Blood Vessels

Seidel, Henry M.; Ball, Jane W.; Dains, Joyce E.; Flynn, John A.; Solomon, Barry S.; Stewart, Rosalyn W.

doi:10.1016/b978-0-323-05570-3.00015-1

Cited by 8 publications

(10 citation statements)

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“…To evaluate crackles, the following scale adapted from Kataoka and Torino et al was used: 1, no crackles; 2, I am uncertain about the presence of fine crackles; 3, definite fine crackles at lung bases; 4, moderate crackles; and 5, bilateral, diffuse crackles 2, 24 . For clinical oedema, the following scale was used: 1, no clinical oedema; 2, slight pitting (2‐mm depth) with no visible distortion; 3, somewhat deeper pit (4 mm) with no readily detectable distortion; 4, noticeably deep pit (6 mm) with the dependent extremity full and swollen; and 5, very deep pit (8 mm) with the dependent extremity grossly distorted 25 …”

Section: Methodsmentioning

confidence: 99%

“…2,24 For clinical oedema, the following scale was used: 1, no clinical oedema; 2, slight pitting (2-mm depth) with no visible distortion; 3, somewhat deeper pit (4 mm) with no readily detectable distortion; 4, noticeably deep pit (6 mm) with the dependent extremity full and swollen; and 5, very deep pit (8 mm) with the dependent extremity grossly distorted. 25…”

Section: Clinical Evaluation Of Volume Statusmentioning

confidence: 99%

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Comparison between lung ultrasonography and current methods for volume assessment in Asian chronic hemodialysis patients

Ngoh

Teng

Chua

et al. 2020

Hemodialysis International

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Introduction: Volume assessment in end-stage kidney disease patients on hemodialysis (HD) remains inadequate by existing methods: clinical examination, bioimpedance spectroscopy, measurement of inferior vena cava diameter by ultrasound (IVCD), and plasma B-type natriuretic peptide (NT-pro BNP). This study aims to compare the performance of lung ultrasound against existing methods for volume assessment in a HD cohort. Methods: Two nephrologists independently performed 28-point lung ultrasound immediately before and after midweek HD in 50 patients. Lung congestion was classified into mild, moderate, and severe categories based on lung ultrasound findings. Clinical examination for crepitations and oedema, change in hydration status (ΔHS) measured by bioimpedance spectroscopy, NT-pro BNP, IVCD during inspiration (IVCDimin), expiration (IVCDimax), and inferior vena cava collapsibility index were also assessed before and after midweek HD. Findings: In all, 61% of patients with normohydration status by bioimpedance spectroscopy had moderate or severe lung congestion on lung ultrasound. There were significant correlations between predialysis lung ultrasound, and NT-pro BNP (r = 0.432, P = 0.004), ΔHS (r = 0.447, P < 0.001), and IVCD parameters (P < 0.05). Some correlations weakened postdialysis (ΔHS [r = 0.322, P = 0.01] and IVCDimax [r = 0.307, P = 0.03]), whereas NT-pro BNP and ΔHS paradoxically increased in 28% and 30% of the cohort, respectively. On receiver operator curve analysis, most methods of volume assessment had limited discriminatory power to detect mild lung congestion. Discussion: Lung ultrasound demonstrates some comparability with existing volume assessment methods in Asian dialysis patients. However, it appears more effective at detecting subclinical pulmonary congestion, and tracking fluid changes real-time compared to bioimpedance spectroscopy and NT-pro BNP.

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Section: Methodsmentioning

confidence: 99%

Section: Clinical Evaluation Of Volume Statusmentioning

confidence: 99%

Comparison between lung ultrasonography and current methods for volume assessment in Asian chronic hemodialysis patients

Ngoh

Teng

Chua

et al. 2020

Hemodialysis International

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“…Edema of each leg was assessed before sleep on a scale of 0-3. 15 With subjects instrumented for sleep studies, lying awake and supine, LFV and neck fluid volume (NFV) were measured simultaneously using a bioelectrical impedance spectrum analyzer (MP150, Biopac Systems Canada Inc, Montreal, Canada). This technique, which is well-validated, uses the impedance to electrical current within a body segment to measure fluid content.…”

Section: Neck and Leg Fluid Volumes And Circumferencesmentioning

confidence: 99%

Night-to-night Variability in Obstructive Sleep Apnea Severity: Relationship to Overnight Rostral Fluid Shift

