Blood Vessels Of Neck Research Articles

Impact of radiological surveillance for major blood vessels on complications of percutaneous dilatational tracheostomy: A retrospective cohort study

PurposePercutaneous dilatational tracheostomy (PDT) is the preferred method for managing long-term ventilator-dependent patients in ICUs. This study aimed to evaluate the association between preprocedural screening (ultrasound Doppler [USD] or computed tomography [CT]) for major neck blood vessels and complications in ICU patients undergoing PDT. Materials and methodsThis was a retrospective cohort study of patients who underwent PDT between 2012 and 2023 at a tertiary referral center. We performed a multivariable analysis and created a propensity-matched cohort. The primary outcome was bleeding within the first seven days after PDT. Secondary outcomes included early and late PDT complications and PTD-related mortality. ResultsA total of 1766 consecutive critically ill patients hospitalized at a tertiary academic hospital were evaluated for PDT. Of these, 881 (49.9 %) underwent only physical examination before PDT, while 885 (50.1 %) underwent additional imaging (CT/USD). A higher proportion of patients in the imaging group were referred to open surgery due to suspected major blood vessels interfering with the procedure (6.2 % vs. 3.0 %, p = 0.001). Among the 1685 patients who underwent PDT, there was no significant difference in the rate of early bleeding between the physical examination group and the imaging group (4.6 % vs. 6.3 %, p = 0.12). Similarly, the overall early complication rates (5.5 % vs. 7.6 %, p = 0.08), late complication rates (1.6 % vs. 2.2 %, p = 0.42), and PDT-related mortality rates (0.7 % vs. 0.6 %, p = 0.73) did not exhibit significant differences between the two groups. In a propensity score-matched cohort, results remained consistent. ConclusionsPhysical examination can effectively identify major neck blood vessels without increasing the risk of bleeding during and after PDT.

Histomorphological study of tongue in Indigenous peacock (Pavo cristatus)

The current study aimed to examine the histomorphological features of the oral salivary ducts and the peacock tongue (Pavo cristatus) of this species. In this study, eight healthy adult peacocks were used after collecting them from a commercial market in Baghdad to investigate and describe the tongue in these bird species. After being euthanized, they were killed by cutting off the major neck blood vessels and bleeding until death; the tongue was identified. The tongue was the sharp end, elongated, somewhat triangular, and measured 8.2 mm. The apex, trunk, and base are its three sections. There are 4 to 5 layers of big conical papillae on the area where the root and body converge. Without gustatory papillae, the dense keratinized epithelium stratified squamous epithelia that lined the dorsal surface and were sparse on the ventral surfaces. The body and tongue root contain cells of the epithelium. It was supported by hyaline cartilage as a short plate. Lingual salivary glands situated anterior and posterior are superficial branch tubuloalveolar glands. This research was conducted at the University of Baghdad/ College of Veterinary Medicine in the Anatomy and Histology Department. Our result concluded that modifying the bird tongue, papillae distribution, and mucosa epithelium histological features is mainly restricted to feeding types that also have similarities with other avian species. Keywords: peacock, tongue, lingual papillae, keratinized epithelium

Death From Hanging ; A Case Report

The cause of death in cases of hanging is often due to pressure on the neck blood vessels, causing a lack of blood that carries oxygen to the brain. Because asphyxia is a process, overall in the body there will usually be general signs that are almost the same for all cases / causes. Asphyxia is a term often used to describe the cessation of effective respiration or absence of pulsation which is also used in all cases of hanging. By definitionAsphyxia is reduced oxygen saturation in the blood and tissues causing death. A case was reported to the Department of Forensic Medicine and Medicolegal Science FK USU from East Medan. A known corpse has been examined, male sex, circumcised, medium stature, body length 176 cm, tan skin color, straight hair, black mixed with gray hair. From the results of external and internal examinations, theory and the discussion above, it can be concluded thatthe cause of death of the victim was suffocation due to pressure on the neck due to the victims body weight which prevented air from entering the respiratory tract due to hanging. Review The medicolegal aspect of this case is due to ones own actions (suicide).

