The effects of hyperventilation (HV) on mean arterial pressure (MAP) are variable. To identify factors affecting the MAP response to HV, we dissected the effects of hypocapnic HV (HHV) and isocapnic HV (IHV) and evaluated the effects of acute vs. prolonged HHV. In 11 healthy subjects the cardio- and cerebrovascular effects of HHV and IHV vs. normal ventilation were examined for 15 min in the supine position and also for 15 min during 60 degrees head-up tilt. The end-tidal CO(2) of the HHV condition was set at 15-20 mmHg. With HHV in the supine position, mean cerebral blood flow velocity (mCBFV) declined [95% confidence interval (CI) -43 to -34%], heart rate (HR) increased (95% CI 7 to 16 beats/min), but MAP did not change (95% CI -1 to 6 mmHg). However, an augmentation of the supine MAP was observed in the last 10 min of HHV compared with the first 5 min of HHV (95% CI 2 to 12 mmHg). During HHV in the tilted position mCBFV declined (95% CI -28 to -12%) and MAP increased (95% CI 3 to 11 mmHg) without changes in HR. With supine IHV, mCBFV decreased (95% CI -14 to -4%) and MAP increased (95% CI 1 to 13 mmHg) without changes in HR. During IHV in the tilted position MAP was further augmented (95% CI 11 to 20 mmHg) without changes in CBFV or HR. Preventing hypocapnia during HV resulted in a higher MAP, suggesting two contrasting effects of HV on MAP: hypocapnia causing vasodepression and hyperpnea without hypocapnia acting as a vasopressor.
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http://dx.doi.org/10.1152/japplphysiol.00003.2008 | DOI Listing |
Objective: Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti.
Design: An unblinded randomized clinical trial (enrolled April 2021-March 2022) with 12-month follow-up.
Anaesth Intensive Care
January 2025
Department of Intensive Care, Launceston General Hospital, Launceston, Australia.
Medical emergency team (MET) activations were designed to improve patient safety and outcomes by providing timely and specialised care to patients experiencing clinical deterioration. The primary objective of this study was to describe the association between MET events in the early (24-h) postoperative period and in-hospital mortality as well as length of stay. A retrospective data linkage study was performed of prospectively collected data from patient administrative data and the MET database at Launceston General Hospital located in Tasmania, Australia.
View Article and Find Full Text PDFJ Clin Anesth
January 2025
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:
Study Objective: To assess whether, in a lung resection cohort with a low probability of confounding by indication, higher FiO is associated with an increased risk of impaired postoperative oxygenation - a clinical manifestation of lung injury/dysfunction.
Design: Pre-specified registry-based retrospective cohort study.
Setting: Two large academic hospitals in the United States.
J Sports Sci
January 2025
Applied Sport, Technology, Exercise and Medicine Research Centre, Swansea University, Wales, UK.
We investigated the effects of low and high frequency isometric handgrip exercise training (IHGT) on resting blood pressure, and the affective/perceptual responses during training. Sixty young normotensive adults were randomised to either a no-intervention control group (CON: = 20; 12 female) or a group performing either two (LOW: = 20; 18 female) or four (HIGH: = 20; 13 female) sessions/week of IHGT for 4 weeks. IHGT involved 4 × 2-min holds at 30% maximal voluntary contraction using the dominant hand.
View Article and Find Full Text PDFKorean J Anesthesiol
January 2025
Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyukwan University School of Medicine, Seoul, Republic of Korea.
Background: Remimazolam is a novel ultra-short-acting benzodiazepine known for its hemodynamic stability over propofol. However, its hemodynamic effects compared to those of etomidate are not well established. This study aimed to determine whether the use of remimazolam is non-inferior to etomidate with regard to the occurrence of post-induction hypotension in patients undergoing coronary arterial bypass grafting.
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