Significant Differences In Heart Rate Research Articles

Intravenous dexmedetomidine enhances the experience of visceral pain in parturients during cesarean delivery under spinal anesthesia

Background and hypothesis Visceral pain is a common incidence in cesarean delivery under spinal anesthesia. Dexmedetomidine (DEX) has analgesic, sedative, anxiolytic effect, as it is an α 2-receptor agonist. Intraoperative visceral pain resulting from manipulation of the uterus and traction of the peritoneum is still a challenge for anesthetists. The present study hypothesized that single intravenous bolus dose of DEX added as a supplement to intrathecal anesthesia for an elective cesarean section could reduce intraoperative visceral pain, lessen blood pressure swings, and produce an acceptable sedative effect, with minimal fetal and maternal consequences. Patients and methods A randomized double-blinded placebo-controlled study was conducted. A total of 70 patients were randomly allocated to receive either intravenous DEX or placebo (saline) before spinal anesthesia. The primary outcomes were decreased intraoperative visceral pain. Secondary outcomes included the stability of hemodynamic parameters (blood pressure and heart rate), sedation score, time to rescue analgesia reduction, neonatal APGAR score, and any adverse effects (nausea and vomiting). Results There was a significant difference between the groups in the incidence of moderate to severe visceral pain (P<0.001), intraoperative fentanyl requirements (P=0.004), and longer time to rescue analgesia (P<0.001). Both groups had comparable mean blood pressure (P>0.005); however, there was a highly significant difference in heart rate (P=0.01). Moreover, a significantly higher sedation score was seen in the DEX group (2.08±0.8) in comparison with the control group (1±0). APGAR score was comparable in the studied groups. Conclusion As a single intravenous bolus, DEX seems to be an excellent supplement to intrathecal anesthesia for an elective cesarean section. It can reduce intraoperative visceral pain and lessen blood pressure swings and produce an acceptable sedative effect with minimal fetal and maternal influence.

Hemodynamic efficacy and safety of using modified gelatin solution and polyhydric alcohol solution for fluid resuscitation of patients with septic shock

Objective ‒ to compare the hemodynamic effects and safety of the infusion of succinylated gelatin solution, sorbitol-containing solution, and 0.9 % normal saline (0.9 % sodium chloride), analyze their effect on the treatment of septic shock and mortality.Materials and methods. A prospective randomized clinical trial that included 94 adult patients with an active surgical infection and septic shock was conducted. There were 34 (36.2 %) male and 60 (63.8 %) female patients aged between 19 and 96 years, mean age was (66.51 ± 17.06) years. An appropriate solution in a volume of 500 ml was used for resuscitation, then hemodynamic and other clinical and laboratory parameters were monitored.Results. There was no significant difference in mean arterial pressure (MAP) between the 3 groups until the 40th minute (p>0.05). At the 45th minute MAP in the NS group differed only from MAP in the Gel group (p=0.007). At the 50th minute MAP in the NS group did not differ from the baseline (p=0.139). From the 50th minute to 2 hours, MAP in the Gel and Sorb groups was higher than in the NS group in all measurements (p<0.05). There was no statistically significant difference in heart rate (HR) in any measurement (p>0.05). Cardiac output (CO) did not differ up to the 30th minute (p>0.05), at the 35th minute, CO differed only between Gel and NS groups (p=0.019), from the 40th minute to 2 hour CO in Gel and Sorb groups were significantly higher than in NS group in all measurements (p<0.05). Oxygen delivery (DO2) also did not differ up to the 30th minute (p>0.05), from the 35th minute to the 45th minute a significant difference was found only between Gel and NS groups (p<0.05), from the 50th minute to 2 hour DO2 in Gel and Sorb group was significantly higher than in NS group in all measurements (p<0.05). After infusion of the gelatin-containing solution and sorbitol-containing solution, the acid-base balance of the blood improved significantly. The dose of gelatin-containing and sorbitol-containing solutions applied in this study was safe for the renal function of the patients with septic shock. However, it is possible that a decrease in blood fibrinogen concentrations may be associated with the use of a gelatin-containing solution. Significant improvement in the Glasgow Coma Scale scores was observed only in patients in the group receiving the sorbitol-containing solution. The difference in 28-day mortality between the groups was not statistically significant (p=0.993).Conclusions. In our observations, when using these three types of solution in patients with septic shock, hemodynamic effects up to the 40th minute did not differ between groups. From the 40th minute to 2 hour, the volemic effect of 4 % succinylated gelatin solution and balanced polyionic solution with 6 % sorbitol was significantly better, compared to the 0.9 % sodium chloride solution. The volume of solutions used in these three groups did not affect renal function in patients with septic shock. The amount of balanced polyionic solution used with 6 % sorbitol and 0.9 % sodium chloride solution did not affect blood coagulation function. But the use of 4 % succinyl gelatin solution reduced the concentration of fibrinogen in the blood. After infusion of the gelatin-containing solution with buffer formulations and sorbitol-containing solution with buffer formulations, the acid-base status of the blood was significantly improved compared to 0.9 % sodium chloride solution. Infusion of the gelatin-containing solution and 0.9 % sodium chloride solution did not affect the Glasgow coma score in patients. After infusion of the sorbitol-containing solution, patients’ consciousness was improved by this scale. The 28-day mortality did not differ significantly between groups.

