Mean Arterial Pressure Research Articles

A bundle to prevent postinduction hypotension in high-risk noncardiac surgery patients: the ZERO-HYPOTENSION single-arm interventional proof-of-concept study.

A bundle to prevent postinduction hypotension in high-risk noncardiac surgery patients: the ZERO-HYPOTENSION single-arm interventional proof-of-concept study.

Correlation between maternal hemodynamic and sFlt-1/PlGF ratio in pregnancies affected by hypertensive disorders and fetal growth restriction.

Correlation between maternal hemodynamic and sFlt-1/PlGF ratio in pregnancies affected by hypertensive disorders and fetal growth restriction.

A single-blind, randomized, controlled contingency management trial on physiological indices and biomarkers of cardiovascular health in people with cocaine use disorder.

A single-blind, randomized, controlled contingency management trial on physiological indices and biomarkers of cardiovascular health in people with cocaine use disorder.

Effect of Dexmedetomidine on Cerebrovascular Carbon Dioxide Reactivity During Pediatric Cardiac Surgery With Cardiopulmonary Bypass.

Effect of Dexmedetomidine on Cerebrovascular Carbon Dioxide Reactivity During Pediatric Cardiac Surgery With Cardiopulmonary Bypass.

Associations between time spent in sedentary behaviors and metabolic syndrome risk in physically active and inactive European older adults.

To determine how clustered metabolic risk based on a validated continuous metabolic syndrome risk score is associated with objectively assessed time in sedentary behaviors (SB) in physically active and inactive older adults, while considering adherence to healthy eating habits. Cross-sectional study SETTING AND PARTICIPANTS: The study comprises 871 community-dwelling older adults (age 65-79 years) recruited from four European countries. Daily times spent in SB and physical activity (PA) were assessed by accelerometers (Actigraph GT3X) for a week. Waist circumference, triglycerides, HDL-cholesterol, mean arterial blood pressure, fasting glucose and insulin were determined, and a continuous metabolic syndrome risk score (cMSy) was generated using principal component analysis. Healthy eating habits were assessed by food record. General linear models stratified by adherence to PA guidelines (active/inactive) were used to examine differences in cMSy across tertiles of time in SB (Low, Medium, High) with adjustment for covariates, including healthy eating habits. A significantly (p < 0.05) lower cMSy was observed among older adults in the low SB tertile compared to medium and high SB tertiles, with no difference between the latter tertiles. The favorable effect of low amounts of SB on cMSy was indicated in both active and inactive groups, and regardless of healthy eating habits. Further, being active was related to a more favorable cMSy across all SB tertiles. Low amounts of time spent in SB are related to a lower metabolic syndrome risk regardless of adherence to PA guidelines and healthy eating habits in older adults, supporting guidelines targeting limited amounts of SB alongside engagement in moderate-to-vigorous PA for promotion of metabolic health.

Multisystem hemodynamic effects of terlipressin in cirrhosis: A scoping review.

Multisystem hemodynamic effects of terlipressin in cirrhosis: A scoping review.

Non-invasive monitoring of microcirculation dynamics in hypovolemic shock: a novel application of diffuse correlation spectroscopy

