Vascular Tone in Patients with Hemorrhagic Shock

Miyagatani, Yasusuke; Yukioka, Tetsuo; Ohta, Shöichi; Ohta, Shin; Matsuda, Hiroharu; Shimazu, Hideaki; Shimazaki, Shuji

doi:10.1097/00005373-199908000-00010

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…Dutch and Redman (1983) studied cardiovascular activity during psychological stressors with significant PTT decreases measured during the cold-pressor test, reaction-time task, video game and problem solving. Vascular tone, that is the degree of vasoconstriction experienced by a blood vessel relative to its maximally dilated state, has also been assessed in patients with haemorrhagic shock (Miyagatani et al 1999), following mood changes whilst listening to music (Matsuura 2002), genital haemodynamics in sexual dysfunction (Prause et al 2005, Brauer et al 2006, physiological studies (Foo andLim 2006a, Foo et al 2006), haemodialysis (Burkert et al 2006), and the ambulatory monitoring of patients prone to hypoglycaemic events (Harris et al 1996).…”

Section: Neurologymentioning

confidence: 99%

Photoplethysmography and its application in clinical physiological measurement

2007

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Photoplethysmography (PPG) is a simple and low-cost optical technique that can be used to detect blood volume changes in the microvascular bed of tissue. It is often used non-invasively to make measurements at the skin surface. The PPG waveform comprises a pulsatile ('AC') physiological waveform attributed to cardiac synchronous changes in the blood volume with each heart beat, and is superimposed on a slowly varying ('DC') baseline with various lower frequency components attributed to respiration, sympathetic nervous system activity and thermoregulation. Although the origins of the components of the PPG signal are not fully understood, it is generally accepted that they can provide valuable information about the cardiovascular system. There has been a resurgence of interest in the technique in recent years, driven by the demand for low cost, simple and portable technology for the primary care and community based clinical settings, the wide availability of low cost and small semiconductor components, and the advancement of computer-based pulse wave analysis techniques. The PPG technology has been used in a wide range of commercially available medical devices for measuring oxygen saturation, blood pressure and cardiac output, assessing autonomic function and also detecting peripheral vascular disease. The introductory sections of the topical review describe the basic principle of operation and interaction of light with tissue, early and recent history of PPG, instrumentation, measurement protocol, and pulse wave analysis. The review then focuses on the applications of PPG in clinical physiological measurements, including clinical physiological monitoring, vascular assessment and autonomic function.

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Section: Neurologymentioning

confidence: 99%

Photoplethysmography and its application in clinical physiological measurement

2007

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“…Catecho-lamines and adrenocorticotrophic hormones assume a marked role in response to haem-orrhage [9,4]. Immediate post-haemorrhagic hyperthermia has been reported in previous studies in goats [14,20,21].…”

Section: Thermoregulation and Heart Rate (Hr)mentioning

confidence: 90%

“…The primary physiologic response to compensate for haemorrhagic shock is via the sympathetic nervous system; baroreceptors in the carotid sinus and chemoreceptors sense hypovolaemia and hypoxaemia, respectively [8]. Also, endocrine-mediated mechanisms help to maintain perfusion in shock; the release of catecholamines activates α 1 receptors in the peripheral vascular smooth muscle causing peripheral vasoconstriction [9]. Proportional increase in heart rate (HR) and a decrease in mean arterial pressure (MAP) have been reported in animals exposed to haemorrhage [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Thermoregulation and Haematological Responses to Induced Acute Haemorrhage in Adult Nubian Goats

