Minerva anestesiologica
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Minerva anestesiologica · Aug 2016
Validation of a novel index of hemorrhage using a lower body negative pressure shock model.
Vital signs are late indicators of blood loss in trauma patients. Indexed Heart to Arm Time (iHAT) is a non-invasive index based on a modified pulse transit time (mPTT) indexed to the time between R waves on the electrocardiogram (RR interval). We aimed to investigate how early iHAT is able to detect central hypovolemia during the progression from mild to severe simulated hemorrhage induced by applying lower body negative pressure (LBNP). ⋯ iHAT measures both the reduction in preload and the parabolic heart rate increase due to the linear decrease in stroke volume. iHAT was able to detect a progressive central volume loss in a model of hemorrhage in healthy volunteers undergoing LBNP. A rising trend in iHAT can be a useful marker for progressive volume loss during moderate to severe bleeding.
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Minerva anestesiologica · Aug 2016
Comparative StudyInfluence of supraglottic airway device placement on cerebral hemodynamics.
Supraglottic airway devices (SGDs) are of current use in anesthesia practice and in emergency conditions. It has been suggested that cerebral blood flow (CBF) can decrease after SGD insertion or cuff inflation; however, it is uncertain if this reduction is caused by the SGD or the anesthetic drugs utilized for the anesthetic procedure. During minor surgery we separated CBF measurements by an adequate time interval in order to measure the distinctive changes in cerebral hemodynamics associated with anesthesia induction, SGD insertion and cuff inflation. ⋯ SGD insertion and cuff inflation did not influence cerebral hemodynamics in anesthetized patients undergoing minor surgery. At normal etCO2 range, the CBF reduction with transient increase in PI was associated with anesthesia induction and not SGD insertion itself.