Effects of Mother's Voice Recording Toward Premature Infant Heart Rate Changes at the Rsud Dr. Moewardi

Background: The World Health Organization (WHO) states that premature birth occurs before 37 weeks of complete pregnancy and is a leading cause of death of newborns. As for interventions that could be done to improve this, includes listening to the mother's voice and lullabies (lullaby). Mother's voice can affect respiration rate, heart rate, oxygen saturation, infant’s oral feeding skill, premature infant weight gain, brain maturation, and the infant’s physical response.Objective: The purpose of this research was to find the effect of mother's voice recordings on the state of the heart rate of premature babies in the HCU Neonatal Room of RSUD Dr. Moewardi. This study was completed in the neonatal HCU room of RSUD Dr. Moewardi.Method: The sampling technique used is consecutive sampling method, based on inclusion and exclusion criteria. This study uses a quasi-experimental design with a pre and post-test design without control group. The analysis test used was paired t-test since the normality test results showed p values of 0.05 (normal distribution).Result: The results of the Paired T-Test showed a p-value of 0,000 (p0.05) which means, there is significant difference in heart rate between before and after the application of the mother's voice recording.Conclusion: In conclusion Mother's voice recording influences changes in the heart rate of premature babies. The implications of the mother's voice recording can be used for the treatment of premature infants in the HCU Neonatal room and NICU.

Comparative Study on the Heart Rate and Blood Pressure of Debre Markose University 3rd Year Nursing and Sport Science Female Students During Rest and Exercise

The aim of this study is to determine the association of heart rate (HR) and blood pressure (BP) between Debre Markos University sport science and nursing students at rest time and during exercise. For this study, 40 healthy and volunteer female students were used as the sample of this study from the total of 70 3 rd year nursing and sport science female students. HR and BP was recorded both during rest and exercise after training during step test. In this study, 40.5 cm height steeper, box or bench was used for step test. The duration of the training for step-test exercise was 3-minutes. The investigation was on the parameters of HR, BP, syastolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and recovery HR. The data was analyzed by using simple descriptive analysis. The finding suggested that there is a significant difference in HR and BP in female sport science students both during rest and exercise after training than healthy nursing female students. So, generally as compared to nursing students, sport science students HR and BP had shown a significant difference during rest and exercise. Keywords : Blood pressure; Exercise; Heart rate DOI: 10.7176/JTHS/52-03 Publication date: December 31 st 2020

Remifentanil infusion during desflurane anesthesia reduces tissue blood flow while maintaining blood pressure and tissue oxygen tension in the masseter muscle and mandibular bone marrow.

The aim of this study was to compare changes in tissue blood flow and tissue oxygen tension in the masseter muscle and mandibular bone marrow induced by remifentanil under desflurane or sevoflurane anesthesia. Eleven male tracheotomized Japan White rabbits were anesthetized with desflurane or sevoflurane under mechanical ventilation. The order of the inhalation of desflurane or sevoflurane was randomized. Desflurane or sevoflurane was administered at 1.0 minimum alveolar concentration and remifentanil was infused at 0.4 µg/kg/min. Observed variables included heart rate (HR), blood pressure (BP), common carotid artery blood flow (CCBF), mandibular bone marrow tissue blood flow (BBF), masseter muscle tissue blood flow (MBF), mandibular bone marrow tissue oxygen tension (PbO2), and masseter muscle tissue oxygen tension (PmO2). Two way repeated measures ANOVA showed no interaction between volatile anesthetics and remifentanil infusion except for MBF. There were significant differences in HR, SBP, DBP, MAP and CCBF between desflurane and sevoflurane groups. There were also significant differences in HR, SBP, DBP, MAP, CCBF, BBF and PbO2 before, during and after remifentanil infusion. Desflurane reduced tissue blood flow in the masseter muscle and mandibular bone marrow while better maintained HR and BP than sevoflurane. Under remifentanil infusion, although both anesthetics reduced tissue blood flow, tissue oxygen tension was maintained in masseter muscle and mandibular bone marrow.

