assessed in each evaluation. RESULTS: It is important to monitor the erection response after the vasoactive agent (hardness scale), and scanning during the best-quality erection should be contemplated. Manual self-stimulation, audiovisual sexual stimulation (AVSS), and vasoactive agent re-dosing protocols must be taken into account to reduce the influence of psychogenic factors and to help the patient to get the hardest erection possible. Such measurements contribute to the maximal relaxation of the erectile tissue, so the hemodynamic parameters are not underestimated. CONCLUSIONS: CDDU is a relevant specialized tool to assess patients with erectile dysfunction; therefore, this guideline will help to standardize and establish uniformity in its conduction and interpretation, taking into consideration the complexity and heterogeneity of CDDU evaluations of the penis.


Assuntos
Pênis , Disfunção Erétil , Hemodinâmica , Humanos , Masculino , Ereção Peniana , Ultrassonografia Doppler em Cores
2.
Asian Cardiovasc Thorac Ann ; 28(7): 427-430, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33023305

RESUMO

Based on current guidelines, 15% to 20% of patients undergoing mitral valve repair for regurgitation develop left ventricular dysfunction (ejection fraction < 50%-55%) despite a normal baseline. Two schools of thought have been debated: preexisting myocardial disease or suboptimal intraoperative myocardial protection. In our view, they could be reconciled. It is well recognized that left ventricular ejection fraction with a standard cut off at 50%-55% has limited sensitivity in detecting early systolic impairment in mitral regurgitation patients. Mitral regurgitation also leads to mitochondrial oxidative stress, thus rendering the myocardium more susceptible to ischemia-reperfusion injury and precipitating postoperative cardiac dysfunction. The fall in left ventricular ejection fraction early after mitral valve repair was shown to be caused by the reduction in both myocardial contractility and left ventricular stroke volume. To mitigate the risk to myocardial reperfusion injury, appropriate cardioplegia volume and distribution and well-defined surgical repair processes are equally important. We use transesophageal echocardiography-guided cardioplegia delivery, imaging the intramyocardial flow and ensuring adequate protection of the subendocardium during mitral valve repair. Mild aortic regurgitation on a beating heart often leads to left ventricular dilatation with diminished cardioplegia flow in the myocardium, thus requiring direct ostia cardioplegia. Systematic transesophageal echocardiography assessment before surgery is essential for establishing the mitral regurgitation mechanisms and translating them into precise surgical repair strategies. The benefits of transesophageal echocardiography-guided cardioplegia delivery warrant further clinical trials in order to evolve into part of a high surgical standard.


Assuntos
Ecocardiografia Transesofagiana , Parada Cardíaca Induzida , Anuloplastia da Valva Mitral , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Disfunção Ventricular Esquerda/prevenção & controle , Ecocardiografia Transesofagiana/efeitos adversos , Parada Cardíaca Induzida/efeitos adversos , Hemodinâmica , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Anuloplastia da Valva Mitral/efeitos adversos , Insuficiência da Valva Mitral/diagnóstico por imagem , Insuficiência da Valva Mitral/fisiopatologia , Traumatismo por Reperfusão Miocárdica/diagnóstico por imagem , Traumatismo por Reperfusão Miocárdica/etiologia , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Fatores de Risco , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia , Função Ventricular Esquerda
3.
Asian Cardiovasc Thorac Ann ; 28(7): 381-383, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33023307
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 390-393, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018010

RESUMO

In this paper, we investigate the effect of stimulation durations on the hemodynamic responses (HRs) in the somatosensory cortex. In doing so, the relationship between stimulation duration and the initial dip is also investigated. The HRs are measured using functional near-infrared spectroscopy (fNIRS). The HR signals related to finger poking are acquired from the left somatosensory cortex. Two different stimulation durations (i.e., 1 and 5 sec) were tested in this study. From the results of the study, it is concluded that the stimulation duration of 1 sec (short stimulus) evokes initial dip in the somatosensory cortex, but it disappears as the stimulation duration gets longer. Therefore, the 1-sec stimulation duration can serve the purpose of the fNIRS-based brain-computer interface.


