Objective: Ischaemia and reperfusion can result in permanent tissue damage. During complex open abdominal aortic surgery, transient clamping of the renovisceral arteries may be required to successfully complete the vascular repair. Endovascular shunting (endoshunting) presents an alternative technique for managing such temporary renovisceral ischaemia.
View Article and Find Full Text PDFObjective: Temporary arterial shunting is an established method to prevent tissue ischaemia. Although less well established, shunting might also be achieved through endovascular and hybrid techniques, known as endoshunting. Endoshunting offers advantages, for example, enabling minimally invasive access and avoiding complete occlusion of the donor artery.
View Article and Find Full Text PDF[This corrects the article DOI: 10.1016/j.ejvsvf.
View Article and Find Full Text PDFObjective: Acute tissue ischaemia may arise due to arterial emergencies or during more complex vascular procedures and may be mitigated by temporary shunting techniques. Endovascular shunting (ES) techniques enable percutaneous access and shunting from the donor artery without the need to completely interrupt the arterial flow in the donor artery. An endoshunt system may also cover longer distances than most conventional shunts.
View Article and Find Full Text PDFBackground: The atrial natriuretic peptide (ANP) released from the heart regulates intravascular volume and is suspected to increase capillary permeability. Contradictory results regarding ANP and glycocalyx degradation have been reported. The aim of this study was to investigate if an infusion of ANP causes degradation of the endothelial glycocalyx.
View Article and Find Full Text PDFActa Anaesthesiol Scand
August 2021
Background: Arterial haematocrit (Hct) has been shown to decrease after anaesthesia induction, most probably because of an increased plasma volume (PV). The primary objective was to quantify change in PV if mean arterial pressure (MAP) was kept at baseline level or allowed to decrease to 60 mm Hg. Our secondary objective was to evaluate underlying mechanisms of this response.
View Article and Find Full Text PDFObjectives: Acute kidney injury is a well-known complication after cardiac surgery and cardiopulmonary bypass (CPB). In this experimental animal study, we evaluated the effects of atrial natriuretic peptide (ANP) on renal function, perfusion, oxygenation and tubular injury during CPB.
Methods: Twenty pigs were blindly randomized to continuous infusion of either ANP (50 ng/kg/min) or placebo before, during and after CPB.
Background: Administration of agents that enhance platelet reactivity may reduce the perioperative bleeding risk in patients treated with the adenosine diphosphate (ADP)-receptor antagonist ticagrelor. Adrenaline potentiates ADP-induced aggregation and activation in blood samples from ticagrelor-treated patients, but it has not previously been evaluated in vivo.
Methods: Ten healthy male subjects were included in an interventional study.
Essentials Strategies to improve platelet function may reduce excessive bleeding during cardiac surgery. Patients were randomized to standard care or standard care + noradrenaline infusion. Low-dose noradrenaline improved intraoperative platelet aggregation and clot formation.
View Article and Find Full Text PDFActa Anaesthesiol Scand
October 2018
The purpose of this study was first to evaluate the near infrared spectroscopy (NIRS) device, INVOS 4100 as a method of measuring exercise and arterial occlusion induced muscle ischemia in human leg, by comparison with InSpectra tissue spectrometer Model 325, and secondly to determine the influence of skin and subcutaneous thickness on the NIRS measurements. Twenty healthy subjects (43 ± 8 years) volunteered for the study. Tissue oxygen saturation (StO2) in the anterior tibial muscle was measured simultaneously with InSpectra Model 325 in one leg and INVOS 4100 in the contralateral leg during an exercise test until muscle exhaustion and arterial occlusion with and without exercise.
View Article and Find Full Text PDFPatients with norepinephrine-dependent vasodilatory shock after cardiac surgery (n = 10) were compared with uncomplicated postcardiac surgery patients (n = 10) with respect to jejunal mucosal perfusion, gastric-arterial PCO2 gradient, and splanchnic oxygen demand/supply relationship. Furthermore, the effects of norepinephrine-induced variations in MAP on these variables were evaluated in vasodilatory shock. Norepinephrine infusion rate was randomly and sequentially titrated to target MAPs of 60, 75, and 90 mmHg (0.
View Article and Find Full Text PDFAnimal studies have suggested that autoregulation of intestinal blood flow is severely impaired during cardiopulmonary bypass (CPB). We investigated the jejunal mucosal capacity to autoregulate perfusion during nonpulsatile CPB (34 degrees C) in 10 patients undergoing elective cardiac surgery. Changes in mean arterial blood pressure (MAP) were induced by altering the CPB flow rate randomly for periods of 3 min from 2.
View Article and Find Full Text PDFObjectives: To evaluate the potential differential effects of norepinephrine, an alpha1-, beta1-, and beta2-receptor agonist, to the alpha1-agonist phenylephrine on jejunal mucosal perfusion, gastric-arterial PCO2 gradient, and the global splanchnic oxygen demand-supply relationship after cardiac surgery.
Design: A randomized, prospective, interventional crossover study.
Setting: A university cardiothoracic intensive care unit.
Objectives: To evaluate the effect of norepinephrine alone and norepinephrine combined with dopamine on jejunal mucosal perfusion, gastric-arterial pCO(2) gradient, and global splanchnic oxygen demand-supply relationship after cardiac surgery.
Design: A prospective interventional study.
Setting: A university cardiothoracic intensive care unit.