Cardiovascular Responses to Stress Utilizing Anticipatory Singing Tasks

Abstract. Models of psychobiological stress reactivity have a foundation in the measurement of responses to standardized stress tasks. Tasks with anticipatory phases have been proposed as an effective method of stress induction, either as a stand-alone task or replacement constituent elements for existing stressor paradigms. Tasks utilizing singing as a primary stressor have been proposed but the efficacy of these tasks have not been demonstrated while maintaining adherence to a resting/reactivity/recovery framework desirable for heart rate variability (HRV) measurement. This study examines the viability of an anticipatory sing-a-song task as a method for inducing mental stress and examines the utility of the task with specific reference to measures of cardiovascular reactivity and recovery activity, and standard protocols to examine HRV reactivity and recovery. Participants completed a dual task with a math task and an anticipation of singing component. Responses were examined according to a resting/reactivity/recovery paradigm and the findings indicate that the sing-a-song stimulus is effective in generating a stress response. Significant differences in heart rate and self-reported stress between baseline and stressor conditions were detected, with greater magnitude differences between baseline and anticipatory phases. This study has demonstrated the viability of the anticipation of singing as a standardized stressor using cardiovascular measures and has described variants of this task that may be used for repeated measures study designs.

A Follow-Up Study on the Effects of Football Scrimmages on Blink Reflex Parameters in Division I Athletes

The objective was to conduct a follow-up study to access the effects of football scrimmages on blink reflex parameters using the Eyestat. Eyestat is a noninvasive diagnostic tool measuring changes in blink reflex parameters. Prior research cited significant differences in various blink reflex parameters between active play, concussion, and baseline; however, the number of subjects for the active play population was small and within a football practice versus a football scrimmage. Fifty-eight division I male football players, between the ages of 18 and 22 years, participated in multiple sessions during a 3 week period of football scrimmages and a spring game. In addition, a subgroup of these subjects (N = 20) provided a minimal of 3 or more scans throughout the study. During various points of play, subjects completed the blink test and had heart rates assessed. For the blink test, subjects placed their face against the apparatus, which directed a puff of air to the corner of the subject's eye to stimulate the blink. Five puffs were administered in a random fashion over a 20-second period while videography captured and recorded the blink. The results of the study cited significant differences in heart rates above 55% of predicted heart rate maximum in excursions only (p = 0.00), while significant differences were found in under the threshold (p = 0.05) and excursions (p = 0.00) in heart rates less than 55% of maximum heart rate. In those athletes (N = 20) where 3 scans were taken, there were no significant differences within subjects in any of the blink reflex parameters. Future studies should continue to evaluate the timing of post exercise visual tracking assessments within healthy populations to determine the effects on ocular changes as eye-tracking devices are becoming increasingly popular to assess neurological health.

Non-bronchoscopic Bronchoalveolar Lavage as a Refinement for Safely Obtaining High-quality Samples from Macaques.

Nonbronchoscopic bronchoalveolar lavage (NB-BAL) is a minimally invasive diagnostic and research tool used to sample the cells of lower airways and alveoli without using a bronchoscope. Our study compared NB-BAL and bronchoscopic bronchoalveolar lavage (B-BAL) in terms of costs, cell yields, and the number of post-procedural complications in macaques. We also analyzed procedure times, BAL fluid volume yields, and vital signs in a subset of animals that underwent NB-BAL. Compared with the B-BAL technique, NB-BAL was less expensive to perform, with fewer complications, fewer animals requiring temporary or permanent cessation of BALs, and higher cell yields per mL of recovered saline. The average procedure time for NB-BAL was 6.8 ± 1.6 min, and the average NB-BAL lavage volume yield was 76 ± 9%. We found no significant differences in respiration rate before, during, or after NB-BAL but did find significant differences in heart rate and oxygen saturation (SpO₂). This study demonstrates that NB-BAL is a simple, cost-effective, and safe alternative to B-BAL that results in higher cell yields per mL, improved animal welfare, and fewer missed time points, and thus constitutes a refinement over the B-BAL in macaques.

