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  • 1
    Electronic Resource
    Electronic Resource
    Heterogeneous regional vascular responses to simulated transient hypovolemia in man (1994)
    Springer
    Intensive care medicine 20 (1994), S. 414-420 
    Details
    ISSN: 1432-1238
    Keywords: Hypovolemia ; Cardiac output ; Regional blood flows ; Cardiovascular reflexes ; Catechol-amines ; Healthy volunteers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To describe the evolution of systemic and regional blood flows during and after hypovolemia in humans. Design Simulation of hypovolemia by a prolonged application of lower body negative pressure (LBNP). Setting Laboratory of Clinical Research, Surgical Intensive Care Unit of an University Hospital. Participants 8 healthy male volunteers. Interventions 3 successive and increasing 15min-levels of LBNP were followed by a progressive return (10 min) to atmospheric pressure, then a 60min-recovery period. Measurements and main results Simulated hypovolemia induced a parallel one-third decrease in cardiac output (bioimpedance), musculocutaneous (venous plethysmography) and splanchnic (ICG clearance) blood flows. Adrenergic-mediated peripheral vasoconstriction prevented any change in mean arterial pressure. The decrease in renal blood flow (PAH clearance) was limited, glomerular filtration rate (inulin clearance) unchanged and thus filtration fraction increased. All the cardiovascular and biological variables returned to pre-LBNP values during the recovery period except for splanchnic blood flow which remained below control values 60 min after the return to atmospheric pressure. Conclusions Since a sustained splanchnic vasoconstriction follows a transient normotensive hypovolemia in healthy men despite adequate treatment considering arterial pressure and cardiac output, the therapeutic goals of fluid resuscitation after hypovolemic shock might be revisited and a supranormal value of cardiac output proposed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01710651
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Transgastric, pulsed doppler echocardiographic determination of cardiac output (1996)
    Springer
    Intensive care medicine 22 (1996), S. 34-38 
    Details
    ISSN: 1432-1238
    Keywords: Cardiac output ; Transesophageal echocardiography ; Doppler ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. Design Cardiac output was simultaneously measured by thermodilution (TD) and a transgastric, pulsed Doppler method. Setting The study was carried out in a surgical intensive care unit as part of the management protocol of the patients. Patients Thirty consecutive acutely ill patients with a Swan-Ganz catheter, mechanically ventilated, sedated and with a stable hemodynamic condition were included. Measurements Pulsed Doppler TEE was performed using a transgastric approach in order to obtain a long axis view of the left ventricle. Cardiac output was calculated from the left ventricular outflow tract diameter, the velocity time integral of the blood flow profile and heart rate. Results One patient was excluded because of the presence of aortic regurgitation and another, because of the impossibility of obtaining a transgastric view. Twenty-eight simultaneous measurements were performed in 28 patients. A clinically acceptable correlation and agreement were found between the two methods (Doppler cardiac output=0.889 thermodilution cardiac output +0.74l/min,r=0.975,p〈0.0001). Conclusion Transgastric pulsed Doppler measurement across the left ventricular outflow tract with TEE is a very feasible and clinically acceptable method for cardiac output measurement in acutely ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728328
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate cardiac function at the early phase of severe trauma. Design Prospective, clinical study. Setting Anesthesiological Intensive Care Unit. Patients 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%,p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg,p=0.02). Conclusion The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Key words Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To evaluate cardiac function at the early phase of severe trauma. Design: Prospective, clinical study. Setting: Anesthesiological Intensive Care Unit. Patients: 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results: All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%, p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg, p=0.02). Conclusion: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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