Neoplasms

Symptoms and General Pathology

All Conditions

Heart and Blood Diseases

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Rare Diseases

Neoplasm Metastasis

Hypertension

Renal Insufficiency

Constriction, Pathologic

Aortic Valve Stenosis

Essential Hypertension

Vascular Diseases

Neoplastic Processes

Aortic Valve Disease

Heart Valve Diseases

Heart Diseases

Ventricular Outflow Obstruction

Kidney Diseases

Urologic Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Reproductive Control Agents

Respiratory System Agents

All Drugs and Chemicals

Vasodilator Agents

Anti-Inflammatory Agents

Antihypertensive Agents

Amino Acids

Herbal and Botanical

Albuterol

Nitroglycerin

Caseins

Glycyrrhizic Acid

Bisoprolol

Bronchodilator Agents

Anti-Asthmatic Agents

Tocolytic Agents

Adrenergic Agents

Adrenergic beta-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Chelating Agents

Sympatholytics

Adrenergic beta-1 Receptor Antagonists

Adrenergic beta-Antagonists

Adrenergic Antagonists

Arginine

Licorice

Subjects with primary or secondary hypertension and normotensive control subjects. In addition haemodynamic recordings to 50 subjects suffering from chronic fatigue syndrome will be performed.

Subjects who had voluntarily decided to participate in a professionally coached marathon school (Varala Sports Institute, Tampere) were given the chance for haemodynamic recordings before, during and after the training protocol.

Normotensive subjects, daily liquorice ingestion (daily glycyrrhizin dose 290-370 mg) for 2 weeks, haemodynamic measurements before and after the intervention.

Daily ingestion of yoghurt containing small milk casein-derived polypeptides for 12 weeks versus placebo yoghurt.

Hypertensive subjects, bisoprolol 5 mg once daily versus placebo in a double-blind, cross-over protocol.

Subjects with aortic stenosis confirmed by echocardiography

35 normotensive subjects who received research drugs (nitroglycerin, salbutamol, placebo resoriblet, placebo inhalation, L-arginine infusion, saline infusion) in a placebo-controlled, double-blinded manner

Altogether 80 athletes participating in a full length Ironman competition. Non-invasive recordingds are performed under normal conditions during the training period and after completion of a full-length Ironman competition.

From the beginning of the study until the end of year 2016 a single dose of sublingual nitroglycerin was given to examine the associated acute haemodynamic effects (recordings completed).

Nitroglycerin 0.25 mg (single dose, no longer given since January 2017)

From the beginning of the study until the end of year 2016 a 400 µg dose of inhaled salbutamol was given to examine the associated acute haemodynamic effects (recordings completed).

Salbutamol 400 µg (single dose, no longer given since January 2017)

From the beginning of the study until the end of year 2016 L-arginine infusion 10 mg/kg/min could be given for 10 minutes to examine acute haemodynamic effects (recordings completed).

L-arginine (10 min infusion, no longer given since January 2017)

Daily liquorice intake (daily glycyrrhizin dose 290-370 mg) for two weeks, measurements before and after intervention (recordings completed).

Liquorice (2 weeks, glycyrrhizin 290-370 mg daily, no longer given since 2012)

Daily intake of yoghurt containing small milk casein-derived polypeptides (12 weeks) and placebo yoghurt (12 weeks), measurements before and after intervention (recordings completed 2011).

Small milk casein-derived polypeptides (12 weeks daily, recordings completed 2011)

Bisoprolol 5 mg daily for 3 weeks and placebo tablet daily for 3 weeks, double-blind, randomized, placebo-controlled cross-over protocol. Measurements before and after interventions (recordings completed 2011).

Bisoprolol (5 mg daily for 3 weeks, recordings completed 2011)

Ilkka H Pörsti, MD, PhD, Professor

Elina J Hautaniemi, PhD

Ilkka Pörsti, Professor

Ilkka H Pörsti, Professor

Ilkka Pörsti, MD, PhD, Professor

Ilkka Pörsti, MD, PhD

The primary aim of the present study was to examine the haemodynamic changes in primary hypertension and secondary hypertension (renal diseases, endocrine diseases, obesity-associated hypertension) with a non-invasive haemodynamic measurement protocol utilizing radial pulse wave analysis and whole-body impedance cardiography in both supine position and during head-up tilt. For comparison, haemodynamics of subjects with chronic fatigue syndrome will also be recorded.

Elevated blood pressure (BP) and related cardiovascular complications are the leading causes of morbidity and mortality in the modern world. In routine clinical practice, the haemodynamic status is commonly assessed by measuring heart rate and blood pressure at rest, which provides only limited information about functional haemodynamic status. In addition, the haemodynamic changes resulting in similar elevations of BP may differ substantially between patients and disorders.