Efeito da pré‐administração de flurbiprofeno axetil na CE50 do propofol durante anestesia em pacientes não estimulados: estudo clínico randomizado

Background and objectivesPreoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol. MethodsNinety‐six patients (ASA I or II, aged 18–65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10 mL of Intralipid, and groups B, C and D received 0.5 mg.kg‐1, 0.75 mg.kg‐1 and 1 mg.kg‐1 of FA, respectively, 10 minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The “up‐and‐down” method was used to calculate the EC50 of propofol. During the equilibration period, if BIS ≤ 50 (or BIS > 50), the next patient would receive a 0.5 μg.mL‐1‐lower (or‐higher) propofol Target‐Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10 minutes after FA administration, after induction, after intubation, and 15 minutes after intubation. ResultsThe EC50 of propofol was lower in Group C (2.32 μg.mL‐1, 95% Confidence Interval [95% CI] 1.85–2.75) and D (2.39 μg.mL‐1, 95% CI 1.91–2.67) than in Group A (2.96 μg.mL‐1, 95% CI 2.55–3.33) (p = 0.023, p = 0.048, respectively). There were no significant differences in the EC50 between Group B (2.53 μg.mL‐1, 95% CI 2.33–2.71) and Group A (p ˃ 0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66 ± 6 vs. 80 ± 10 bpm, p < 0.01) and 15 minutes after intubation (61 ± 4 vs. 70 ± 8 bpm, p < 0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15 minutes after intubation than at baseline (p < 0.05). ConclusionHigh‐dose FA (0.75 mg.kg‐1 or 1 mg.kg‐1) reduces the EC50 of propofol, and 1 mg.kg‐1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre‐administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.

Effect of pre-administered flurbiprofen axetil on the EC50 of propofol during anesthesia in unstimulated patients: a randomized clinical trial

Background and objectivesPreoperative use of flurbiprofen axetil (FA) is extensively adopted to modulate the effects of analgesia. However, the relationship between FA and sedation agents remains unclear. In this study, we aimed to investigate the effects of different doses of FA on the median Effective Concentration (EC50) of propofol. MethodsNinety-six patients (ASA I or II, aged 18–65 years) were randomly assigned into one of four groups in a 1:1:1:1 ratio. Group A (control group) received 10mL of Intralipid, and groups B, C and D received 0.5mg.kg−1, 0.75mg.kg−1 and 1mg.kg−1 of FA, respectively, 10minutes before induction. The depth of anesthesia was measured by the Bispectral Index (BIS). The “up-and-down” method was used to calculate the EC50 of propofol. During the equilibration period, if BIS≤50 (or BIS>50), the next patient would receive a 0.5μg.mL−1-lower (or -higher) propofol Target-Controlled Infusion (TCI) concentration. The hemodynamic data were recorded at baseline, 10minutes after FA administration, after induction, after intubation and 15minutes after intubation. ResultsThe EC50 of propofol was lower in Group C (2.32μg.mL−1, 95% Confidence Interval [95% CI] 1.85–2.75) and D (2.39μg.mL−1, 95% CI 1.91–2.67) than in Group A (2.96μg.mL−1, 95% CI 2.55–3.33) (p=0.023, p=0.048, respectively). There were no significant differences in the EC50 between Group B (2.53μg.mL−1, 95% CI 2.33–2.71) and Group A (p>0.05). There were no significant differences in Heart Rate (HR) among groups A, B and C. The HR was significantly lower in Group D than in Group A after intubation (66±6 vs. 80±10bpm, p<0.01) and 15minutes after intubation (61±4 vs. 70±8bpm, p<0.01). There were no significant differences among the four groups in Mean Arterial Pressure (MAP) at any time point. The MAP of the four groups was significantly lower after induction, after intubation, and 15minutes after intubation than at baseline (p<0.05). ConclusionHigh-dose FA (0.75mg.kg−1 or 1mg.kg−1) reduces the EC50 of propofol, and 1mg.kg−1 FA reduces the HR for adequate anesthesia in unstimulated patients. Although this result should be investigated in cases of surgical stimulation, we suggest that FA pre-administration may reduce the propofol requirement when the depth of anesthesia is measured by BIS.