Human CSF movement influenced by vascular low frequency oscillations and respiration.

Cerebrospinal fluid (CSF) movement through the pathways within the central nervous system is of high significance for maintaining normal brain health and function. Low frequency hemodynamics and respiration have been shown to drive CSF in humans independently. Here, we hypothesize that CSF movement may be driven simultaneously (and in synchrony) by both mechanisms and study their independent and coupled effects on CSF movement using novel neck fMRI scans. Caudad CSF movement at the fourth ventricle and hemodynamics of the major neck blood vessels (internal carotid arteries and internal jugular veins) was measured from 11 young, healthy volunteers using novel neck fMRI scans with simultaneous measurement of respiration. Two distinct models of CSF movement (1. Low-frequency hemodynamics and 2. Respiration) and possible coupling between them were investigated. We show that the dynamics of brain fluids can be assessed from the neck by studying the interrelationships between major neck blood vessels and the CSF movement in the fourth ventricle. We also demonstrate that there exists a cross-frequency coupling between these two separable mechanisms. The human CSF system can respond to multiple coupled physiological forces at the same time. This information may help inform the pathological mechanisms behind CSF movement-related disorders.

STUDY ON HYPERTENSION-RELATED TARGET ORGAN DAMAGE IN ESSENTIAL HYPERTENSION PATIENTS WITH HYPOKALEMIA

Objective: To explore the early target organ damage in essential hypertension patients with hypokalemia,we nalysed ambulatory blood pressure, cardiac structure and function, early renal function, neck blood vessels and head imaging in patients with essential hypertension. Design and method: 590 patients with hypertension who were nalysedsed from January 2015 to June 2021 were selected, including 257 cases with hypokalemia and 76 cases have primary aldosteronism.Collect patients’ general information, biochemistry, urine routine, office blood pressure, 24 h ambulatory blood pressure monitoring.The results were statistically nalysed by SPSS. Results: Compared with the essential hypertension group,average systolic blood pressure during the day, average diastolic blood pressure during the day, average systolic blood pressure at night, and average diastolic blood pressure at night, 24 h average systolic blood pressure, 24 h average diastolic blood pressure, daytime systolic blood pressure load rate, night diastolic blood pressure load rate, 24 h systolic blood pressure load rate, and 24 h diastolic blood pressure load rate were significantly higher in both the hypokalemia group and the essential hyperaldosteronism group (P < 0.05). Urinary microalbumin in the primary hypertension with hypokalemia group and primary aldosteronism group was significantly higher than that in the primary hypertension group (P < 0.05).The 24 h average diastolic blood pressure, night systolic blood pressure load rate, and 24 h systolic blood pressure load rate were all positively correlated with urine microalbumin(P < 0.05); they were negatively correlated with serum potassium ion (P < 0.05). The nighttime mean systolic blood pressure and nighttime systolic pressure load rate were independently positively correlated with urine microalbumin (P < 0.05), and serum potassium ions were independently negatively correlated with urine microalbumin by Multiple linear regression analysis (P < 0.05). Conclusions: Essential hypertension patients with hypokalemia have higher 24 h blood pressure and blood pressure load rate, and have more serious early renal damage than patients with normal potassiumic Otherwise, Serum potassium concentration was an independent risk factor for urinary microalbumin in essential hypertension patients with hypokalemia

P14: Vibration-Mediated Endothelial Cell-Platelet Interaction: A Thrombotic Risk Factor in Obstructive Sleep Apnea and Beyond