Therefore, we investigated the haemodynamic changes in primary and secondary hypertension and in the control subjects with non-invasive radial pulse wave analysis and whole-body impedance cardiography. The method includes the determination of volume status using bioimpedance spectroscopy, determination of peripheral and central BP, cardiac function, vascular resistance, arterial compliance and indices of pulse wave reflection. Besides the measurements performed in the supine position, passive orthostatic challenge is included in the protocol to assess the upright functional haemodynamic status.

The repeatability and reproducibility of the protocol was first examined with a double-blind, randomized protocol in 35 subjects (methodological study group), and after that the administration of research drugs has been open-label. The effects of single doses of two largely endothelium-dependent agents, inhaled salbutamol and intravenous L-arginine, and one endothelium-independent agent, sublingual nitroglycerin, were investigated. However, challenges with the acute dosing of all medical compounds was terminated at the end of December 2016. Thereafter, the measurement protocol has included supine and upright recordings on the tilt-table, followed by supine measurements during paced breathing (15 breaths per minute for 5 minutes, 6 breaths per minute for 5 minutes) that modulate the autonomic nervous tone.

The study population has consisted of subgroups described below. The study protocol of each subgroup has been approved by the ethics committee of the Pirkanmaa Hospital District (Ethics committee ID's above), and the administration of research drugs has also been approved by the Finnish Agency for Medicines (EudraCT-numbers above).

HaemoDYNAMICs in Primary and Secondary Hypertension

Non-Invasive HaemoDYNAMICs in Primary and Secondary Hypertension: the DYNAMIC-study

Haemodynamic measurements are performed at baseline, and after approximately 10 years of follow-up

All cardiovascular events during follow-up

Rapid haemodynamic responses are assessed during the same measurement session (the response to head-up tilt and to research drugs salbutamol, nitroglycerin and L-arginine)

The change in haemodynamic variables after daily consumption of liquorice (2 weeks); bisoprolol (3 weeks); small milk casein-derived polypeptides (12 weeks)

Recordings are performed during normal conditions (training peroid) and after completion of a full-length Ironman competition

Finnish Foundation for Cardiovascular Research

Paavo Nurmi Foundation

Sigrid Jusélius Foundation

Finnish Cultural Foundation

Tampere Tuberculosis Foundation

Medical Research Fund of the Tampere University Hospital, Finland

Aarne Koskelo Foundation

Finnish Medical Foundation

Finnish Kidney Foundation

Päivikki and Sakari Sohlberg Foundation, Finland

Tampere University

MD, PhD, Professor of Internal Medicine

Digestive System Diseases

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Pharmaceutical Solutions

Administered in 250ml boluses, until cardiac output has been optimised.

Hartmann's solution

John P Williams, PhD

David Read, BMBS

The purpose of this study is to investigate whether increases in the blood flow from the heart (the cardiac output), induced by the administration of intravenous fluids, lead to an increase in the blood flow to the vital organs, in patients undergoing bowel surgery.

This study will involve 2 phases. Firstly, potential volunteers will be invited to meet the research fellow (medical doctor) undertaking this study, who will check their suitability to participate in the study and who will obtain informed consent.

The second phase is the study itself which will take place whilst volunteers are having their bowel operation. They will attend theatre in the normal way, but once they have been anaesthetised (put to sleep), a special monitor called an oesophageal doppler probe will be placed into their oesophagus (food pipe) via the nose. This monitor is frequently used in bowel surgery to help assess how much intravenous fluid to administer to a patient by measuring the cardiac output (the amount of blood pumped out of the heart each minute). Using the cannula (drip) already inserted in the arm to allow administration of the anaesthetic, a special fluid, called an ultrasound contrast agent, will be injected into the drip, to allow a contrast enhanced ultrasound scan of the abdominal organs to be performed, to measure the blood flow to these organs. A small sample of blood will be taken from the earlobe to allow us to measure a chemical in the blood called lactate.

After this, intravenous fluid will be administered in order to increase the amount of blood pumped out of the heart. Once the oesophageal doppler monitor suggests that an adequate amount of fluid has been given, a second ultrasound scan will be performed to measure whether blood flow to the abdominal organs has also increased. A further blood sample will be taken from your earlobe to measure any change in lactate level.

At the completion of the operation, a third ultrasound scan will be performed and another sample of blood taken from the earlobe, to help assess blood flow to the organs.