Effect of vasoactive agents on the prognosis of children in the third stage of hand-foot-mouth disease

To study the effect of the application timing of vasoactive agents on the prognosis of children in the third stage of hand-foot-mouth disease (HFMD). A retrospective analysis was performed on the medical data of children in the third stage of HFMD between April 2012 and September 2016. According to the application time of vasoactive agents (milrinone combined with phentolamine) after admission, the children were divided into an early stage (within 2 hours after admission) group with 32 children, a middle stage (within 2-6 hours after admission) group with 28 children, and a late stage (more than 6 hours after admission) group with 26 children. Venous blood samples were collected before vasoactive agent treatment and after 24 hours of vasoactive agent treatment to measure the levels of creatine kinase-MB (CK-MB), troponin (TnI), and brain natriuretic peptide (BNP). The recovery time of left ventricular ejection fraction (LVEF), respiratory rate, blood pressure, and heart rate were recorded. The response rate to the treatment within 72 hours of treatment was evaluated. The early stage group had a significantly higher overall response rate to the treatment than the middle stage and late stage groups (P<0.0167). After 24 hours of treatment, there were significant differences in heart rate, blood pressure, respiratory rate, and LVEF among the three groups (P<0.05). The early stage group showed the most significant improvement in these parameters (P<0.0167). Compared with the middle stage and late stage groups, the early stage group had significantly shorter recovery time of LVEF, respiratory rate, heart rate, and blood pressure (P<0.0167). After 24 hours of treatment, the early stage group had a significantly lower level of BNP than the middle stage and late stage groups (P<0.05). Vasoactive agents should be given to children with critical HFMD as early as possible to improve cardiovascular function, reduce the risk of disease progression, and improve prognosis.

Observation on the efficacy of CT-guided lumbar sympathetic chemical destructive block in the treatment of cold sensation of limbs

Objective: To observe the clinical effects of CT-guided chemical destructive block of lumbar sympathetic nerve in the treatment of cold sensation of limbs. Methods: In this retrospective analysis, clinical data of 43 patients with cold sensation of limbs treated by lumbar sympathetic chemical destructive block in the Affiliated Hospital of Jiaxing University from January 2015 to January 2018 were collected. The changes of heart rate, non-invasive blood pressure (NIBP), oxygen saturation (SpO(2)), plantar temperature and peripheral perfusion index (PI) of patients were recorded and analyzed before treatment and 5 min after injection of anhydrous ethanol. The patients were followed up at postoperative 1 day, 1 week, 1 month, 3 months, 6 months, 1 year and 2 years. Results: Fourty-three patients underwent bilateral lumbar sympathetic nerve chemical destructive block under the CT-guided, and all patients were punctured to the target successfully. The PI of patients before and after treatment were 1.2±0.6, 7.2±3.0 respectively, which was significantly increased after treatment compared with before treatment, and the difference was statistically significant (t=12.386, P<0.05). The plantar temperature of patients before and after treatment respectively were (29.6±1.7)℃, (34.6±1.1)℃, which was significantly increased after treatment compared with before treatment, and the difference was statistically significant (t=15.057, P<0.05). There were no significant differences in heart rate, NIBP and SpO(2) between before and after treatment (all P>0.05). Lumbar sympathetic chemical destructive block was clinically effective in 39 patients (90.7%) and ineffective in 4 patients (9.3%). Among the 39 clinically effective patients, the curative effects were excellent in 29 cases and improved in 10 cases. Postoperative recurrence occurred in 10 cases (25.6%). The satisfaction rates of patients at 1 day, 1 week, 1 month, 3 months, 6 months, 1 year and 2 years after operation were 93.0%, 90.7%, 86.0%, 76.7%, 69.7%, 65.1% and 53.4%, respectively. Conclusion: Lumbar sympathetic chemical destructive block is a safe and effective way for the treatment of cold sensation of limbs, which can improve the symptoms of cold sensation of limbs to some extent.

Effect of different fluid resuscitation strategies on renal function in patients with septic shock induced acute kidney injury

