Objective: To observe the changes in hemodynamics and oxygen metabolism in pigs with severe acute pancreatitis (SAP) so as to provide a theoretical basis for clinical treatment.
Methods: A porcine model of SAP was reproduced by infusing normal saline (1 ml/kg) of sodium taurocholate (4%) and trypsin (1%) into the pancreatic duct (n=8). Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary arterial wedge pressure (PAWP), mean pulmonary arterial pressure(MPAP) and cardiac output were continuously measured with the aid of Swan-Ganz catheter and electrocardiography monitor, and cardiac index (CI) was calculated. Oxygen delivery (DO(2)), oxygen consumption (VODO(2)) and oxygen extraction (ODO(2)ext) were calculated according to the analysis of the blood-gases in arterial and mixed venous blood at 0, 6, 12, 24, 36 hours after taurocholic acid injection, and the result were analyzed.
Results: Compared with baseline (0 hour), MAP and CI decreased significantly 12 hours after the acid insult (all P<0.05). Both of partial pressure of artery (PaO(2)) and DO(2) showed a tendency to fall. Compared with 0 hour, PaO(2) decreased significantly at 6, 12, 24 and 36 hours (all P<0.05), and DO(2)at 24 hours (P<0.05). The trends of VO(2) and O(2)ext were consistent, both of them peaked at 6 hours (both P<0.05), then, began to lower, and the difference was statistically significance at 24 hours (both P<0.05).
Conclusion: There is not only hemodynamic disturbances but also oxygen metabolism dysfunction in pigs with SAP. The pathogenesis of multiple organ dysfunction syndrome might be attributable to the lowering of VO(2) and O(2)ext.
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Pediatr Transplant
February 2025
Division of Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Background: Pediatric solid organ transplantation is challenging due to the limited availability of suitable organs resulting in an increasing waitlist. Many pediatric transplant recipients receive organs from deceased donors, often after neurologic determination of death. Organ donation from patients on extracorporeal membrane oxygenation (ECMO) at the time of death has been described in adults, offering the potential for donation after circulatory determination of death (DCDD) with minimal ischemia time.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
3rd Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Hypertrophic cardiomyopathy (HCM) is a complex and heterogeneous cardiac disorder, often complicated by cardiogenic shock, a life-threatening condition marked by severe cardiac output failure. Managing cardiogenic shock in HCM patients presents unique challenges due to the distinct pathophysiology of the disease, which includes dynamic left ventricular outflow tract obstruction, diastolic dysfunction, and myocardial ischemia. This review discusses current and emerging therapeutic strategies tailored to address the complexities of HCM-associated cardiogenic shock and other diseases with similar pathophysiology that provoke left ventricular outflow tract obstruction.
View Article and Find Full Text PDFDiseases
December 2024
Department of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Noncardiogenic pulmonary edema after cardiac surgery is a rare but severe complication. The etiology remains poorly understood; however, the issue may arise from multiple sources. Possible causes include a significant inflammatory response or an autoimmune process.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Critical Care Medicine, Shulan Hangzhou Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, 310022, People's Republic of China.
Background: With the shift in donor lung allocation from blood type and waiting order to the use of the lung allocation score (LAS) system, there are increasingly more cases of ECMO bridging lung transplantation. However, there are still some problems in case selection, implementation, and management.
Methods: We analyzed and summarized a series of data on ECMO bridging lung transplantation through an extensive literature review.
Physiol Rep
December 2024
Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois, USA.
Multiple sclerosis (MS) is a chronic neurological condition resulting in decreased aerobic capacity (peak VO). The hemodynamic responses to peak exercise in MS are unknown. Further, it is unknown if the hemodynamic responses are due to disease or fitness.
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