Potential participants (patients with colorectal cancer offered an operation) will be highlighted from the Derbyshire NHS trusts colorectal multidisciplinary team meeting. All patients who fulfil entry requirements will be seen by the research fellow after their outpatient meeting with their particular surgeon (if they agree). Information packs containing details of the study (information sheet and consent form) will be given and any questions answered. Patients will be allowed to take the packs away with them and decide whether they would be keen to participate. Interested patients will be consented by the research fellow during their subsequent pre-operative clinic appointment.

The study will take place intra-operatively. Monitoring will be instituted as determined necessary by the attending anaesthetists, but as a minimum will consist of pulse oximetry, ECG and non-invasive blood pressure recording. Intravenous cannulae will be sited and general anaesthesia induced by the anaesthetist responsible for the patient, as would be normal for this type of surgery. Once the patient has been transferred to the operating theatre, the research fellow will insert an ODM probe via either the nasal or oral route and the CO and SV will be measured; this constitutes normal care. A sterile Phillips iU22 USS probe will be placed on the patient's abdomen and the research fellow will administer SonoVue contrast agent intravenously via the cannula already sited to facilitate anaesthesia, up to a maximum dose of 2.4ml. Visceral MVBF will be measured using this CEUS technique. Capillary blood samples will be taken from earlobe for measurement of blood lactate levels by the research fellow. At this stage, as would typically occur during an operation of this nature, the research fellow will administer intravenous colloid suspension in boluses of 3ml/kg, up to a maximum of 15ml/kg, until the CO has been maximised, as judged by the ODM. At this stage, the research fellow will perform a further CEUS of the abdominal viscera by administering Sonovue contrast agent (2nd dose of up to 2.4ml) and measuring MVBF with the Phillips iU22. Repeat samples of capillary blood will be drawn to measure the lactate level by the research fellow. At the end of the operation, a 3rd CEUS of the abdominal viscera, along with further SV \& CO readings, will be made.

Vascular Changes During Colorectal Surgery

Measurement of Changes in Macro- and Microvascular Blood Flow During Major Colorectal Surgery

University of Nottingham

Clinical research fellow in anaesthesia

Syndrome

Central Nervous System Depressants

Antirheumatic Agents

Analgesics

Anesthetics

Propofol

Chrysarobin

Patients undergoing oesophageal- or ventricular resection (n=30)

Measurements are conducted from before induction of anaesthesia and until 2 hours after the start of surgery and include internal carotid artery blood flow, mean arterial pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, forehead skin blood flow and haemoglobin concentrations, depth of anaesthesia, and frontal lobe, skin, and muscle oxygenation. Further measurements are conducted during hyperventilation before induction of anaesthesia and during hypo-, normo- and hypercapnia during anaesthesia.

Blood samples are obtained from the arterial line for evaluation of the arterial CO2 tension and markers of mesenteric traction syndrome. Total volume of blood sampled is less than 75 ml.

Study of cerebral blood flow

Niels H. Secher, MD, D.M.Sc.

Niels D. Olesen, MD

General anaesthesia often reduces blood pressure whereby blood flow to the brain and other vital organs may become insufficient. Thus, medicine is often administered during anaesthesia to maintain blood pressure. However, it is unclear at what level blood pressure should be aimed at during anaesthesia.

Several factors may affect blood flow to the brain during anaesthesia. During surgery on the internal organs, a hormone may be released that dilates blood vessels and causes a so-called mesenteric traction syndrome characterised by a decrease in blood pressure and flushing. This reaction lasts for approximately thirty minutes and is observed in about half of the patients who undergo surgery on the stomach and intestines. It is unknown whether a mesenteric traction syndrome affects blood flow to the brain. Ventilation is also of importance for blood flow to the brain. Thus, blood flow to the brain is reduced by hyperventilation and increases if breathing is slower. It is unclear whether the relation between blood flow to the brain and ventilation is affected during anaesthesia.

This study will evaluate how blood flow to the brain is affected by anaesthesia and standard treatment of a possible reduction in blood pressure. Further, the study will assess whether blood flow to the brain is affected by development of a mesenteric traction syndrome. Lastly, the project will evaluate blood flow to the brain during short-term changes in the patient's ventilation by adjustments on the ventilator.

Thirty patients planned for major abdominal surgery will be included in the project. The study will take place from the patient's arrival at the operation room and until two hours after the start of surgery. Placement of catheters and anaesthesia are according to standard care. Blood flow to the brain will be evaluated using ultrasound. Oxygenation of the brain, skin and muscle will be evaluated by probes that emit light. Depth of anaesthesia is assessed by recording the electrical activity of the brain. Blood pressure is measured by a catheter placed in an artery at the wrist and blood samples will be drawn from the catheter.