To compare the therapeutic effect of fluid resuscitation strategy guided by pulse-indicated continuous cardiac output (PiCCO) monitoring and early goal-directed therapy (EGDT) on renal function of acute kidney injury (AKI) patients caused by septic shock. Septic shock patients with AKI admitted to the intensive care unit (ICU) of Tianjin Fifth Central Hospital and Teda International Cardiovascular Hospital from March 2017 to February 2020 were enrolled. All patients were given fluid resuscitation. Patients were divided into PiCCO-guided fluid resuscitation group [PiCCO group, intrathoracic blood volume index (ITBVI) was maintained between 850-1 000 mL/m2] and EGDT-guided fluid resuscitation group [EGDT group, central venous pressure (CVP) was maintained between 8-12 mmHg (1 mmHg = 0.133 kPa) or CVP ≤ 15 mmHg when patients received mechanical ventilation (MV)] according to both the patient's condition and the informed consent of the patient's family. The changes of heart rate (HR), mean arterial pressure (MAP), CVP, blood lactic acid (Lac), fluid balance, urine volume and serum creatinine (SCr) at 6, 24, and 48 hours after fluid resuscitation in the two groups were observed, and the renal replacement therapy (RRT), duration of MV, length of ICU stay and 28-day mortality between the two group were compared. (1) A total of 94 patients were enrolled, including 51 in the EGDT group and 43 in the PiCCO group. There was no significant difference in gender, age, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, procalcitonin (PCT), HR, MAP, CVP, Lac or SCr at ICU admission between the two groups. (2) The parameters of hemodynamics, fluid balance, urine volume and SCr were improved with the time of resuscitation in the two groups, and there was no significant difference in HR, MAP or Lac between the two groups. Compared with the EGDT group, the CVP decreased significantly at 24 hours and 48 hours after fluid resuscitation in the PiCCO group (mmHg: 9.1±0.9 vs. 12.0±1.3 at 24 hours, 8.0±1.0 vs. 10.2±1.3 at 48 hours), the fluid balance significantly decreased (mL: 2 929.8±936.3 vs. 3 898.4±923.5 at 24 hours, 3 143.5±1 325.4 vs. 4 843.8±1 326.7 at 48 hours), and the condition of urine volume and SCr were better in the PiCCO group [urine volume (mL×kg-1×h-1): 1.02±0.21 vs. 0.79±0.14 at 24 hours, 1.28±0.18 vs. 0.94±0.22 at 48 hours; SCr (μmol/L): 145.7±37.6 vs. 164.3±46.4 at 24 hours, 128.4±33.6 vs. 143.5±37.7 at 48 hours), with significant differences (all P < 0.05). (3) Compared with the EGDT group, the rate of RRT in the PiCCO group was lower [11.6% (5/43) vs. 17.6% (9/51)], the duration of MV and the length of ICU stay were shorter [duration of MV (days): 4.64±1.31 vs. 6.50±2.19, length of ICU stay (days): 10.35±3.50 vs. 14.50±5.78), with significant differences (all P < 0.05). There was no significant difference in the 28-day mortality between the PiCCO group and EGDT group [14.0% (6/43) vs. 15.7% (8/51), P > 0.05]. Fluid resuscitation strategy guided by PiCCO in septic shock patients with AKI can reduce the amount of fluid load, improve renal function, shorten the MV duration and length of ICU stay, and shows clinical significance.

Effect of General Anesthesia on Cardiac Magnetic Resonance-Derived Cardiac Function in Repaired Tetralogy of Fallot.

Cardiac magnetic resonance imaging (CMR)-derived ejection fraction (EF) predicts adverse outcomes in repaired tetralogy of Fallot (rTOF) and drives timing of pulmonary valve replacement. Certain patient populations require sedation for successful CMR image acquisition. General anesthesia (GA) has been shown to depress EF and heart rate (HR) in animal models, however, its effect on congenital heart disease is unknown. A retrospective review was conducted of all CMR patients referred with rTOF between January 2011 and May 2019. The cohort was separated into GA and non-GA groups. Propensity score matching (PSM) adjusted for selection bias. A kernel matching algorithm was used to match subjects and the differences in mean treatment effect on the treated were computed for left ventricular (LV) and right ventricular (RV) EF, HR, and cardiac index (CI). 143 patients met criteria, 37 patients under GA (mean age 15years, range 2-45, 59% male), and 106 patients without GA (mean age 21years, range 10-53, 50% male). Unmatched analysis showed significant depression of LV EF (50 vs. 57%, p < 0.001) and RV EF (42 vs. 48%, p < 0.001) in the GA group compared to the non-GA group. There was no significant difference in HR or CI. After matching and PSM adjustment, the GA group had a significant decreasein LV EF (49 vs. 56%, p < 0.001), RV EF (41 vs. 48%, p < 0.001), CI (2728 vs. 3701ml/min/m2, p < 0.001), and HR (72 vs. 79bpm, p = 0.04). General anesthesia with sevoflurane results in depressed CMR-derived EF.

An exploration of heart rate and perceived exertion differences between class and competition in freestyle-disco dance

ABSTRACT Freestyle-disco is a relatively new and complex competitive dance style that, to our knowledge, has yet to be researched. Thus, the purpose of this research was to explore two fundamental physiological characteristics of exercise in relation to freestyle-disco as a starting-point for future research into the style. From this, the authors hope to better understand the processes and complexities involved in studying these particular dancers. This study investigated differences in heart rate (HR) and ratings of perceived exertion (RPE) between class and competition in freestyle-disco and slow dance. Five female dancers aged 12 to 16 years, from one freestyle-disco school volunteered to participate in the study. HR data were recorded using heart rate monitors at two classes and two competitions. RPE scores were collected after each competitive performance and each section of the class. No significant differences in HR or RPE were found for freestyle-disco or slow dance performance between class and competition. The methodological limitations that arose in this work means that these findings are merely speculative however they do provide initial insight to an under-researched dance style. As such, we hope this research will be a catalyst for further investigation to learn more about this exciting dance style.

Chute scoring as a potential method for assessing individual differences in arousal among ewes

Chute scoring has been used among beef and dairy operations as a method to gauge the relative phenotypic characteristics of animals based on response to physical restraint. While elements of the cattle chute score, such as tail flicking, exit speed, and side kicking, have been validated as behavioral indicators of arousal in cattle, a robust and species-appropriate scale has not been developed for sheep. Given that individual monitoring of breeding ewes is growing in the sheep industry, it could be beneficial to develop such a rating system for ewes. The objectives of this study were to (1) evaluate the consistency of chute score values and behavioral measures over repeated trials, (2) provide a subjective scoring system that human observers may use to identify behavioral indicators of arousal in sheep, and (3) determine if there are physiological measurements which are related to subjective chute scores. Twenty-eight multiparous, crossbred ewes from the same breeding group were restrained in a squeeze chute for 10 min, once a week for five weeks. Trained researchers gave each ewe a chute score based on the behaviors observed. A ‘1−3’ subjective scale adapted from cattle literature was used to designate score values to each ewe (with scores increasing relative to observable agitation). Measures of heart rate, respiration rate, and surface eye temperature were collected while ewes were restrained. Video data of restrained ewes were coded for order of entry, step and bleat rate, and, latency to exit the chute. Chute scores were highly consistent within ewes between nearly all trial day combinations. Positive and significant correlations (Kendall’s Tau) were found between the third, fourth and fifth trials for bleat rate (P < 0.001), step rate (P < 0.001), latency to exit chute (P < 0.001), eye temperature (P < 0.01), and heart rate (P = 0.01). Step rate was a consistent and significant predictor of chute scores on the ‘1−3’ scale (P < 0.0001). Significant differences in heart rate and eye temperature were found between scores 1 and 2, however no overall differences were found between scores 2 and 3 when physiological measures were analyzed independently. Once physiological information was aggregated into a collective arousal response, significant differences were identified between scores 1 and 2 (P = 0.001), and, 2 and 3 (P = 0.05). The authors suggest a simple 3-point scale may be reasonable for detecting relative differences in reactivity for production ewes, with inclusion of elements of active behaviors related to arousal (e.g. vigilance behavior, ear postures).

Heart Rate And Rating Of Perceived Exertion During High-intensity Interval Training: Implications For Prescribing Intensity

High-intensity interval training (HIIT) is a popular and effective time-efficient alternative to moderate-intensity continuous training for improving cardiorespiratory fitness in a wide range of populations. However, there is limited research investigating the most effective and practical way to prescribe training intensities for HIIT. PURPOSE: To determine heart rate (HR) and rating of perceived exertion (RPE) responses across a single bout of HIIT. Additionally, the relationship between HR and RPE were examined. METHODS: Young adults (n=16; age 21.8±1.4 years; 10 females) visited the lab on two separate occasions. At the first visit, participants completed an incremental exercise test on a cycle ergometer to determine peak power output (PPO). Participants completed the HIIT session during their second lab visit. The HIIT protocol involved ten, 1-minute bouts of cycling at 80% PPO interspersed with 1-minute of active rest cycling at 20% PPO. HR and RPE were measured at the end of the first, fifth and tenth work interval. RPE was measured using the CR10 Borg scale. One-way repeated measures ANOVAs were used to determine HR and RPE responses across the HIIT session. Pearson correlations were utilized to assess relationships between HR and RPE. RESULTS: HR and RPE both significantly increased from the first (HR 157±16 bpm; RPE 5.0±1.8) to the fifth interval (HR 174±14 bpm; RPE 6.8±1.7; p<0.05 for both). However, there were no significant differences in HR or RPE between the fifth and tenth interval (180±12 bpm; RPE 7.7±1.9 p>0.05 for both). There were no significant relationships between HR and RPE for any of the time points (r=-0.01 to -0.34, p=0.19 to 0.89) or the average of the session (r=0.37, p=0.16). CONCLUSIONS: HR and RPE both increased initially during the HIIT session with no further increase after mid-point. There were no significant relationships between HR and RPE. These findings suggest that RPE, using the CR10 Borg scale, may not replicate HR for determining intensity during HIIT. Future research may be beneficial to determine a practical method for prescribing exercise intensity during HIIT. Further, it would be beneficial to examine the use of RPE and HR as methods of prescribing intensity in long-term, real-world intervention studies.

