Pig model of pulmonary embolism: where is the hemodynamic break point?

Title:

Pig model of pulmonary embolism: where is the hemodynamic break point?

Creator:

Kudlička, J., Mikuláš Mlček, Hála, P., Lacko, S., Janák, D., Hrachovina, M., Jan Malík, Jan Bělohlávek, Petr Neužil, and Otomar Kittnar

Identifier:

https://cdk.lib.cas.cz/client/handle/uuid:083dfdec-8466-4837-bca4-d07b1cca4f82
uuid:083dfdec-8466-4837-bca4-d07b1cca4f82

Subject:

Fyziologie člověka a srovnávací fyziologie, plicní embolie, hemodynamika, šok (lékařství), pulmonary embolism, hemodynamics, shock (medicine), pig model, 14, and 612

Type:

article, články, model:article, and TEXT

Format:

print

Description:

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

Language:

English

Rights:

http://creativecommons.org/licenses/by-nc-sa/4.0/
policy:public

Source:

Physiological research | 2013 Volume:62 | Number:Suppl 1

Harvested from:

CDK

Metadata only:

false