Abdalla

Abdelatif

Omer

2019

JALSI

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Background and Objectives: Acute haemorrhage is a major cause of morbidity and mortality in surgery and trauma due to ischaemic lesions followed by multiple organ dysfunction. After haemorrhage, compensatory redistribution of blood volume may occur to more vital and survival organs. The objective of the study was evaluation of thermoregulation and haematological responses to acute haemorrhage in Nubian goats. Materials and Methods: The study used 6 female mature goats, weighing 18.0 kg on average. The goats were subjected to 40% bleeding. The rectal temperature (Tr), respiration rate (RR) and heart rate (HR) were monitored before bleeding and then immediately after bleeding and at 1,2,3,4,5,6,24 hrs post-bleeding. Venous blood samples were collected before and then immediately after bleeding and at 6, 24, 48, 72 hrs post-bleeding. The haemoglobin concentration (Hb), packed cell volume (PCV), total leukocyte count(TLC), differential leukocyte count (DLC), serum total protein, albumin, and concentrations of sodium (Na) were determined. Results: The post-bleeding values of Tr, RR and HR were significantly higher compared to the pre-bleeding values. The post-bleeding values of PCV, Hb concentration, erythrocyte count and TLC were lower compared to prebleeding values. The ratios of lymphocytes, monocytes and eosinophils decreased, whereas the neutrophil ratio increased post-bleeding. The values of serum total protein, albumin and serum Na concentrations decreased post-bleeding. Conclusion: The studies indicate that the goat can be adopted as a valid research model in investigations of experimental haemorrhage. The findings have implications in the fields of veterinary haematology and surgery and comparative medicine.

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“…It is well known that an intense redistribution of blood flow from non-vital organs to vital organs characteristically occurs in states of shock, causing peripheral hypoperfusion. ( 31 ) The peripheral hypoperfusion is generated by an increase in sympathetic-neurohumoral activity ( 31 , 32 ) and is associated with worse systemic perfusion and poor prognosis. ( 15 , 32 ) Since previous reports showed that the PI is a very sensitive method for assessing adrenergic responses, ( 33 , 34 ) the adrenergic stimulus (secondary to the sympathetic response to shock and to use of vasopressors) also becomes a direct hypothesis that could explain the relatively preserved peripheral vascular reactivity despite the peripheral hypoperfusion in the septic group: it implies the existence of a peripheral ischemic reserve in septic shock.…”

Section: Discussionmentioning

confidence: 99%

Perfusion index for assessing microvascular reactivity in septic shock after fluid resuscitation

Menezes¹,

Cunha²,

Júnior³

et al. 2018

Revista Brasileira De Terapia Intensiva

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ObjectiveMicrocirculation disturbances are implicated in the prognosis of septic shock. Microvascular hyporesponsiveness can be assessed by an oximetry-derived perfusion index and reactive hyperemia. Using this perfusion index, we investigated reactive hyperemia and its relationship with peripheral perfusion and clinical-hemodynamic parameters in septic shock.MethodsEighty-two patients were evaluated: 47 with septic shock and 35 controls. Tests were performed within 24 hours after admission. The perfusion index was evaluated before and after a 3-min blood flow occlusion using a time-response analysis for 5 min. The perfusion index was also evaluated in the hyperemic phases and was mainly derived by mechanosensitive (ΔPI0-60) and metabolic mechanisms (ΔPI60-120). Correlation tests were performed between reactive hyperemia and clinical-hemodynamic data.ResultsReactive hyperemia measured by the perfusion index was significantly lower in patients with septic shock, but this was only observed for the first 45 seconds after cuff-deflation. In the remaining period, there were no statistical differences between the groups. The peaks in the perfusion index were similar between groups, although the peak was reached more slowly in the septic group. Values of ΔPI0-60 were lower in shock [01% (-19% - -40%) versus 39% (6% - 75%); p = 0.001]. However, ΔPI60-120 was similar between the groups [43% (18% - 93%) versus 48% (18% - 98%); p = 0.58]. The time-to-peak of the perfusion index was correlated positively with the SOFA scores and negatively with C-reactive protein; the peak of the perfusion index was positively correlated with vasopressor doses; and the ΔPI60-120 values were positively correlated with C-reactive protein and vasopressor doses. No other significant correlations occurred.ConclusionsThis perfusion index-based study suggests that septic shock promotes initial peripheral vascular hyporesponsiveness and preserves posterior vascular reactivity to a considerable degree. These results demonstrate a time-dependent peripheral hyperemic response and a significant ischemic reserve in septic shock.

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Vascular Tone in Patients with Hemorrhagic Shock

Abstract: These data demonstrate that the Ev increases in hemorrhagic shock. Furthermore, normotensive hypovolemic conditions generated by persistent bleeding can be detected by measuring the Ev.

Cited by 9 publications

References 21 publications

Photoplethysmography and its application in clinical physiological measurement

Photoplethysmography and its application in clinical physiological measurement

Thermoregulation and Haematological Responses to Induced Acute Haemorrhage in Adult Nubian Goats

Perfusion index for assessing microvascular reactivity in septic shock after fluid resuscitation

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