Whole Body Oxygen Consumption in Awake, Sleeping, and Anesthetized Dogs

Mikat, Marianne; Zindler, M.; Arndt, J. O.

doi:10.1097/00000542-198403000-00009

Cited by 42 publications

(12 citation statements)

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“…At this stage the CI is already significantly increased, and SVR is already decreased. Initial pressures measured under general anesthesia might have been underestimated because general anesthesia causes a reduction of cardiac output, SVR, RAP and WPAP (18)(19)(20). However, because all patients were their own controls, it is unlikely that this underestimation would have significantly distorted intraoperative hemodynamic changes.…”

Section: Tipsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt worsens the hyperdynamic circulatory state of the cirrhotic patient: Preliminary report of a prospective study†

et al. 1994

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The aim of this prospective nonrandomized study was to assess the immediate and short-term sequelae of transjugular intrahepatic portosystemic shunting on the circulatory hyperdynamic state of the cirrhotic patient. Twelve transjugular portosystemic shunting procedures were performed in 12 cirrhotic patients for sclerotherapy failure (10 cases) and/or intractable ascites (4 cases). Self-expandable stents 10 mm in diameter were used in all cases. Portal pressure measurement and right-heart catheterization were performed before and 30 min and 1 mo after the procedure. The portoatrial pressure gradient decreased from 15 +/- 3 to 7 +/- 3 mm Hg 30 min after surgery (p < 0.0001) to 8 +/- 3 mm Hg 1 mo after surgery (p < 0.001, in comparison with basal values). The cardiac index increased from 4.5 +/- 1.3 to 5.7 +/- 1.5 L/min.m2 30 min after surgery (p < 0.001) to 7.4 +/- 1.4 L/min.m2 1 mo after surgery (p < 0.001). Systemic vascular resistance decreased from 808 +/- 323 to 646 +/- 209 dyne.sec.cm-5 30 min after surgery (p < 0.01) to 467 +/- 101 dyne.sec.cm-5 1 mo after surgery (p < 0.05). This study demonstrates that transjugular portosystemic shunting rapidly and significantly worsens the hyperdynamic circulatory state of the cirrhotic patient. Although apparently noninvasive, this procedure should be considered with caution in cirrhotic patients with limited cardiac reserve.

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Section: Tipsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt worsens the hyperdynamic circulatory state of the cirrhotic patient: Preliminary report of a prospective study†

et al. 1994

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“…Effect of anesthetics on critical oxygen delivery 27,57,58. Effect of anesthetics on oxygen consumption 15,57,59. …”

mentioning

confidence: 99%

Comparative cardiovascular and pulmonary effects of sedatives and anesthetic agents and anesthetic drug selection for the trauma patient

Haskins

2006

J Vet Emergen Crit Care

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Objective: To integrate and compare the effects of tranquilizer/sedatives and anesthetic drugs on various parameters of cardiovascular function in normal dogs and in dogs stressed by hypovolemia, anemia, and endotoxemia, and to discuss the relative merits and appropriate precautions of anesthetic drugs with respect to specific patient physiologic complications. Data sources: Personal data and experiences in conjunction with veterinary and human clinical and research studies. Human and veterinary data synthesis: Drugs that produce calming, sedation, muscle relaxation, analgesia, and loss of consciousness have the potential to produce marked cardiorespiratory effects particularly in hemorrhaged, hypovolemic‐traumatized animals. Acute but key cardiovascular components that are affected by sedative and anesthetic drugs include heart rate and rhythm, venous return (preload), systemic vascular resistance (afterload), and myocardial contractile (inotropic) and relaxation (lusitropic) properties. In addition, all sedative and anesthetic drugs alter or depress normal baroreceptor reflex activity, thereby inhibiting or eliminating the animal's normal physiologic response to decreases in arterial blood pressure and predisposing to tissue hypoperfusion, decreased oxygen delivery, and oxygenation. Oxygen delivery needs to be adequate to meet the metabolic (oxygen) requirements of the patient. Decreases in oxygen delivery to tissues increases oxygen extraction, thereby maintaining tissue oxygenation (supply‐independent oxygen consumption phase) until compensatory processes reach their limit and any further decrease in oxygen delivery causes a decrease in oxygen consumption (supply‐dependent oxygen consumption phase). The critical oxygen delivery that defines the transition between these 2 phases is generally higher in the anesthetized state than in the awake state. The effect of anesthetics on critical oxygen delivery at comparable anesthetic dosages is pentobarbital=ketamine>alfentanil>etomidate=propofol>inhalational anesthetics. Anesthetics generally decrease oxygen consumption from the awake, baseline state; exceptions are ketamine and ether. Ketamine, however, increases oxygen delivery and oxygen extraction. Conclusions: The transition from the awake to the anesthetized state is a huge imposition on the physiology of animals and, therefore, should be accomplished with great care and proper vigilance. Rapid, ‘crash’ induction of anesthesia should be avoided in hypotension‐prone animals and slow, prolonged induction should be avoided in animals with respiratory disorders. It is not recommended to implement an unfamiliar protocol in critical patients, even if it might be pharmacologically preferable. Familiarity with an anesthetic drug is a very important reason for its selection.

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“…At rest, the brain normally consumes about 3 mmol of oxygen/min to peform its work; ion pumping, which accounts for 50-60% of this work [6], declines under the influence of anesthesia or sedation [8] and in conditions where confusion or coma are prominent features, e.g., in diabetic ketoacidosis (DKA) [5].…”

Section: Organs and Biologic Workmentioning

confidence: 99%

Rate of Production of Carbon Dioxide in Patients with a Severe Degree of Metabolic Acidosis

Kamel¹,

Richardson²,

Goguen³

et al. 1993

Nephron

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Whole Body Oxygen Consumption in Awake, Sleeping, and Anesthetized Dogs

Cited by 42 publications

References 0 publications

Transjugular intrahepatic portosystemic shunt worsens the hyperdynamic circulatory state of the cirrhotic patient: Preliminary report of a prospective study†

Transjugular intrahepatic portosystemic shunt worsens the hyperdynamic circulatory state of the cirrhotic patient: Preliminary report of a prospective study†

Comparative cardiovascular and pulmonary effects of sedatives and anesthetic agents and anesthetic drug selection for the trauma patient

Rate of Production of Carbon Dioxide in Patients with a Severe Degree of Metabolic Acidosis

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