Electrode migration is the most common complication of spinal
cord stimulation (SCS). The problem of longitudinal migration has
already been solved, but lateral migration remains the most
common current complication. The present article describes new
electrodes fixation opportunities for the reduction of lateral
migration in SCS. The pig was chosen as an animal model to
illustrate a new protocol of electrode fixation for the control of
lateral and longitudinal migration. The displacement of the
electrode was measured using two different optical methods: the
digital image stereo-correlation and the digital image processing
methods. Fixation with two anchors has always considerably
reduced electrode displacement and when fixation is done with two
anchors and a loop then lateral migration is reduced by 62.5 %
and longitudinal migration is reduced by 94.1 %. It was shown that
the results are significantly different at the α=0.001 significance
level. Based on a statistical evaluation it is possible to state that the
differences between experimental results obtained for three
different protocols of lead fixation are statistically significant and
we can recommend the new fixation method for common practice.
Early recognition of collapsing hemodynamics in pulmonary embolism is necessary to avoid cardiac arrest using aggressive medical therapy or mechanical cardiac support. The aim of the study was to identify the maximal acute hemodynamic compensatory steady state. Overall, 40 dynamic obstructions of pulmonary artery were performe d and hemodynamic data were collected. Occlusion of only left or right pulmonary artery did not lead to the hemodynamic collapse. When gradually obstructing the bifurcation, the right ventri cle end-diastolic area expanded proportionally to pulmonary artery mean pressure from 11.6 (10.1, 14.1) to 17.8 (16.1, 18.8) cm 2 (p<0.0001) and pulmonary artery mean pressure increased from 22 (20, 24) to 44 (41, 47) mmHg (p<0.0001) at the poin t of maximal hemodynamic compensatory steady state. Sim ilarly, mean arte rial pressure decreased from 96 (87, 101) to 60 (53, 78) mmHg (p<0.0001), central venous pressure increased from 4 (4, 5) to 7 (6, 8) mmHg (p<0.0001), heart rate increased from 92 (88, 97) to 147 (122, 165) /min (p<0.0001), contin uous cardiac output dropped from 5.2 (4.7, 5.8) to 4.3 (3.7, 5.0) l/min (p=0.0023), modified shock index increased from 0.99 (0.81, 1.10) to 2.31 (1.99, 2.72), p<0.0001. In conclusion, in stead of continuous cardiac output all of the analyzed parameters can sensitively determine the individual maximal compensatory response to obstructive shock. We assume their monitoring can be used to predict the critical phase of the hemodynamic status in routine practice., J. Kudlička ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy