Archive for the ‘Coronary Artery’ Category


Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: ConclusionIt is conceivable that the tachyarrhythmias encountered during CABS and rewarming may be responsive to short-acting beta adrenergic blockade in light of the elevated levels of free T3 and T4. add comment
Serum ACE activity, when corrected for hemodilution, was unchanged during CABS and hypothermia. However, the mean postoperative ACE activity in our patients was lower than the stated normal value- and also below preoperative values in any age- and disease-matched group. We have described lowered ACE activity in critically ill patients, including a group of postoperative CABS patients who had intraoperative hypothermia. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Conclusion
  • We believe that a correction for the hemodilution which occurs during CABS is critical and that hormone values measured during surgery must be interpreted in light of this correction. Serum T3, when corrected in this manner, is unchanged throughout CABS. These data are in contrast to recent findings by Robushi et al, who describe a low serum T3 during CABS; however, no correction for hemodilution was made in that study. While serum FT3 levels have been noted to increase during euther-mic abdominal surgery, others have reported no change during euthermic abdominal or euthermic CABS. Our data show both an increase in free T3 levels and an increase in the dialyzable fraction of T3 after the onset of bypass and hypothermia. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Outcome
  • Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Catecholamine FindingsThe changes observed in plasma catecholamines are probably not related to the anesthetic agent, heparin, or to the extracorporeal bypass machine because these variables were constant throughout the fall in core temperature. Also, the changes in catecholamines probably cannot be ascribed to the antihypertensive drugs received by some of these patients preoperatively, because there was no statistical difference between patients who were, and were not, receiving these medications. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Catecholamine Findings
  • Human plasma NE levels have been used as an index of SNS activity. On the other hand, plasma EPI concentrations indicate adrenal medullary activity because EPI is almost exclusively formed in this tissue. http://antimicrobialmed.com/buy-amoxil-online.html
    The present observation regarding hypothermia and catecholamines is consistent with previous work in hypothermic baboons in which we described a “switch off” of the SNS below a core temperature of 31°C. The SNS, which is important during hypothermia, has been studied by Oyer et al, who showed that rewarming hamsters from hypothermia is delayed if beta-adrenergic blockade is present. The release of NE has also been well documented only during mild surface cooling. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Discussion
  • Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: ACEACE
    The serum ACE activity, when corrected for hemodilution, was unchanged from a preinduction value of 14.4 ± 1.9 units/ml when measured at temperatures of 32°C and 24°C, 9.0 ± 1.3 units/ml and 14.3 ± 2.3 units/ ml, respectively.
    Findings in Patients During Rewarming (Table 4). http://asthma-inhalers-online.com/buy-advair-diskus-inhaler.html
    The mean time required for rewarming to 37°C was 38 ± 4 minutes, during which time the mean arterial blood pressure and heart rate increased in parallel with normalization of temperature. The plasma NE concentration increased to 736 ±110 pg/ml, at 35°C compared to a “basal” hypothermic (25°C) value of 442 ± 108 pg/ml (p<0.05). The plasma EPI value did not change between 25°C and 35°C (341 ± 115 pg/ml and 377 ±107 pg/ml, respectively). Neither serum ACE activity or T3 concentrations increased during the 38 ± 4 minutes of intraoperative rewarming. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: ACE
  • Catecholamines (Table 2)
    During the induction phase of intraoperative hypothermia, core temperature, and mean arterial blood pressure decreased. As the core temperature fell to 32°C, plasma NE and EPI concentrations rose (p<0.05) to 685 ± 184 (662 ± 172) pg/ml and 563 ± 200 (506 ± 191) pg/ml, respectively, from basal preinduction concentrations (37°C) of 287 ±40 pg/ml and 50±15 pg/ml, respectively. However, with further cooling to 24°C, the NE and EPI values declined (p<0.05) to 442 ±12 (312 ±86) pg/ml and 174 ±78 (130 ± 62) pg/ml, respectively, which were not different from basal measurements. No significant differences in intraoperative plasma catecholamine concentrations were found between patients who had received preoperative nitrates alone versus those receiving nitrates plus beta blockers and/or calcium channel blockers. http://birthcontroltab.com/generic-plan-b-0-75mg.html (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Results
  • Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: AssaysAssays
    Serum T3 (normal: 85 to 200 ng/dl) and T4 (normal: 5.1 to 10 (Ag/dl) concentrations were measured by sensitive and specific radioimmunoassays. The FT, (normal: 230 to 480 pg/dl) and FT, (normal: 1.3 to 3.8 ng/dl) values were determined by equilibrium dialysis. The dialyzable fraction of the total hormone concentration as well as the calculated free hormone concentration are reported. The serum ACE activity was measured by a sensitive radiometric assay as described previously (normal: 16.8 ±5 units/ml). (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Assays
  • The patients were perfused with a pump flow of 3 to 5 L/min and their core temperature was lowered to 24°C (in less than ten minutes) and maintained by cooling this perfusion blood in an ice bath (0 to 15°C). After completion of surgery, the patients were rewarmed in less than 60 minutes by heating the perfused blood to 42°C. Core temperature was measured as esophageal temperature. The temperature was also determined rectally and via the pulmonary artery catheter. All three temperatures were consistently within one degree in all patients. (more…)

  • Comments Off on Alterations in Sympathetic Nervous System Activity with Intraoperative Hypothermia during Coronary Artery Bypass Surgery: Methods
  • Categories


    Advertising


    Most Popular

    • None found

    Recent Comments

    • None found