Abstract Background Microcirculatory dysfunction is a poor prognostic indicator for the management of critically ill patients, highlighting the need for the development of appropriate assessment methods. Current microcirculatory parameters are often indirect, invasive, or lack immediacy and continuity, with no standardised markers for critical care. Diffuse correlation spectroscopy (DCS), a near-infrared optical technique, facilitates the non-invasive real-time monitoring of microvascular dynamics via the blood flow index (BFI). However, the relationship between BFI and conventional microcirculatory parameters in hypovolemic shock remains unclear. This study examined the utility of DCS in assessing the microcirculation during hypovolemic shock in a canine model. Methods Six male beagle dogs underwent controlled blood withdrawal to induce hypovolemic shock, defined as a ≥ 30% decrease in cardiac output (CO) and mean arterial pressure (MAP) &lt; 60 mmHg or systolic arterial pressure (SAP) &lt; 90 mmHg. BFI was measured using a DCS device attached to the skin of the forelimb. From baseline to blood withdrawals followed by transfusions, changes in BFI were compared with microcirculatory parameters, mixed venous oxygen saturation (SvO₂), core-to-skin temperature gradient (ΔT), veno-arterial difference in partial pressure of carbon dioxide (PCO₂ gap), and serum lactate. Correlation and receiver operating characteristic (ROC) analyses were performed to determine the cut-off value of relative BFI for predicting whether lactate levels exceeded 22.5 mg/dL. Results Blood withdrawal resulted in significant reductions in BFI, CO, and radial artery blood flow, with the corresponding deteriorations in the ΔT, SvO₂, and PCO2 gap and lactate levels. BFI showed significant correlations with ΔT (correlation coefficient [CC] = − 0.48, 95% confidence interval [CI] − 0.69 to − 0.18, p &lt; 0.01), SvO₂ (CC = 0.67, 95% CI 0.43 to 0.81, p &lt; 0.01), and PCO2 gap (CC = − 0.63, 95% CI − 0.79 to − 0.39, p &lt; 0.01). ROC analysis identified a relative BFI threshold of 35.5% of the baseline for predicting elevated lactate levels, with 62% sensitivity and 100% specificity (AUC = 0.75). Conclusions Blood flow index measured by DCS reflects peripheral perfusion changes and is significantly correlated with clinical parameters during blood withdrawal and transfusion, highlighting its potential for non-invasive, continuous microcirculation monitoring in hypovolemic shock.

Sympathetic reactivity to emotional stress in women with major depressive disorder.

Sympathetic reactivity to emotional stress in women with major depressive disorder.

The effects of rhythmic handgrip exercise on muscle sympathetic nerve activity: A systematic review and meta-analysis.

The effects of rhythmic handgrip exercise on muscle sympathetic nerve activity: A systematic review and meta-analysis.

18β-glycyrrhetinic acid improves pulmonary hypertension by regulating the vascular non-inflammatory molecule-1/L-arginine/nitric oxide signaling pathway.

18β-glycyrrhetinic acid improves pulmonary hypertension by regulating the vascular non-inflammatory molecule-1/L-arginine/nitric oxide signaling pathway.

The effects of hypnosis and music intervention on comfort and anxiety during weaning from mechanical ventilation: A pilot study.

The effects of hypnosis and music intervention on comfort and anxiety during weaning from mechanical ventilation: A pilot study.

Anesthetic Management for Endovascular Repair of the Thoracic Aorta.

Anesthetic Management for Endovascular Repair of the Thoracic Aorta.

MiR-145-enriched BMSCs-derived exosomes ameliorate neurogenic erectile dysfunction in aged rats via TGFBR2 inhibition.

miR-145-enriched BMSCs-derived exosomes ameliorate neurogenic erectile dysfunction in aged rats via TGFBR2 inhibition.

Predictors of postoperative acute kidney injury in robotic-assisted pulmonary lobectomy.