Classificação da intensidade dos jogos Kinect Sports® em universitários através das variáveis hemodinâmicas e da percepção subjetiva de esforço

This study analyzed the intensity of Kinect Sports® games in college students through hemodynamic variables and perceived exertion. An experimental study, with 34 young students (21.5 ± 1.9 years) who underwent three consecutive games sessions, divided into boxing, bowling, baseball, and tennis games; sand, golf, athletics, and ski flights; table tennis, football, darts, and American football. Heart rate (HR), blood pressure (BP), and rate of perceived exertion (RPE) were recorded every two minutes of each game. One-way ANOVA for repeated measurements was used to verify differences in HR, BP, and RPE at each time of the game and the effect size (p <0.05). There were significant differences in HR (p <0.01, η2p <0.284) in boxing, athletics and baseball games; in PAS (p <0.01, η2p <0.203) in athletics and baseball, as well as in RPE (p <0.01, η2p <0.309) in boxing, athletics, skiing, sand volleyball, tennis, football and table tennis. As for the classification of the games by intensity, through the percentage of proximity of the Maximum Heart Rate (HRmax), only the Boxing game presented with strong intensity (70 to 89% of the HRmax), 50% as moderate intensity (55 to 69% FCmax), and 42% of games at light intensity (35 to 54% of FCmax). It is concluded that a classification table that identifies the intensity of Kinect Sports® games in university students allows selecting games that are geared to the subject's physical condition, making the practice of this activity an alternative for the individual to move from rest to an active state generating beneficial impacts to health.

Prospective evaluation of vascular changes in acute respiratory infections in children with cystic fibrosis

Background/aim Acute exacerbations and chronic inflammation are risk factors for cardiovascular disease (CVD) in cystic fibrosis (CF) patients. The aim of this study was to investigate the effects of acute exacerbation therapy on arterial stiffness in children with CF.Materials and methods Augmentation index (Aix) and pulse wave velocity (PWV) were measured before and after treatment and 1 month after the end of treatment in patients with acute exacerbation. The relationship between hemodynamic measurements and c-reactive protein (CRP) and pulmonary function tests (PFTs) was investigated.Results Measurements before and after treatment were evaluated in 27 patients and were repeated in 21 patients who were clinically stable 1 month following acute exacerbation. There was a significant decrease in CRP and an increase in spirometry parameters after treatment. While no significant difference was found between PWV (P = 0.33), a significant difference for Aix before (41.95 ± 12.96%) and after (30.95 ± 11.47%) treatment and before treatment and stable clinical condition (34.19 ± 14.36%) was obtained (P =0.00, and P =0.01, respectively). No significant difference in heart rate and other hemodynamic measurements was found. Pretreatment Aix is associated with poor clinical condition (PFTs, BMI, and clinical score) and systemic inflammation (CRP) (P <0.05).Conclusion The decrease of arterial stiffness (Aix) with acute exacerbation treatment in children with CF has been demonstrated. This result shows that systemic inflammation in CF may cause an increase in arterial stiffness and recurrent exacerbations may increase the risk of CVD.

Validity of the Talk Test as a Method to Estimate Ventilatory Threshold and Guide Exercise Intensity in Cardiac Patients.

To determine the relationship between the Talk Test (TT) and ventilatory threshold (VT) in patients with cardiac disease and to compare the TT with exercise intensity guidelines. Twenty cardiac patients, aged 65 ± 8.5 yr, performed 2 exercise tests with identical ramp protocols on a cycle ergometer on the same day. One test was a submaximal effort to assess exercise intensity using the TT. The other was a cardiopulmonary exercise test using breath-by-breath gas analysis to identify VT and cardiorespiratory fitness. Oxygen uptake and workload at the last positive stage (TTpos) was significantly lower than at VT. and workload at the equivocal stage (TTeq) and the first negative stage (TTneg) were not significantly different from VT, but limits of agreement (LoA) were wide. There was no significant difference in heart rate (HR) at TTpos and TTeq compared with VT, but HR at Tneg was significantly higher. The correlations between the TT and VT ranged from 0.37 to 0.60. Intensity at the different TT stages ranged from 58-77% of . All TT stages were within intensity guidelines of 40-80% of . Although no significant differences were found in and workload for TTeq and TTneg when compared with VT, LoA demonstrated wide ranges, suggesting poor individual correspondence. The different stages of the TT can be used as a practical method to guide exercise intensity in patients with cardiac disease.