Assuntos
Interfaces Cérebro-Computador , Espectroscopia de Luz Próxima ao Infravermelho , Dedos , Hemodinâmica , Córtex Somatossensorial
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 394-397, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018011

RESUMO

Functional near-infrared spectroscopy (fNIRS) provides an effective tool in neuroscience studies of cognition in infants. fNIRS signals are normally processed by applying ANOVA analysis on the grand average of the hemodynamic responses to investigate the cognitive-related differences between experimental groups. However, this averaging approach does not account for any differences in the temporal patterns of the responses. Therefore, we propose a new approach based on a combination of tensor decomposition and ANOVA. First, a four-way tensor of the hemodynamic responses is arranged as time × frequency × channel× subject and decomposed using Canonical Polyadic Decomposition (CPD). Next, ANOVA is applied to identify significant patterns between subjects. Instead of averaging, the CPD can capture the distinct patterns between groups in all the dimensions. We used fNIRS dataset of 70 infants who participated in an experiment to investigate cortical activation to an agent (i.e., mechanical claws vs. human hands) with different events (i.e., function and non-function). In the comparison with the traditional ANOVA, CPD+ANOVA identified the same significance factors. However, CPD+ANOVA discovered new information on the temporal and spatial patterns indicating a longer interval hemodynamic responses, which was missed using the traditional ANOVA. This new analysis of hemodynamic responses as captured using fNIRS will improve neuroscience and cognitive studies.


Assuntos
Neurociências , Espectroscopia de Luz Próxima ao Infravermelho , Cognição , Mãos , Hemodinâmica , Humanos , Lactente
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 398-401, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018012

RESUMO

We propose a framework for studying the electrophysiological correlates of BOLD-fMRI. This framework relies on structured coupled matrix-tensor factorization (sCMTF), a joint multidimensional decomposition which reveals dynamical interactions between LFP/EEG oscillatory features and BOLD-fMRI data. We test whether LFP/EEG-BOLD co-fluctuations and regional hemodynamic response functions can be estimated by sCMTF using whole-brain modelling of restingstate activity. We produce permuted datasets to show that our framework extracts EEG/LFP temporal patterns that correlate significantly with BOLD signal fluctuations. Our framework is also capable of estimating HRFs that accurately embodies simulated hemodynamics, with a word of caution regarding initialization of the sCMTF algorithm.


Assuntos
Mapeamento Encefálico , Imagem por Ressonância Magnética , Eletroencefalografia , Fenômenos Eletrofisiológicos , Hemodinâmica
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1489-1492, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018273

RESUMO

Cerebrovascular Reactivity (CVR), the responsiveness of blood vessels to a vasodilatory stimulus, is an important indicator of cerebrovascular health. Assessing CVR with fMRI, we can measure the change in the Blood Oxygen Level Dependent (BOLD) response induced by a change in CO2 pressure (%BOLD/mmHg). However, there exists a temporal offset between the recorded CO2 pressure and the local BOLD response, due to both measurement and physiological delays. If this offset is not corrected for, voxel-wise CVR values will not be accurate. In this paper, we propose a framework for mapping hemodynamic lag in breath-hold fMRI data. As breath-hold tasks drive task-correlated head motion artifacts in BOLD fMRI data, our framework for lag estimation fits a model that includes polynomial terms and head motion parameters, as well as a shifted variant of the CO2 regressor (±9 s in 0.3 s increments), and the hemodynamic lag at each voxel is the shift producing the maximum total model R2 within physiological constraints. This approach is evaluated in 8 subjects with multi-echo fMRI data, resulting in robust maps of hemodynamic delay that show consistent regional variation across subjects, and improved contrast-to-noise compared to methods where motion regression is ignored or performed earlier in preprocessing.Clinical Relevance- We map hemodynamic lag using breathhold fMRI, providing insight into vascular transit times and improving the regional accuracy of cerebrovascular reactivity measurements.


Assuntos
Circulação Cerebrovascular , Imagem por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Hemodinâmica , Oxigênio
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2319-2323, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018472

RESUMO

This paper proposes a computational framework for automatically optimizing the shapes of patient-specific tissue engineered vascular grafts. We demonstrate a proof-of-concept design optimization for aortic coarctation repair. The computational framework consists of three main components including 1) a free-form deformation technique exploring graft geometries, 2) high-fidelity computational fluid dynamics simulations for collecting data on the effects of design parameters on objective function values like energy loss, and 3) employing machine learning methods (Gaussian Processes) to develop a surrogate model for predicting results of high-fidelity simulations. The globally optimal design parameters are then computed by multistart conjugate gradient optimization on the surrogate model. In the experiment, we investigate the correlation among the design parameters and the objective function values. Our results achieve a 30% reduction in blood flow energy loss compared to the original coarctation by optimizing the aortic geometry.


