Length-dependent regulation of left ventricular function in coronary surgery patients.

Abstract:

BACKGROUND:Load-dependent impairment of left ventricular (LV) function was observed after leg elevation in a subgroup of coronary surgery patients. The present study investigated underlying mechanisms by comparing hemodynamic effects of an increase in LV systolic pressures with leg elevation to effects of a similar increase in systolic pressures with phenylephrine. METHODS:The study was performed in patients undergoing elective coronary surgery prior to cardiopulmonary bypass. High-fidelity LV pressure tracings (n = 25) and conductance LV volume data (n = 10) were obtained consecutively during leg elevation and after phenylephrine administration (5 microg/kg). RESULTS:Leg elevation resulted in a homogeneous increase in end-diastolic volume. The change in stroke volume (SV), stroke work (SW) and dP/dtmax was variable, with an increase in some patients but no change or a decrease in other patients. For a matched increase in systolic pressures, phenylephrine increased SW and dP/dtmax in all patients with no change in SV. Load dependence of relaxation (slope R of the tau-end-systolic pressure relation) was inversely related for changes in SV, SW, and dP/dtmax with leg elevation but not with phenylephrine. CONCLUSIONS:The different effects of leg elevation and phenylephrine suggest that the observed decrease in SV, SW, and dP/dtmax with leg elevation in some patients could not be attributed to an impaired contractile response to increased systolic LV pressures. Instead, load-dependent impairment of LV function after leg elevation appeared related to a deficient length-dependent regulation of myocardial function.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

De Hert SG,Gillebert TC,Ten Broecke PW,Moulijn AC

doi

10.1097/00000542-199908000-00011

subject

Has Abstract

pub_date

1999-08-01 00:00:00

pages

379-87

issue

2

eissn

0003-3022

issn

1528-1175

journal_volume

91

pub_type

杂志文章
  • Direct evidence for the ongoing brain activation by enhanced dynorphinergic system in the spinal cord under inflammatory noxious stimuli.

    abstract:BACKGROUND:Dynorphin A in the spinal cord is considered to contribute to nociceptive stimuli. However, it has not yet been determined whether activation of the spinal dynorphinergic system under nociceptive stimuli plays a role in direct acceleration of the ascending nociceptive pathway. In this study, the authors inve...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181ca31d9

    authors: Taketa Y,Niikura K,Kobayashi Y,Furuya M,Shimizu T,Narita M,Imai S,Kuzumaki N,Maitani Y,Yamazaki M,Inada E,Iseki M,Suzuki T,Narita M

    更新日期:2010-02-01 00:00:00

  • Predicting patient nonappearance for surgery as a scheduling strategy to optimize operating room utilization in a veterans' administration hospital.

    abstract:BACKGROUND:Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient com...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200604000-00029

    authors: Basson MD,Butler TW,Verma H

    更新日期:2006-04-01 00:00:00

  • Diphenylhydramine increases ventilatory drive during alfentanil infusion.

    abstract:BACKGROUND:Diphenhydramine is used as an antipruritic and antiemetic in patients receiving opioids. Whether it might exacerbate opioid-induced ventilatory depression has not been determined. METHODS:The ventilatory response to carbon dioxide during hyperoxia and the ventilatory response to hypoxia during hypercapnia (...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199809000-00013

    authors: Babenco HD,Blouin RT,Conard PF,Gross JB

    更新日期:1998-09-01 00:00:00

  • A Pharmacokinetic and Pharmacodynamic Study of Oral Dexmedetomidine.

    abstract:BACKGROUND:Dexmedetomidine is only approved for use in humans as an intravenous medication. An oral formulation may broaden the use and benefits of dexmedetomidine to numerous care settings. The authors hypothesized that oral dexmedetomidine (300 mcg to 700 mcg) would result in plasma concentrations consistent with sed...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003568

    authors: Chamadia S,Pedemonte JC,Hobbs LE,Deng H,Nguyen S,Cortinez LI,Akeju O

    更新日期:2020-12-01 00:00:00

  • Plastic change of N-type Ca channel expression after preconditioning is responsible for prostaglandin E2-induced long-lasting allodynia.

    abstract:BACKGROUND:Although considerable evidence indicates neuronal Ca channels play significant roles in pain perception, their possible importance in hypersensitization after acute inflammation has not been investigated. METHODS:Using carrageenan for inducing hypersensitization, the authors investigated the analgesic effec...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200312000-00019

    authors: Yokoyama K,Kurihara T,Makita K,Tanabe T

    更新日期:2003-12-01 00:00:00

  • Long-term pain and activity during recovery from major thoracotomy using thoracic epidural analgesia.