Background: Obstructive sleep apnea (OSA) is an independent risk factor for thrombotic stroke. OSA stroke is felt to be driven by hypoxia and post apneacatecholamine surge, leading to platelet activation and thrombosis. OSA is also associated with significant snoring and related neck vibration. In our work related to thrombogenicity of mechanical circulatory support (MCS) devices we demonstrated that device vibration and related shear are biomechanical activators of platelets. Recently we showed that snore-associated vibration is platelet activating. As OSA snore, vibration is imparted to major neck blood vessels, i.e. carotid and jugular, and activated platelets interact with vessel endothelial cells, the effect of vibration on endothelial thrombogenicity warrants further definition. Methods: OSA snore recordings were obtained from the human sleep lab. A speaker-platform device, validated to generate snore neck vibrations, was fabricated (snore emulator). Human umbilical vein endothelial cells (HUVECs) grown on petri dishes, placed on the emulator and exposed to snore vibrations for 4,8,12, 24,or 36 hours at 37oC., non-vibration cultures serving as controls. HUVEC viability (LDH assay) and platelet adhesion (inactivated platelets bound, measured via scanning EM) were serially assessed. Results: HUVEC exposed to snore vibration remained viable, though with a progressive decline in viability vs control, i.e. a 28.9% and 46.5% reduction at 24h and 36h, respectively (p<0.05). Interestingly, vibration led to a disproportionally greater increase in thrombogenicity, with net platelet adhesion increasing by 64% and 86% at 24h and 36h respectively (p<0.05) Conclusion: Vibration, as a general biomechanical stimulus, previously demonstrated to increase platelet activation, also leads to endothelial dysfunction, including loss of viability, with an even greater increase in endothelial thrombogenicity. Further definition of vibration-mediated endothelial dysfunction has implication for developing translational therapeutics for OSA, as well as providing insight for endothelial-contacting therapeutic device design.

Electromagnetic simulation for diagnosing damage to femoral neck vasculature: A feasibility study

BackgroundFemoral neck fractures are common injuries managed by orthopedic surgeons across the world. From pediatrics to geriatrics, disruption of the blood supply to the femoral neck is a well-recognized source of morbidity and mortality, oftentimes resulting in avascular necrosis of the femoral head. This devastating complication occurs in 10–45% of femoral neck fractures. Therefore, it is vital for orthopedic surgeons provide efficient treatment of this injury, in order to optimize the patient's potential outcome and prevent long-term sequelae. MethodsIn this study, the anatomy of the proximal femur, including femoral metaphysis, femoral neck, vasculature, and femoral head, were simulated in COMSOL Finite Element Analysis (FEA) software. Electric fields were generated in a fashion that exploited disruptions within the vasculature of the femoral neck. This study was aimed at developing an alternative imaging modality for narrowing or disrupting the femoral neck's vasculature. The variables used for investigation included: frequency, penetration depth, and magnitude of the electrical energy. These variables, when combined, allowed for enhanced simulated visualization of the vasculature of the femoral neck and theoretically expedited diagnosis of obvious, or occult, femoral neck injury. ResultsSimulated blood vessels were developed in two-dimensions: the phi direction (circular), and z-direction. Two different frequencies, 3 GHz, and 5 GHz were considered, with 100-J energy pulses within blood vessels of 2.54 mm in diameter. The fat surrounding the bone to the outside surface body was simulated at 0.25 inch (0.65 cm). An additional model, with layered fat and skin above the vessels, was simulated at 2000J and successfully able to visualize the femoral neck's blood vessels. Results showed a distinguished E field across the blood boundary of nearly 170 V/M. ConclusionsThe electric field simulation data within the Phi and Z directions promises the feasibility of a subsequent practical model.

MOLECULAR STUDIES OF THE EFFECTS OF THE ANTIVIRAL DRUG, OSELTAMIVIR (TAMIFLU), ON THE DNA OF THE TESTES’ CELLS AND THE LEUCOCYTES OF THE MALE ADULT ALBINO RATS