Assuntos
Coartação Aórtica , Aorta , Coartação Aórtica/cirurgia , Prótese Vascular , Hemodinâmica , Humanos , Procedimentos Cirúrgicos Vasculares
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2589-2593, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018536

RESUMO

Left ventricular assist devices (LVADs) are used to treat patients with severe (New York Heart Association class IV) heart failure. Thrombosis and bleeding are severe LVAD-related complications; thus, an effective anticoagulation regimen is crucial for successful postoperative management. The CH-VAD™ (CH Biomedical, Inc.) is a small, implantable, full-support (>5 L/min) LVAD with a centrifugal flow pump that has a fully magnetically levitated rotor, which confers superior hemocompatibility. In this study, the CH-VAD™ was implanted in two calves to evaluate its hemocompatibility and to establish an anticoagulation regimen for future GLP (good laboratory practice) studies. Heparin infusion was used during the surgery, and during postoperative management, the proper dosage of warfarin was given orally to maintain an international normalized ratio (INR) between 2.0 and 3.0. Pump performance, animal condition, and hematology results were recorded throughout the study (approximately 60 days). The results show that under the established anticoagulation regimen, the CH-VAD™ was well tolerated in the bovine model, with no significant thrombus or thromboembolic lesion formation in distal end organs. Low plasma free hemoglobin levels suggest that the device did not cause hemolysis. These results and the experience gained pave the way for future GLP studies.


Assuntos
Insuficiência Cardíaca , Coração Auxiliar , Trombose , Animais , Bovinos , Hemodinâmica , Humanos , Varfarina
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2654-2657, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018552

RESUMO

Historically, cardiovascular computational models have been developed considering the case of a 70 Kg male patient. However, hemodynamic quantities differ widely due to sex, age, and weight. In this study, we developed a female-specific model of the blood circulation of a young (18-40 y.o.) woman with BSA of 1.6 m2. The lumped-parameter (0D) model, which includes the uterus, has been calibrated with female-specific parameters and validated with sex-specific literature data.


Assuntos
Hemodinâmica , Modelos Cardiovasculares , Feminino , Humanos
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2658-2661, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018553

RESUMO

The sound generated by diseased carotid arteries was investigated through computational means using three-dimensional, idealized, stenosed carotid bifurcation models. Stenosis levels of 50% and 70% with axi-symmetric and asymmetric stenosis shapes were considered. The hemodynamic flow field was obtained by solving the incompressible, Navier-Stokes equations. The resulting pressure fluctuations at the vessel walls were then used as input for a linearized wave equation for the propagation of vibrations through the modeled surrounding tissue. As observed in prior studies, the sound spectra obtained at the tissue surface indicate a 'break frequency', i.e. a frequency beyond which there is a drop-off in sound spectra intensity. This frequency was found to scale with stenosis diameter and average velocity at the stenosis throat, provided the stenosis shape remained the same. This has important implications on past attempts to estimate stenosis diameter from the break frequency.


Assuntos
Auscultação , Artérias Carótidas , Constrição Patológica , Hemodinâmica , Humanos , Som
12.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2671-2674, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018556

RESUMO

The ongoing advances in the field of cardiovascular modelling during the past years have allowed for the creation of accurate three-dimensional models of the major coronary arteries. The aforementioned 3D models can accurately mimic the human coronary vasculature if they are combined with sophisticated computational fluid dynamics algorithms and shed light to non-trivial issues that concern the clinicians. One of these issues is to define whether a coronary lesion is more dangerous to present with ischemia if it is at a proximal or a distal part of the vessel. In this work, we aim to investigate the aforementioned issue by reconstructing in 3D a coronary arterial model from a healthy subject using Computed Tomography Coronary Angiography images and by editing it to create eight diseased arterial models that contain one or two lesions of different severities. After carrying out the appropriate blood flow simulations using the finite element method, we observed that the distal lesions are more dangerous than the proximal ones in terms of hemodynamic significance. Moreover, the distal severe stenosis (i.e. 70% diameter reduction) present with the highest peak Wall Shear Stress (WSS) values in comparison to the proximal ones.


Assuntos
Estenose Coronária , Vasos Coronários , Animais , Angiografia por Tomografia Computadorizada , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Coração , Hemodinâmica , Humanos
13.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2804-2807, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018589

RESUMO

The advances in cardiovascular modelling over the past two decades have given the opportunity to create accurate three dimensional models of the coronary vasculature which, combined with advanced computational fluid dynamics algorithms can shed light to intriguing matters that concern clinicians. One of these issues is the presence of a stenosis near bifurcations in one of the major coronary vessels. In this work, we try to shed light on the aforementioned matter by creating a healthy arterial bifurcation reconstructed using the fusion of Optical Coherence Tomography and X-Ray angiography images. The healthy model was edited by adding an artificial stenosis of 50% diameter reduction into three different locations after the bifurcation, thus creating three diseased models. After performing the appropriate blood flow simulations, we observed that the location of the stenosis affects the Wall Shear Stress (WSS) distribution but it does not affect the functional significance of the stenosis itself.


