The ultrasonic cardiac output monitor (USCOM) is a noninvasive transcutaneous continuous wave Doppler method for assessing hemodynamics. There are no published reference ranges for normal values in adults (aged 18–60 years) for this device. This study aimed to (1) measure cardiovascular indices using USCOM in healthy adults aged 18–60 years; (2) combine these data with those for healthy children (aged 0–12), adolescents (aged 12–18), and the elderly (aged over 60) from our previously published studies in order to present normal ranges for all ages, and (3) establish normal ranges of USCOM‐derived variables according to both weight and age. This was a population‐based cross‐sectional observational study of healthy Chinese subjects aged 0.5–89 years in Hong Kong. USCOM scans were performed on all subjects, to produce measurements including stroke volume, cardiac output, and systemic vascular resistance. Data from previously published studies (children, adolescents, and the elderly) were included. Normal ranges were defined as lying between the 2.5th and 97.5th percentiles. A total of 2218 subjects were studied (mean age = 16.4, range = 0.5–89; 52% male). From previous studies, 1197 children (aged 0–12, 55% male), 590 adolescents (aged 12–18, 49% male), and 77 elderly (aged 60–89, 55% male) were included. New data were collected from 354 adults aged 18–60 (47% male). Normal ranges are presented according to age and weight. We present comprehensive normal ranges for hemodynamic parameters obtained with USCOM in healthy subjects of all ages from infancy to the elderly.
The method clearly identified the two clinical groups with no overlap of data points. The discriminant power of SMII and PKR may offer valuable diagnostic methods and monitoring tools in anaesthesia and critical care. This is the first report of normal ranges for SMII and PKR.
This study presents normal values for cardiovascular indices in Chinese adolescents using the ultrasonic cardiac output monitor. When referenced to body surface area, the differences between Caucasians and Chinese were insignificant.
These studies were designed to test the hypothesis that the renal vasodilation and increased glomerular filtration rate (GFR) after a high-protein meal are mediated by the tubuloglomerular feedback (TGF) mechanism. In eight chronically instrumented conscious dogs, a meal of raw beef (10 g/kg) caused GFR to increase from 66 +/- 5 to 90 +/- 7 ml/min and effective renal plasma flow (ERPF) to increase from 191 +/- 25 to 281 +/- 24 ml/min, while plasma alpha-amino N levels rose from 4.0 +/- 0.1 to 7.3 +/- 0.6 mg/dl. On another day the dogs were given an infusion of furosemide to block TGF, and fluid and salt losses were continuously replaced. Furosemide alone caused GFR to increase in most animals, although the average change did not reach statistical significance, and ERPF increased by 31%. Sodium excretion rose from 15 +/- 5 to 2,390 +/- 280 mueq/min, and urine flow rose from 1.17 +/- 0.22 to 20.5 +/- 2.4 ml/min. Autoregulatory capability was also abolished (autoregulatory index = 0.87 +/- 0.09 compared with 0.19 +/- 0.05 before furosemide). However, there was no significant change in GFR and ERPF after a subsequent meat meal in dogs receiving furosemide. On another day, some of the dogs were given another loop diuretic, ethacrynic acid, which caused no change in GFR, whereas its effects on ERPF, sodium excretion, and urine output were similar to those of furosemide. There were also no changes in GFR or ERPF after a meat meal during ethacrynic acid administration, despite normal increases in plasma alpha-amino N.(ABSTRACT TRUNCATED AT 250 WORDS)
BackgroundWhilst there is a presumption in medicine that ageing adversely affects cardiovascular function, it is unknown if resting haemodynamics are compromised in the elderly, and if so, to what degree. This study was intended to answer several questions; whether age-related changes in haemodynamics occur; whether there was a difference between the haemodynamics of ageing subjects with and without mild chronic disease; whether there was a difference in haemodynamics as measured from either the aortic or the pulmonary valve; and to establish reference ranges for this population.MethodsChinese adults aged over 60 years were divided into three age bands of 61–70, 71–80 and over 80 years. The haemodynamic parameters were measured using a non-invasive Doppler ultrasound-based instrument, the Ultrasonic Cardiac Output Monitor (USCOM).ResultsOne hundred and sixty-five subjects (48.5% males) were recruited. 78 (47.3%) had no known disease whilst 87 (52.7%) had mild chronic illness. A total of 21 individual haemodynamic parameters were measured or calculated for each subject. There were no significant differences in stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR) or in body surface area (BSA)-indexed parameters, SV index (SVI), cardiac index (CI) and SVR index (SVRI) across age groups, or in other indexed haemodynamic parameters. No significant differences in indexed haemodynamics were found between those subjects with and those without mild chronic disease. Small, statistically significant, but clinically insignificant, differences (< 5%) were found between the aortic and pulmonary valve measurements for SV, SVI and heart rate.ConclusionsAgeing does not have any significant effect on resting haemodynamics in the elderly population studied. Mild chronic disease does not adversely affect resting haemodynamics in this population.General SignificanceReference ranges were established for 21 haemodynamic parameters, as measured by USCOM, for an elderly Chinese population but not for non-Chinese populations.
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