The present study was designed to evaluate the possible induced molecular damage on the DNA of the testes’ cells and leucocytes, after the oral administration of oseltamivir phosphate tamiflu, which is used as anti-influenzal drug. Forty male adult albino rats (Rattus norvegicus) were used in this study. The testes were the organ of choice in the present work since the drug’s effects on the male reproductive system has gained increasing importance over the past two decades, in addition to the leucocytes. The therapeutic scheme, minimum and maximum protective schemes of tamiflu applied to humans were converted to their correspondents in the rats. The rats were divided into 4 groups, 10 rats in each group, as follows: Group I: Negative control group. Group II: The rats were given the therapeutic scheme (1.35 mg/kg) of tamiflu twice/day for 5 consecutive days. Group III: The animals were given the short-term prophylactic scheme of tamiflu (1.35 mg/kg, once/day for 10 days), and Group IV: The rats treated with the long-term prophylactic scheme of tamiflu (1.35 mg/kg, once/ day for 45 days). The rats in the afore-mentioned groups were killed one day after the last dose by severing the neck blood vessels and the testes were dissected out and cut into pieces and were prepared for DNA gel electrophoresis. Besides, heparinized blood samples were collected immediately for the study by using the Comet assay.

Stereoscopic (3D) Visualization Improves Medical Student Comprehension of Head and Neck Vascular Anatomy

The use of 3D stereoscopic models (3DSM) of head and neck blood vessels in anatomy education has not been studied in detail. We investigated whether 3DSM created from a prior study (Cui et al. 2015) would improve student learning of head and neck vascular anatomy. Comparisons were made between the use of 3DSM and identical but 2D flat screen images extracted from the 3D models in a first year medical gross anatomy course. Anatomical knowledge was tested via pre‐ and post‐learning session anatomy knowledge tests. In addition student fluency with mental rotation (pre‐ and post‐session rotation tests.) Results were analyzed using a Wilcoxon rank‐sum test and linear regression analysis. A total of 39 first year medical students participated in the study. Baseline pre‐learning session test scores were equivalent, 5.85±2.37 and 5.03±1.93 for 3DSM and 2D groups respectively. Students who utilized the 3DSM (n=21) scored significantly higher on the post‐learning tests compared to those using 2D images (n = 18) (11.43±2.79 vs 8.75±2.81) (p =0.0033). There was no significant difference on the mental rotation test scores between 3DSM (17.29±5.36) and 2D groups (17.39±6.42) after learning sessions (p=0.6208). In summary, the use of virtual stereoscopic 3D models improved medical student performance on knowledge tests of head and neck vascular anatomy, suggest new avenues for the use of virtual models in medical education.Support or Funding InformationFaculty Scholarship Exchange Award

Parameters of ocular hydrodynamics in case of major neck blood vessels compression by thyroid nodules

to study aqueous humor secretion and outflow in patients, whose major blood vessels of the neck got compressed by thyroid nodules. Ocular hydrodynamics was assessed in 60 patients (119 eyes) with uni- or bilateral benign thyroid nodules compressing the major neck blood vessels. Most patients demonstrated a significant decrease in parameters of aqueous humor secretion and outflow. After decompression, ocular hydrodynamics usually improved reaching its normal level. Compression of the major neck blood vessels by thyroid nodules impedes drainage of the aqueous humor and serves as a risk factor of secondary phlebohypertensive glaucoma.

Characteristics of the venous drainage of the central nervous system in patients with multiple sclerosis

In this clinical observational study 157 patients with MS, without disease modifying therapy, and 56 healthy participants were included. The ulstasonographic examination of the neck blood vessels and deep brain veins was performed. Insufficient drainage was defined by presence of: chronic cerebrospinal vein insuficiency; and/or segmental stenosis of internal jugular vein; and/or reflux in internal jugular vein during Valsalva maneuvre. In the patient group we determined: course of the disease, functional disability determined by EDSS (Expanded Disability Status Scale), disease progression determined by MSSS (Multiple Sclerosis Severity Score). Frequency of at least one of the phenotypes was significantly higher in patients with secundary progressive compared to patients with relapsing–remitting course. Mean values of EDSS and MSSS were significantly higher in patients with at least one of investigated phenotypes compared to patients without the presence of these phenotypes. Insufficient venous drainage of central nervous system (CNS) was significantly more frequent in patients with longer duration of disease, higher grade of functional disability and secondary progressive form of MS.