    abstract:BACKGROUND:Pain following thoracotomy can persist for years with an undetermined impact on quality of life. Factors hypothesized to modulate this painful experience include analgesic regimen, gender, and type of incision. METHODS:A total of 157 generally healthy patients of both genders scheduled for segmentectomy, lo...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200211000-00029

    authors: Ochroch EA,Gottschalk A,Augostides J,Carson KA,Kent L,Malayaman N,Kaiser LR,Aukburg SJ

    更新日期:2002-11-01 00:00:00

  • Analysis of strategies to decrease postanesthesia care unit costs.

    abstract:BACKGROUND:The goal of this study was to identify interventions that anesthesiologists can make to decrease total costs of a postanesthesia care unit (PACU). METHODS:Data were collected retrospectively from patients who underwent ambulatory surgery at our tertiary care center. RESULTS:Supplies and medications account...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199501000-00013

    authors: Dexter F,Tinker JH

    更新日期:1995-01-01 00:00:00

  • 5-HT1A receptor agonist Befiradol reduces fentanyl-induced respiratory depression, analgesia, and sedation in rats.

    abstract:BACKGROUND:There is an unmet clinical need to develop a pharmacological therapy to counter opioid-induced respiratory depression without interfering with analgesia or behavior. Several studies have demonstrated that 5-HT1A receptor agonists alleviate opioid-induced respiratory depression in rodent models. However, ther...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000490

    authors: Ren J,Ding X,Greer JJ

    更新日期:2015-02-01 00:00:00

  • Diagnostic value of histamine and tryptase concentrations in severe anaphylaxis with shock or cardiac arrest during anesthesia.

    abstract:BACKGROUND:The diagnosis of acute life-threatening allergic reactions during anesthesia relies on clinical signs, histamine and/or tryptase measurements, and allergic testing. In patients who die after the reaction, skin tests cannot be performed, and the effect of resuscitation manoeuvres on mediator concentrations is...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000276

    authors: Laroche D,Gomis P,Gallimidi E,Malinovsky JM,Mertes PM

    更新日期:2014-08-01 00:00:00

  • Sufentanil disposition. Is it affected by erythromycin administration?

    abstract:BACKGROUND:Because oral erythromycin administration has been associated with reduced elimination of alfentanil, suspicion has been raised about related opioids with similar metabolic pathways. A controlled crossover study of sufentanil pharmacokinetics was undertaken to resolve this issue. METHODS:Six subjects had mea...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Bartkowski RR,Goldberg ME,Huffnagle S,Epstein RH

    更新日期:1993-02-01 00:00:00

  • Stereoselectivity of bupivacaine in local anesthetic-sensitive ion channels of peripheral nerve.

    abstract:BACKGROUND:The local anesthetic bupivacaine exists in two stereoisomeric forms, R(+)- and S(-)-bupivacaine. Because of its lower cardiac and central nervous system toxicity, attempts were made recently to introduce S(-)-bupivacaine into clinical anesthesia. We investigated stereoselective actions of R(+)-and S(-)-bupiv...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199909000-00031

    authors: Nau C,Vogel W,Hempelmann G,Bräu ME

    更新日期:1999-09-01 00:00:00

  • Isozyme-specific effects of protein kinase C in pain modulation.

    abstract:BACKGROUND:Protein kinase C (PKC) is a family of serine/threonine kinases that contains more than 10 isozymes. Evidence suggests that PKC may play important roles in pain modulation, but the isozyme-specific effects of PKC on different aspects of pain modulation are not fully understood. We hypothesize that different P...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182390788

    authors: Zhao C,Leitges M,Gereau RW 4th

    更新日期:2011-12-01 00:00:00

  • Mechanisms of differential axial blockade in epidural and subarachnoid anesthesia.

    abstract::The mechanisms of persistent differential blocks that accompany subarachnoid and epidural anesthesia are clarified here with the aid of two principles derived from in vitro study of individual myelinated axons: 1) conduction can leap two consecutive blocked nodes but not three, and 2) a fiber length with more than thr...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198905000-00023

    authors: Fink BR

    更新日期:1989-05-01 00:00:00

  • Thermoregulatory thresholds for vasoconstriction in pediatric patients anesthetized with halothane or halothane and caudal bupivacaine.

