Arterial waveform analysis

Esper, Stephen A.; Pinsky, Michael R.

doi:10.1016/j.bpa.2014.08.002

Cited by 79 publications

(65 citation statements)

References 136 publications

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“…The relative changes in carotid and femoral arterial blood flows and conductance were calculated as the percentage change from the 30 min average before umbilical cord occlusion, in order to analyse the relative adaptation to asphyxia in both groups, by adjusting for the magnesium‐induced baseline vasodilatation. A beat‐to‐beat assessment of the femoral arterial flow waveform height and width was used to give an indication of the area under the flow waveform during each heartbeat, as an index of stroke volume (Esper & Pinsky, ). This was done by selecting representative waveforms throughout 10 consecutive cardiac cycles from each fetus immediately before occlusion, at the time of peak perfusion during occlusion, and during peak reperfusion after occlusion.…”

Section: Methodsmentioning

confidence: 99%

Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep

Galinsky

Davidson

Drury

et al. 2015

The Journal of Physiology

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Key pointsr Magnesium sulphate is the recommended treatment for pre-eclampsia and is now widely recommended for perinatal neuroprotection.r MgSO 4 has vasodilatory and negative inotropic effects; however, it is unknown whether it impairs the cardiovascular and cerebrovascular adaptations to acute asphyxia in preterm fetuses.r Intravenous infusion of a clinically comparable dose of MgSO 4 to the preterm fetus was associated with no change in blood pressure, reduced fetal heart rate and increased femoral arterial conductance and blood flow; femoral arterial waveform height and width were increased, consistent with increased stroke volume during MgSO 4 infusion.r During asphyxia MgSO 4 was associated with increased carotid and femoral arterial conductance and blood flows; after asphyxia, fetal heart rate was lower and carotid and femoral blood flows and vascular conductance were greater in MgSO 4 -treated fetuses.r These data demonstrate that MgSO 4 may increase perfusion of peripheral vascular beds during adverse perinatal events such as asphyxia.Abstract Magnesium sulphate is a standard therapy for eclampsia in pregnancy and is widely recommended for perinatal neuroprotection during threatened preterm labour. MgSO 4 is a vasodilator and negative inotrope. Therefore the aim of this study was to investigate the effect of MgSO 4 on the cardiovascular and cerebrovascular responses of the preterm fetus to asphyxia. Fetal sheep were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanaesthetised fetuses were randomly assigned to receive an intravenous infusion of MgSO 4 (n = 6) or saline (n = 9). At 105 days all fetuses underwent umbilical cord occlusion for 25 min. Before occlusion, MgSO 4 treatment reduced heart rate and increased femoral blood flow (FBF) and vascular conductance compared to controls. During occlusion, carotid and femoral arterial conductance and blood flows were higher in MgSO 4 -treated fetuses than controls. After occlusion, fetal heart rate was lower and carotid and femoral arterial conductance and blood flows were higher in MgSO 4 -treated fetuses than controls. Femoral arterial waveform height and width were increased during MgSO 4 infusion, consistent with increased stroke volume. MgSO 4 did not alter the fetal neurophysiological or nuchal electromyographic responses to asphyxia. These data demonstrate that a clinically comparable dose of MgSO 4 increased FBF and stroke volume without impairing mean arterial pressure (MAP) or carotid blood flow (CaBF) during and immediately after profound asphyxia. Thus, MgSO 4 may increase perfusion of peripheral vascular beds during adverse perinatal events.

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Section: Methodsmentioning

confidence: 99%

Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep

Galinsky

Davidson

Drury

et al. 2015

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…MAP is the mean pressure averaged over time in the arterial pressure readings. (3,4) Pediatric patients undergoing open heart surgery may have quick and considerable changes in MAP reading that may lead to decreased tissue perfusion. MAP monitoring pointed to rectifying deviations before the consequences of either hypertension or hypotension are recorded .…”

Section: Introductionmentioning

confidence: 99%

“…MAP monitoring pointed to rectifying deviations before the consequences of either hypertension or hypotension are recorded . (3) ABP is a frequent clinical procedure that can be measured noninvasively or invasively. (5) Noninvasive MAP reading using the automatic oscillometric technique with an upper arm inflatable cuff is the most used method postoperatively.…”

Section: Introductionmentioning

confidence: 99%

“…It simplifies the immediate diagnoses of cardiovascular insufficiency and monitor therapy outcome. (3) Thence, it can be a time devour, and necessitates a spacious experience. Over and above, this method is inherent with a risk of bleeding, infection, and distal limb ischemia for these reasons; noninvasive MAP is until now repeatedly used in very young pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

“…(9) The bedside measurement of continued MAP reading has been routinely obtainable through arterial catheterization. (3) Anywise, arterial catheter placement in children is unfavorable before anesthesia administration. Radial artery is the most frequently used, while the femoral artery is the second choice.…”

Section: Introductionmentioning

confidence: 99%

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