“Hanging Donors”: Are We Still Skeptical About the Lungs?

BackgroundSuicidal hanging may cause compression of the neck blood vessels and the airway leading, to hypoxic brain damage caused by cerebral ischemia and respiratory distress. Hanging engenders global tissue hypoxia, particularly affecting the lungs as the result of pulmonary edema and barotrauma. There is scant evidence about outcomes of transplantation with the use of lungs from “hanging donors.” This study evaluates the outcomes of lung transplantations (LTx) that use organs from this group. MethodsWe retrospectively analyzed lung “organ offers” and LTx at our center between January 2007 and November 2013. The outcomes of LTx with lungs from donors with hanging as the cause of death (“hanging group”) were compared with those with donors having other causes of death (control group), with the use of an unadjusted model as well as propensity score matching. ResultsLTx (n = 302) were performed during this period and were grouped on the basis of the cause of death in donors: the hanging group (n = 8) and the control group (n = 294). No statistically significant difference was found in the donor characteristics except for the incidence of cardiac arrest, which was significantly higher in hanging donors. Preoperative characteristics in recipients in both groups were comparable. Intra-operative and post-LTx variables including PaO2/FiO2 ratios, duration of mechanical ventilation, and intensive care unit and hospital stays were comparable. One-year and 3-year survival rates were also comparable in both groups. Two recipients in the hanging group required extracorporeal life support after LTx and could not survive. ConclusionsSuicidal hanging is a relatively rare cause of death for potential organ donors. Because it does not appear to negatively affect outcomes after LTx, it should not be considered per se a contraindication for lung donation. A word of caution is necessary until we gather larger experience with lungs from hanging donors.

Is it Safe to Use Lungs from 'Hanging Donors' for Transplantation?

Objectives: Suicidal hanging may cause compression of the neck blood vessels and the airway leading to hypoxic brain damage due to cerebral ischemia and respiratory distress. Hanging, in addition to global tissue hypoxia, affects particularly the lungs due to pulmonary edema and barotrauma. There is little evidence in literature about outcomes of transplantation utilizing the lungs from 'hanging donors'. This study evaluates the outcome of lung transplantation (LTx) utilizing organs from this group. Methods: Retrospective analysis of lung offers and LTx between 01.2007 and 11.2013 with hanging as cause of death was performed. The outcomes of LTx utilizing the lungs from donors with hanging as cause of death (hanging group) were compared with those with donors with other causes of death (control group) using unadjusted model as well as propensity score matching. Results: 302 LTx were performed during this period and were grouped depending on the cause of death in donors - hanging group (n = 8) and control group (n = 294). To minimize the potential effects of selection bias on patient characteristics, we performed an additional analysis using one-to-three propensity score matching with 32 patients remaining for the analysis. The matching was performed based on donor and recipient characteristics which were statistically different between the two groups in the unadjusted analysis: presence of cardiac arrest and recipient age. Additionally, further clinically important variables such as donor gender, age, type of donation (DBD/DCD), and utilization of EVLP as well as recipient gender and primary diagnosis were used for calculation of propensity scores. After propensity score matching, there were no statistically significant differences in PaO2/FiO2 ratio on arrival at ICU as well as 24, 48 and 72 hours postoperatively. Ventilation duration, ICU and hospital length of stay, need for postoperative ECMO and incidence of BOS were also similar between 'hanging' and control group. Overall cumulative survival was not statistically different with 85.9% versus 75% in control and 'hanging' group, respectively (Log Rank (Mantel-Cox) p = 0.368) at 1 year which was continued at 3 years. Conclusions: Suicidal hanging is a relatively rare cause of death for potential organ donors. As it does not seem to negatively affect outcomes after LTx, it should not be considered as a contraindication for lung donation by itself.