    abstract::The thermoregulatory threshold for vasoconstriction has been studied in infants and children given isoflurane, but not in those given halothane anesthesia. More importantly, the effect of vasoconstriction on central temperature in pediatric patients remains unknown. Also unknown is the effect of caudal analgesia on va...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199203000-00011

    authors: Bissonnette B,Sessler DI

    更新日期:1992-03-01 00:00:00

  • Pulsus alternans during general anesthesia with halothane: effects of permissive hypercapnia.

    abstract:BACKGROUND:Pulsus alternans is a classic type of abnormal pulse. It can be defined as a regular alternation of pulse amplitude in which runs of weak and strong beats follow each other alternatively without any change in cycle length. It may be a sign of severe decompensated congestive heart failure. The authors infrequ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200007000-00017

    authors: Saghaei M,Mortazavian M

    更新日期:2000-07-01 00:00:00

  • Hamilton acute pain service safety study: using root cause analysis to reduce the incidence of adverse events.

    abstract:BACKGROUND:Although intravenous patient-controlled analgesia opioids and epidural analgesia offer improved analgesia for postoperative patients treated on an acute pain service, these modalities also expose patients to some risk of serious morbidity and even mortality. Root cause analysis, a process for identifying the...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0b013e3182a76f59

    authors: Paul JE,Buckley N,McLean RF,Antoni K,Musson D,Kampf M,Buckley D,Marcoux M,Frketich R,Thabane L,Cheng J

    更新日期:2014-01-01 00:00:00

  • Risk Factors for Failure to Rescue in Myocardial Infarction after Noncardiac Surgery.

    abstract:BACKGROUND:Compared to other perioperative complications, failure to rescue (i.e., death after suffering a complication) is highest after perioperative myocardial infarction (a myocardial infarction that occurs intraoperatively or within 30 days after surgery). The purpose of this study was to identify patient and surg...

    journal_title:Anesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/ALN.0000000000003330

    authors: Mazzarello S,McIsaac DI,Beattie WS,Fergusson DA,Lalu MM

    更新日期:2020-07-01 00:00:00

  • Resting metabolic rate of the critically ill patient: measured versus predicted.

    abstract::Critically ill patients requiring mechanical ventilation are particularly susceptible to malnutrition. A knowledge of the energy requirements of these patients is essential in designing nutritional regimens. This study examines 45 resting energy-expenditure measurements performed in a group (n = 40) of postoperative, ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198606000-00001

    authors: Weissman C,Kemper M,Askanazi J,Hyman AI,Kinney JM

    更新日期:1986-06-01 00:00:00

  • Changes in functional residual capacity and lung mechanics during surgical repair of congenital heart diseases: effects of preoperative pulmonary hemodynamics.

    abstract:BACKGROUND:To characterize the impact of lung volume changes in the lung function impairment after the surgical repair of congenital heart diseases, combined measurements of functional residual capacity, lung clearance index, and respiratory mechanics were performed in children with hypoperfused lungs (tetralogy of Fal...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181a32887

    authors: von Ungern-Sternberg BS,Petak F,Hantos Z,Habre W

    更新日期:2009-06-01 00:00:00

  • Left ventricular mechanical consequences of dihydropyridine calcium channel modulation in conscious and anesthetized chronically instrumented dogs.

    abstract:BACKGROUND:Volatile anesthetics depress left ventricular contractile function by altering voltage-dependent slow calcium (Ca2+) channel activity in the sarcolemmal membrane. This investigation examined the left ventricular systolic and diastolic mechanical effects of the dihydropyridine Ca2+ channel antagonist nifedipi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199407000-00026

    authors: Pagel PS,Hettrick DA,Warltier DC

    更新日期:1994-07-01 00:00:00

  • Development of a module for point-of-care charge capture and submission using an anesthesia information management system.

    abstract:BACKGROUND:The use of electronic charge vouchers in anesthesia practice is limited, and the effects on practice management are unreported. The authors hypothesized that the new billing technology would improve the effectiveness of the billing interface and enhance financial practice management measures. METHODS:A cust...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200607000-00028

    authors: Reich DL,Kahn RA,Wax D,Palvia T,Galati M,Krol M

    更新日期:2006-07-01 00:00:00

  • Shannon entropy applied to the measurement of the electroencephalographic effects of desflurane.