e20090 Background: Acute Kidney Injury (AKI) has been extensively documented as a predictor of poor perioperative outcomes in thoracic surgery [1,2]. Even minor increases in creatinine are associated with longer hospital stays, mechanical respiratory ventilation, progression to chronic kidney disease, and even postoperative mortality. Here we explore the predictive factors of AKI for patients who undergo robotic-assisted pulmonary lobectomy (RAPL). Methods: We retrospectively analyzed 797 patients who underwent RAPL by one surgeon over a 13-year period. We define AKI using the modified Kidney Disease Improving Global Outcomes (KDIGO) definition [3] of an increase in serum creatinine of at least 0.3 mg/dL within 48 hours after surgery when compared to values collected within 30 days of preoperatively. Those with end-stage renal disease prior to lobectomy were excluded. Differences in demographics, preoperative comorbidities, and intraoperative data between the AKI and non-AKI cohorts were compared using chi-square tests of independence and multivariate logistic regression. Results: Demographic predictors of AKI include older age (p=0.043), male sex (p=0.013), and higher BMI (p=0.002). Preoperative hypertension (p=0.005) and diabetes mellitus (p=0.010) were also significant risk factors. However, there was no significant difference in the Charles Comorbidity Index (CCI) between AKI and non-AKI cohorts (p=0.055). Additionally, preoperative CKD (p=0.410), CHF (p=1.000), and smoking history (p=0.295) did not significantly affect risk of AKI. Intraoperative predictors included longer operative time (p=0.013), intraoperative blood loss (p &lt; 0.001), and presence of surgical complications (p=0.049). There was no difference in lowest intraoperative mean arterial pressure (p=0.656) or total intraoperative fluid balance (p=0.525). After adjusting for significant variables, estimated blood loss remained the only independent predictor of AKI (p=0.007). Conclusions: Our data suggests that patients without outright CKD, but with significant risk factors, develop postoperative AKI and should be monitored closely. Secondly, this risk may not be fully captured by CCI, which does not include hypertension and BMI. We should also note the importance of minimizing intraoperative blood loss, which is the strongest predictor for AKI.

Assessing Hypertension Management in Peru's Peri-Urban Community in the Wake of the COVID-19 Pandemic.

Assessing Hypertension Management in Peru's Peri-Urban Community in the Wake of the COVID-19 Pandemic.

I-Gel as an Alternative to Endotracheal Tube in Gynecologic Laparoscopic Surgeries: A Comparative Study

Background: Endotracheal Tube (ETT) intubation with rigid laryngoscopy evokes significant hemodynamic changes. Therefore, it is crucial to find an alternative for specific conditions like an irritative airway. For this purpose, the safety and efficacy of I-gel in gynecologic laparoscopic surgeries was examined. Methods: This clinical trial was conducted at Al-Zahra Hospital affiliated with Guilan University of Medical Sciences (GUMS) from July 2023 to May 2024. Eligible women, aged 18 to 55 years, ASA class I and II, were randomly divided into two groups of I-gel and ETT. Hemodynamic status, ease of device placement, ventilation parameters and complications were compared between the two groups. Results: Finally, the data from 92 women were analyzed. In terms of patients’ demographic data (p&gt;0.05), surgery duration (p=0.730), surgeons’ satisfaction (p=0.655), airway pressure (p=0.804), leak volume (p=0.430), ETCO2 values (p=0.957) and side effects (p&lt; 0.05), the results showed no significant difference between the two groups. Easy insertion was observed among 80.4% of the patients in I-gel group and in 93.5% in ETT group (p=0.063). Regarding the hemodynamic parameters, including Heart Rate (HR) and Mean Arterial Pressure (MAP) values, the difference was not significant in any of the measurement times (p&lt; 0.05). Conclusion: I-gel could be suggested as a safe alternative to ETT in special conditions in laparoscopic surgeries.

Enhanced Blood Warmer Regulation with Temperature Based on Fuzzy Logic

Abstract: Blood is a biological liquid that travels through the bloodstream of all humans and animals and distributes important substances, such as nutrients and oxygen to the cells that are at the forefront of metabolic waste production. Blood is a tough, self-healing, and flexible fluid that undergoes secondary cellular and biochemical changes when subjected to extremely low or high temperatures. If the level of the blood is not adjusted to the right temperature, problems like hemolysis, clotting, or worse can occur, which may be very harmful to the person. Thus, the mean arterial pressure can be raised until the pressure sensorcontrolled system is utilized to determine the temperature of the blood during transfusion afterward mechanism for determining temperature and maintaining the heating process. A smart way through the Internet of Things that AI technologies could fundamentally detect a warmer discovered by the IOT system and then the AI could set the temperature higher. For instance, sensors are used to track the temperature during the transfusion of blood. Moreover, fuzzy logic is employed for temperature control, which minds the warmers during blood transfusion. Following these steps, using 0.02 as the average value for absurdity, and 0.06 as the most significant value, the fuzzy logic control facilitates a quicker response time. Also, a weak response condition is recognized with a value of 0.09, right after the parameter values are shown. The Internet of Things technique will exhibit the temperature level using sensors, AI will perceive it, and the blood transfusion will surely have 98.02% accuracy in a person's body.