Intravascular Papillary Endothelial Hyperplasia: Diagnostic Sequence and Literature Review of an Orofacial Lesion

Intravascular papillary endothelial hyperplasia or Masson's tumor is a rare reactive disease of vascular origin characterized by exuberant proliferation of endothelial cells notably occurring within blood vessels of head, neck, and extremities. The importance of this entity is its ability to mimic a variety of diseases both benign and malignant in the orofacial region. Here, we present a case of Masson's tumor within the masseter muscle in a 40-year-old female with emphasis on the sequential investigative procedures performed to diagnose this entity.

Hyperlipidemia as a risk factor for persons in specific professions.

Introduction:The increase in lipid levels associated with other risk factors for the occurrence of ischemic heart disease and stroke is one of the most important health problems in the world. Risk for development of changes is greater for people of specific occupations such as police officers.Material and methods:This prospective study included 300 police officers, 150 as experimental and 150 respondents as a control group. To both groups same methods have been applied: A detailed history, physical examination, complete laboratory evaluation, lipid electrophoresis targeted to hypercholesterolemia, ultrasound of the abdomen and Color Doppler of the neck vascular structures. The results obtained by statistical analysis of the data showed that there was a significant increase in levels of cholesterol and triglyceride levels in experimental compared to the control group. Ultrasound of the abdomen showed fatty infiltrated liver in 16% of respondents from the experimental and 2% of the respondents in the control group 2%. Color Doppler of the neck blood vessels in 14% of respondents from experimental group showed changes in blood vessels, which ranged from mild thickening of the intima of the vessel to a 50% decrease in circulation. For the control group, this percentage was 0.66%. Considering that this study involved young, active working population, hyperlipidemia becomes a bigger problem.

SASOP Biological Psychiatry Congress 2013 Abstracts

SASOP Biological Psychiatry Congress 2013 Abstracts

Perfusion computed tomography relative threshold values in definition of acute stroke lesions

BackgroundPerfusion computed tomography (CT) is a relatively new technique that allows fast evaluation of cerebral hemodynamics by providing perfusion maps and gives confirmation of perfusion deficits in ischemic areas. Some controversies exist regarding accuracy of quantitative detection of tissue viability: penumbra (tissue at risk) or core (necrosis).PurposeTo define brain tissue viability grade on the basis of the perfusion CT parameters in acute stroke patients.Material and MethodsA multimodal CT imaging protocol; unenhanced CT of the brain, CT angiography of head and neck blood vessels, followed by brain perfusion CT and 24 h follow-up brain CT was performed. Perfusion deficits were detected first visually, with subsequent manual quantitative and relative measurements in affected and contra-lateral hemisphere in 87 acute stroke patients.ResultsVisual perfusion deficit on perfusion CT images was found in 78 cases (38 women, 40 men; mean age, 30–84 years). Penumbra lesions (n = 49) and core lesions (n = 42) were detected by increased mean transit time (MTT) on perfusion CT maps in comparison to contra-lateral hemispheres. Cerebral blood volume (CBV) mean values in the penumbra group were increased in the penumbra group and decreased in the core group. Cerebral blood flow (CBF) values were decreased in penumbra and markedly decreased in core lesion.ConclusionPerfusion CT measurements are reliable in estimation of penumbra and core lesions in acute stroke patients, if relative threshold values are used. The most accurate parameter of hypoperfusion is increased MTT above 190%. Relative threshold values for irreversible lesion are CBF <30–40% and CBV <40% in comparison to contra-lateral hemisphere. Penumbra lesion is characterized by MTT increase and CBF decrease, while CBV shows variable values.