Assuntos
Vasos Coronários , Modelos Cardiovasculares , Constrição Patológica , Vasos Coronários/diagnóstico por imagem , Hemodinâmica , Humanos , Estresse Mecânico
14.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2913-2916, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018616

RESUMO

Multisensory stimulation plays an important role in the recovery of ischemic stroke. However, little is known about the interactions between neuronal activities with multi-afferent stimulations and their effects on hemodynamic responses. Optogenetics has been a useful tool in neuroscience research to unravel the mechanisms of neurovascular coupling at cell-specific level. In this study, we applied laser speckle contrast imaging (LSCI) to map the cortical hemodynamic response with high spatiotemporal resolution. The results showed that optogenetic inhibition of pyramidal neurons in sensorimotor cortex induced both local and distant increases of cerebral blood flow (CBF) with dual peaks, and the full width at half maximum (FWHM) was significantly larger than that of the CBF response to optogenetic excitation. Furthermore, optogenetic excitation of pyramidal neurons could significantly increase the local CBF response to sensory stimulation, whereas optogenetic inhibition of pyramidal neurons decreased the local CBF response at the early stage after sensory stimulation and increased the distant CBF response during the recovery period. Our work provided useful insights into the mechanisms of brain stimulation, which might help in clinical neurological applications.


Assuntos
Acoplamento Neurovascular , Circulação Cerebrovascular , Hemodinâmica , Imagem Óptica , Optogenética
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3481-3484, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018753

RESUMO

Neurovascular coupling provides valuable descriptive information about neural function and communication. In this work, we propose to objectively characterize EEG sub-band modulation in an attempt to compare with local variations of fNIRS hemoglobin concentration. First, full-band EEG signals are decomposed into five well-known frequency sub-bands: delta, theta, alpha, beta, and gamma. The temporal amplitude envelope of each sub-band is then computed via Hilbert transformation. The proposed EEG 'spectro-temporal amplitude modulation' (EEG-AM) feature measures the rate at which each sub-band is modulated. Similarities between EEG-AM features and fNIRS hemoglobin concentration are computed for four neighboring channels over the occipital area during resting-state. Experiments with a database of 29 participants show statistically significant similarities between the total hemoglobin concentration and the alpha band modulating the alpha, beta, and gamma frequencies. These results support the idea that the EEG-AM can carry hemodynamic properties.Clinical relevance- This shows that the EEG spectro-temporal amplitude modulation present similarities with the hemoglobin concentration in co-placed channels.


Assuntos
Atenção , Eletroencefalografia , Hemodinâmica , Humanos
16.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026202

RESUMO

We report the case of a 68-year-old patient who arrived at the hospital with a fever and a cough for 7 days, a history of high blood pressure and chronic kidney failure stage 2 according to CKD-EPI (GFR: 62 ml/minute with creatinine: 1.2 mg/dl). Home therapy included lercanidipine and clonidine. A chest radiograph performed in the emergency department immediately showed images suggestive of pneumonia from COVID-19, confirmed in the following days by a positive swab for coronavirus. Kidney function parameters progressively deteriorated towards a severe acute kidney failure on the 15th day, with creatinine values of 6.6 mg/dl and urea of 210 mg/dl. The situation was managed first in the intensive care unit with CRRT cycles (continuous renal replacement therapy) and then in a "yellow area" devoted to COVID patients, where the patient was dialyzed by us nephrologists through short cycles of CRRT. In our short experience we have used continuous techniques (CRRT) in positive patients hemodynamically unstable and intermittent dialysis (IRRT) in our stable chronic patients with asymptomatic COVID -19. We found CRRT to be superior in hemodynamically unstable patients hospitalized in resuscitation and in the "yellow area". Dialysis continued with high cut-off filters until the normalization of kidney function; the supportive medical therapy has also improved the course of the pathology and contributed to the favorable outcome for our patient. During the COVID-19 pandemic, our Nephrology Group at Savona's San Paul Hospital has reorganized the department to better manage both chronic dialyzed patients and acute patients affected by the new coronavirus.