Hemodynamic stability with clonidine versus adrenaline in mandibular third molar surgeries

This randomized clinical trial compares 2% lignocaine with clonidine versus 2% lignocaine with adrenaline for impacted mandibular third molar surgery. Hence, 70 patients aged 18–40 were randomly allocated to either group. We evaluated hemodynamic stability, onset and duration of anesthesia. Clonidine showed lower intraoperative and postoperative systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and mean arterial pressure (MAP). Though onset was slightly slower with clonidine, hemodynamic control was superior. Clonidine appears to be a safer alternative for patients requiring cardiovascular stability.

Explore the effect of HIF-PHI on blood pressure variation rate and anemia efficacy in maintenance hemodialysis patients

ObjectiveThis study aims to investigate the impact of hypoxia-inducing factor prolyl hydroxylase inhibitor (HIF-PHI), specifically Roxadustat, on blood pressure variability, blood pressure indices, hemoglobin, and other biochemical markers in maintenance hemodialysis (MHD) patients.MethodsIn this retrospective, self-controlled study, regular hemodialysis and consistent use of Roxadustat for at least six months were conducted at the Hemodialysis Unit of the First Affiliated Hospital of Nanchang University between June 2019 and November 2022. The study involved MHD patients who had been using erythropoiesis-stimulating agents (ESAs) for at least six months prior to transitioning to Roxadustat. Blood pressure, routine blood data, biochemical parameters, and clinical data were collected before, during, and after dialysis over a 12-month period. Statistical comparisons were made of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and true variability in SBP (SBP-ARV), DBP (DBP-ARV), and MAP (MAP-ARV) in the patients before and after the transition to Roxadustat. Hemoglobin levels and daily antihypertensive drug dosage (DDD) were also analyzed.ResultsA total of 54 MHD patients (32 males and 22 females) were included in the study. Primary diagnoses included chronic nephritis, hypertensive nephropathy, diabetic nephropathy, obstructive nephropathy, polycystic kidney disease, nephrotic syndrome, scleroderma-related kidney injury, and cases of unknown etiology. Repeated measures variance analysis indicated that blood pressure fluctuations during Roxadustat treatment were significantly smaller than during ESA treatment. Statistically significant differences were observed in SBP, DBP, and MAP before and after dialysis (P-values: 0.046, < 0.001, 0.028, and 0.014, respectively). Paired t-tests revealed a significant reduction in SBP-ARV and MAP-ARV before and during dialysis in the Roxadustat group (P = 0.0018, 0.008, and 0.006). Hemoglobin, erythrocyte count, and serum calcium were significantly higher in the Roxadustat group compared to ESA treatment (P = 0.013, 0.012, and 0.003, respectively). In the high SBP variability group, a higher proportion of males, increased hospitalization rates, older age, and a higher prevalence of diabetes were observed.ConclusionMHD patients treated with Roxadustat experienced fewer fluctuations in blood pressure compared to those treated with rHuEPO, and Roxadustat was more effective at increasing hemoglobin levels without compromising efficacy relative to ESAs.Clinical trial numberNot applicable

Combined effects of HCRTR1/2 gene variants and non-genetic factors on sleep-wake transition and hemodynamic stability during propofol, dexmedetomidine, and remifentanil anesthesia.

Combined effects of HCRTR1/2 gene variants and non-genetic factors on sleep-wake transition and hemodynamic stability during propofol, dexmedetomidine, and remifentanil anesthesia.