Computed tomography perfusion measurements for definition of lesions in early acute stroke

Background: Perfusion computed tomography (CT) is an evolving technique in the diagnosis of acute stroke. After complex deconvolution algorithms, perfusion color maps-cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT)— are produced, they give visual confirmation of perfusion deficit in ischemic area, but some discrepancies exist regarding this technique in reliability of quantitative detection of tissue viability: penumbra (tissue at risk) that surrounds core (necrosis). Purpose: The purpose of this prospective study was to define brain tissue viability grade on the basis of the perfusion CT parameters in acute stroke patients. Material and Methods: Multimodal CT imaging protocol (unenhanced CT of the brain, CT angiography of head and neck blood vessels, followed by brain perfusion CT and 24 hours follow-up brain CT) was performed. Perfusion deficit was detected first visually, with subsequent manual quantitative and relative measurements in affected and contra-lateral hemisphere in 87 patients. Results: Visual perfusion deficit on perfusion CT images was found in 78 cases (38 female, 40 male; mean age 30 - 84 years): penumbra lesion (n = 49) and core lesion (n = 42). Both lesion types were detected by increased MTT on perfusion CT map, penumbra area showed mean values 202.40% (113% - 345% ± 57.17) and core (41% - 320% ± 64.53) in comparison to contra-lateral hemisphere. CBV mean values in penumbra group were increased up to 113.10% (45% - 276% ± 36.29) and in core decreased till 41.82% (3% - 107% ± 27.09). CBF values were decreased up to 65.63% (31% - 137% ± 22) in penumbra lesion and markedly decreased till 25.94% (4% - 79% ± 17.35) in core. Conclusion: Our study shows that perfusion CT measurements relative threshold values are recommended in definition of penumbra and core lesions in acute stroke patients.

Away from Home

Journal of Palliative MedicineVol. 15, No. 12 Personal ReflectionAway from HomeRichard J. LinRichard J. LinSearch for more papers by this authorPublished Online:3 Dec 2012https://doi.org/10.1089/jpm.2012.0234AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Away from Home." , 15(12), pp. 1392–1393FiguresReferencesRelatedDetails Volume 15Issue 12Dec 2012 InformationCopyright 2012, Mary Ann Liebert, Inc.To cite this article:Richard J. Lin.Away from Home.Journal of Palliative Medicine.Dec 2012.1392-1393.http://doi.org/10.1089/jpm.2012.0234Published in Volume: 15 Issue 12: December 3, 2012PDF download

Dimension and overlap of femoral and neck blood vessels in neonates

Neonates frequently require access to their central blood vessels. However, limited data exist relating to the size and the anatomical relation of the femoral and neck vessels for neonates of different postmenstrual ages. 1) The size of central blood vessels increases with postmenstrual age of the neonate. 2). External rotation with abduction at the hip will decrease the degree of overlap between the femoral artery and vein. 3) The degree of overlap decreases with increasing postmenstrual age. Prospective descriptive cohort study. Femoral and neck vessel sizes were assessed using ultrasound for three postmenstrual age groups: group A (26 ± 1 wks), group B (32 ± 1 wks), and group C (38 ± 1 wks). The degrees of overlap (major, >50% overlap; minor, ≤50% overlap; no overlap) between the femoral vessels were assessed at the level of the inguinal ligament and 1 cm below the inguinal ligament in a straight hip and in external rotation with abduction of the hip positions. A total of 52 nonconsecutive subjects (group A, seven; group B, 21; group C, 24) were studied. The mean blood vessel dimensions increased with increasing postmenstrual age. Correlation of blood vessel size to growth measurements was better in group A + group B compared to group C. Overlap between the femoral vein and the femoral artery across the neonatal age groups at the level of the inguinal ligament ranged from 57% to 79% and from 43% to 98% at 1 cm below the inguinal ligament. The degree of overlap did not decrease with positioning of the lower extremity in external rotation with abduction of the hip. In the neck blood vessels, the majority of observations showed either minor or major overlap of neck blood vessels in all three groups (group A, 79%; group B, 86%; group C, 90%). Central blood vessel size increases with increasing postmenstrual age. Correlation of blood vessel size to anthropometric measurements was better in the premature neonates compared to term neonates. A high degree of overlap exists within the femoral and cervical blood vessels. In the femoral vessels, the degree of overlap did not decrease with external rotation with abduction of the hip at any postmenstrual age.