Assuntos
Lesão Renal Aguda/terapia , Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Lesão Renal Aguda/diagnóstico por imagem , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Idoso , Anti-Hipertensivos/uso terapêutico , Antivirais/uso terapêutico , Betacoronavirus/fisiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Creatinina/sangue , Cuidados Críticos/métodos , Gerenciamento Clínico , Hemodinâmica , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Comunicação Interdisciplinar , Falência Renal Crônica/complicações , Masculino , Equipe de Assistência ao Paciente , Isolamento de Pacientes , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Diálise Renal/métodos , Respiração Artificial , Ureia/sangue
17.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(9): 1089-1095, 2020.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33051423

RESUMO

OBJECTIVES: To investigate the effect of cardiopulmonary bypass (CPB) with different perfusion flow on carotid artery blood by using the carotid artery ultrasound. METHODS: Forty-five adult patients during Dec. 2014 to Jan. 2015 scheduled for heart valve replacement or ventricular septal defect repair were randomly divided into 3 groups (n=15) according to different perfusion flow during CPB: A Group 1 [(62±2) mL/(kg·min)], a Group 2 [(72±2) mL/(kg·min)], and a Group 3 [(82±2) mL/(kg·min)]. The diameter of the common carotid artery (CCAD), the peak velocity of the common carotid artery (CCAV),the flow of the common carotid artery (CCAF), the diameter of the internal carotid artery (ICAD), the peak velocity of the internal carotid artery (ICAV) and the flow of the internal carotid artery (ICAF) were measured at the responding time points before the anesthesia induction (T1), after the anesthesia induction (T2), 10 min into CPB (T3), 20 min into CPB (T4), 40 min into CPB (T5), 60 min into CPB(T6), 20 min after CPB ending (T7) by doppler ultrasonography, respectively. The hemoglobin (Hb) and lactic acid were compared at the time before CPB(P1),the time when temperature was decreased to the lowest during CPB (P2), the time when temperature was reheated to 35 ℃ (P3), 20 min after CPB was ended (P4), 2 hours after CPB was ended (P5) by α-steady method. The parameters of CPB and hemodynamic parameters at each time point and postoperative condition were recorded. RESULTS: There was no significant difference in Hb and lactic acid between the three groups (all P>0.05). For intra-group comparison, the Hb concentration at P2-P5 was lower than that at P1 (all P<0.05), and the Hb concentration was the lowest at P2 and P3. The level of lactic acid at P3-P5 was higher than those at P1 (all P<0.05).There were no significant differences in measurement of carotid artery between the left and right sides of the patients at T1 (all P>0.05). There was no significant difference in CCAV and CCAF among the 3 groups (both P>0.05). For intra-group comparison, the CCAV at T2-T6 was significantly lower than that at T1 (P<0.05), and higher at T7 than that at T2-T6 (all P<0.05), but it was still significantly lower than that at T1 (P<0.05). The difference of CCAF between T2-T5 and T1 was significant (all P<0.05). ICAV of G1 was lower than G3 at T3 (P<0.05). ICAV of G1 was lower than G2, and G2 was lower that G3 at T4 (both P<0.05). ICAV of G1 was lower than G2 at T6 (P<0.05). For intra-group comparison, the ICAV at T2 was significantly lower than that at T1 (P<0.05), and that at T3-T6 was significantly lower than that at T1 and T2 (all P<0.05). At T3-T6, ICAF of G1 was lower than that of G3 (all P<0.05). For intra-group comparison, ICAF at T2-T6 was significantly lower than that at T1 (all P<0.05). At T4, perfusion flow was positively correlated with CCAF, ICAV and ICAV (all P<0.05). None of the patients had obvious motor, sensory, or consciousness disturbance, and no neurological complications.There was no significant difference in postoperative hospital stay, postoperative ICU time, and postoperative extubation time among the 3 groups (all P>0.05). CONCLUSIONS: Different perfusion flows of CPB have different effects on carotids hemodynamics.There is correlation between carotids hemodynamics and perfusion flow. Carotid ultrasound examination can be used to evaluate cardiac output.


Assuntos
Ponte Cardiopulmonar , Artérias Carótidas , Adulto , Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/cirurgia , Hemodinâmica , Humanos , Perfusão
18.
Artigo em Alemão | MEDLINE | ID: mdl-33053589

RESUMO

The current S3-Guideline for intensive care therapy in patients after cardiac surgery provides a wealth of information and recommendations ranging from monitoring to treatment options for various perioperative clinical situations. This article focuses on the most relevant information applicable to every-day critical care practice, covering important aspects of general and advanced monitoring, goal directed hemodynamic therapy and treatment principles for perioperative left and right heart failure.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Insuficiência Cardíaca , Cuidados Críticos , Hemodinâmica , Humanos
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