    abstract:BACKGROUND:The Shannon entropy is a standard measure for the order state of sequences. It quantifies the degree of skew of the distribution of values. Increasing hypnotic drug concentrations increase electroencephalographic amplitude. The probability density function of the amplitude values broadens and flattens, there...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200107000-00010

    authors: Bruhn J,Lehmann LE,Röpcke H,Bouillon TW,Hoeft A

    更新日期:2001-07-01 00:00:00

  • Ketamine and Etomidate Down-regulate the Hypothalamic-Pituitary-Adrenal Axis in an Endotoxemic Mouse Model.

    abstract:BACKGROUND:We compared the effects of etomidate and ketamine on the hypothalamic-pituitary-adrenal axis during sepsis. METHODS:Mice (n = 5/group) were injected intraperitoneally with lipopolysaccharide (10 mg/kg) and 6 h later randomized to receive ketamine (100 mg/kg), etomidate (30 mg/kg), or saline. At two time poi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001704

    authors: Besnier E,Clavier T,Tonon MC,Selim J,Lefevre-Scelles A,Morin F,Tamion F,Dureuil B,Castel H,Compere V

    更新日期:2017-08-01 00:00:00

  • Porcine malignant hyperthermia: effects of halothane on mitochondrial respiration and calcium accumulation.

    abstract::Vastus lateralis muscle was excised from normal pigs and from pigs susceptible to malignant hyperthermia. Anesthesia consisted of diazepam, N2O:O2, and a lidocaine field block. In the susceptible (MHS) pigs, respiratory control in mitochondria of excised muscle was normal, while electron transport was accelerated. Glu...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:

    authors: Britt BA,Endrenyi L,Cadman DL,Fan HM,Fung HY

    更新日期:1975-03-01 00:00:00

  • Characterization of ryanodine receptor-mediated calcium release in human B cells: relevance to diagnostic testing for malignant hyperthermia.

    abstract:BACKGROUND:Mutations in the ryanodine type 1 receptor (RyR1) are causative for malignant hyperthermia. Studies in human B lymphocytes have shown that measurement of RyR1-mediated intracellular Ca(2+) (Ca(2+)(i)) release can differentiate between normal and malignant hyperthermia-susceptible individuals. The authors hav...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200606000-00014

    authors: McKinney LC,Butler T,Mullen SP,Klein MG

    更新日期:2006-06-01 00:00:00

  • Interaction of halogenated anesthetics with alpha- and beta-adrenoceptor stimulations in diabetic rat myocardium.

    abstract:BACKGROUND:Halogenated anesthetics potentiate the positive inotropic effects of alpha- and beta-adrenoceptor stimulations. Although diabetes mellitus induces significant myocardial abnormalities, the interaction of halogenated anesthetics and adrenoceptor stimulation in diabetic myocardium remains unknown. METHODS:Lef...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200411000-00014

    authors: Amour J,David JS,Vivien B,Coriat P,Riou B

    更新日期:2004-11-01 00:00:00

  • Lung volumes, mechanics, and oxygenation during spontaneous positive-pressure ventilation: the advantage of CPAP over EPAP.

    abstract::To determine if continuous positive airway pressure (CPAP) or expiratory positive airway pressure (EPAP) is superior for achieving or maintaining effective lung volume in spontaneously breathing critically ill patients in acute respiratory failure, the authors measured functional residual capacity (FRC), airway and es...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198110000-00013

    authors: Schlobohm RM,Falltrick RT,Quan SF,Katz JA

    更新日期:1981-10-01 00:00:00

  • Regional and global myocardial circulatory and metabolic effects of isoflurane and halothane in patients with steal-prone coronary anatomy.

    abstract::The use of isoflurane in patients with coronary artery disease remains controversial because of the possibility of "coronary steal". In this study, the effects of isoflurane and halothane on global and regional myocardial blood flow and metabolism were compared, and the relationship between steal-induced myocardial is...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199111000-00006

    authors: Pulley DD,Kirvassilis GV,Kelermenos N,Kater K,Barzilai B,Genton RE,Efstathiou C,Lappas DG

    更新日期:1991-11-01 00:00:00

  • Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living.

    abstract:BACKGROUND:Postoperative delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between postoperative delirium and long-term decline in activitie...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000002849

    authors: Shi Z,Mei X,Li C,Chen Y,Zheng H,Wu Y,Zheng H,Liu L,Marcantonio ER,Xie Z,Shen Y

    更新日期:2019-09-01 00:00:00

  • Inspired oxygen fraction of 0.8 does not attenuate postoperative nausea and vomiting after strabismus surgery.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placeb...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200507000-00005

    authors: Treschan TA,Zimmer C,Nass C,Stegen B,Esser J,Peters J

    更新日期:2005-07-01 00:00:00