White

Lyons

Yadollahi

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives: Overnight rostral fl uid shift from the legs to the neck may narrow the pharynx and contribute to obstructive sleep apnea (OSA) pathogenesis. We hypothesized that night-to-night changes in the apneahypopnea index (AHI) would be associated with changes in overnight rostral fl uid shift. Methods: Twenty-six patients with OSA (AHI ≥ 10) underwent two polysomnograms 14 days apart with measurement of neck and leg fl uid volumes (LFV), neck circumference and upper-airway cross-sectional area before and after sleep. Results: Although mean AHI did not differ between polysomnograms, 35% of patients had a difference in AHI > 10, indicating signifi cant intra-individual variability. There were direct correlations between change in non-rapid-eye movement (NREM), but not REM AHI and change in evening LFV between polysomnograms (r = 0.440, p = 0.036 and r = 0.005, p = 0.982, respectively) and between change in supine, but not non-supine AHI and change in evening LFV (r = 0.483, p = 0.020 and r = 0.269, p = 0.280, respectively). An increase in evening LFV between polysomnograms was associated with a greater overnight decrease in LFV (r = 0.560, p = 0.005) and a greater overnight increase in neck fl uid volume (r = 0.498, p = 0.016). Additionally, a greater overnight increase in neck circumference was associated with a greater overnight increase in neck fl uid volume between polysomnograms (r = 0.453, p = 0.020) and a greater overnight decrease in upperairway cross-sectional area (r = −0.587, p = 0.005). Conclusion: Intra-individual variability in OSA severity may be partly explained by day-to-day changes in evening leg fl uid volume and overnight rostral fl uid shift, which may be most important in the pathogenesis of OSA during NREM and supine sleep. S C I E N T I F I C I N V E S T I G AT I O N S BRIEF SUMMARYCurrent Knowledge/Study Rationale: Overnight rostral fl uid shift from the legs to the neck may narrow the upper airway and contribute to obstructive sleep apnea (OSA) pathogenesis. Intra-individual night-tonight variability in OSA severity may relate to night-to-night variations in overnight rostral fl uid shift. Study Impact: This study found that intra-individual variability in OSA severity may be partly explained by day-to-day changes in evening leg fl uid volume and overnight rostral fl uid shift, which may be most important in the pathogenesis of OSA during NREM and supine sleep. S everity of obstructive sleep apnea (OSA) can vary considerably from night to night, but the reasons for this are unclear. Previous studies found a change in the frequency of apneas and hypopneas per hour of sleep (apnea-hypopnea index, AHI) greater than 10 in 18% to 65% of patients undergoing polysomnograms (PSGs) on consecutive nights or one month apart. [1][2][3][4] Furthermore, in one study, 50% of patients undergoing consecutive night PSGs met criteria for OSA diagnosis (AHI ≥ 10) on one PSG but not on the other. Few studies have examined the reasons for this AHI variability. While one study found increased variabi...

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“…Current vital signs of heart rate, respiratory rate, peripheral oxygenation, and blood pressure may indicate cerebral blood flow and the brain’s receipt of oxygen-rich blood 77,78 . Although, cerebral oxygenation may be a more sensitive indicator of reduced blood flow to the brain, in-depth evaluation is necessary to compare current vital signs with cerebral oxygenation.…”

Section: Challengesmentioning

confidence: 99%

Cerebral Oxygenation Monitoring: A Strategy to Detect Intraventricular Hemorrhage and Periventricular Leukomalacia

Elser

Holditch‐Davis

Brandon

2011

Newborn and Infant Nursing Reviews

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Premature infants are at risk for intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) theorized to be a result from fluctuations in cerebral blood flow. Monitoring cerebral oxygenation offers a method to observe changes in cerebral blood flow that may be beneficial for detecting and preventing IVH and PVL. This article explains the potential for cerebral oxygenation monitoring in detecting IVH and PVL using cerebral oximetry, reviews current knowledge known about cerebral oxygenation, and describes current challenges for cerebral oxygenation to be the next neuroprotective vital sign.

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Blood Vessels

Cited by 8 publications

References 0 publications

Comparison between lung ultrasonography and current methods for volume assessment in Asian chronic hemodialysis patients

Comparison between lung ultrasonography and current methods for volume assessment in Asian chronic hemodialysis patients

Night-to-night Variability in Obstructive Sleep Apnea Severity: Relationship to Overnight Rostral Fluid Shift

Cerebral Oxygenation Monitoring: A Strategy to Detect Intraventricular Hemorrhage and Periventricular Leukomalacia

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