Background General anaesthesia reduces blood pressure, but cerebral autoregulation is considered to maintain its blood flow if mean arterial pressure (MAP) is between 60-150 mmHg. Thus, vasoactive medication is administered to treat anaesthesia-induced hypotension if MAP decreases to below approximately 60 mmHg. In young healthy adults, propofol anaesthesia, with limited reduction in blood pressure, decreases cerebral blood flow by approximately 50% by a decrease in neuronal activity. However, it is unknown whether the anaesthesia-induced reduction in cerebral blood flow is affected by a marked decrease in MAP and whether propofol anaesthesia affects the lower level of cerebral autoregulation.

If central blood volume is maintained, cerebral oxygenation may be unaffected by a decrease in MAP to \~40 mmHg whereas a reduction in central blood volume and cardiac output (CO) during orthostasis or bleeding, reduces cerebral oxygenation when MAP is lower than approximately 80 mmHg. Thus, CO may affect cerebral blood flow and the ability to increase CO is likely of importance for maintaining a sufficient cerebral blood flow.

During anaesthesia, cerebral blood flow and MAP may be affected by various factors including release of vasoactive substances. Manipulation of the abdominal organs may induce a so-called mesenteric traction syndrome (MTS) encompassing a triad of flushing, hypotension, and tachycardia in about half of the patients who undergo major abdominal surgery. MTS typically develops 15-20 min after the start of surgery and the haemodynamic manifestations, that appear to be mediated by prostaglandin I2, last for approximately 30 min. The effect of MTS on cerebral blood flow is unknown. Prostaglandin I2 dilates cerebral arteries in vitro but does not affect cerebral blood flow when administered to healthy subjects. In a previous study we found that MTS increases near-infrared spectroscopy determined frontal lobe oxygenation possibly due to an increase in extracranial circulation while there was no effect on middle cerebral artery mean flow velocity as an index of changes in cerebral blood flow.

Propofol anaesthesia appears not to affect the CO2 reactivity of the middle cerebral artery as determined by transcranial Doppler ultrasonography, but the CO2 reactivity of the internal carotid artery during propofol anaesthesia is unknown.

Objective The purpose of this study is to evaluate how internal carotid artery blood flow is affected by propofol anaesthesia and related hypotension, and by administration of phenylephrine as standard care to treat anaesthesia-induced hypotension. Further, the study will assess whether internal carotid artery blood flow is affected by development of MTS and whether propofol anaesthesia affects the CO2 reactivity of the internal carotid artery.

Hypotheses

1. Propofol anaesthesia and related anaesthesia-induced hypotension (MAP \< 65 mmHg) reduces internal carotid artery blood flow
2. Treatment of anaesthesia-induced hypotension by administration of phenylephrine increases internal carotid artery blood flow
3. Development of MTS increases near-infrared spectroscopy determined frontal lobe oxygenation due to an increase in forehead skin blood flow and oxygenation with no effect on internal carotid artery blood flow
4. Propofol anaesthesia lowers the CO2 reactivity of the internal carotid artery

Methods The study will include thirty patients undergoing oesophageal- or ventricular resection. The study lasts from when the patient arrives to the operating room and until two hours after the start of surgery. As part of standard care all patients will be instrumented with arterial and central venous catheters. Anaesthesia will be induced by propofol and maintained by propofol and remifentanil combined with epidural anaesthesia. Development of MTS is defined by flushing within the first 60 min of surgery. Measurements include unilateral internal carotid artery blood flow evaluated by duplex ultrasound, MAP and heart rate as recorded by a transducer connected to the arterial line, central haemodynamics (stroke volume, CO, and total peripheral resistance) evaluated by pulse contour analysis of the arterial pressure curve, frontal lobe and muscle oxygenation as determined by near-infrared spectroscopy, forehead skin blood flow, haemoglobin concentrations, and oxygenation assessed by laser Doppler flowmetry, and depth of anaesthesia determined by Bispectral Index. At each time point 2 measurements of internal carotid artery blood flow are collected and the mean is taken. Arterial blood will be drawn for analysis of the arterial CO2 tension (PaCO2).

During the study PaCO2 will be maintained at the value before induction of anaesthesia by ventilator adjustments. Internal carotid artery CO2 reactivity before induction of anaesthesia will be determined by evaluations of blood flow and PaCO2 during normoventilation and during hyperventilation to reduce PaCO2 by 1.5 kPa as guided by end-tidal CO2 tension (PetCO2) and measurements will be conducted when PetCO2 has been stable for 5 min. The CO2 reactivity during anaesthesia will be determined by evaluations of internal carotid artery blood flow and PaCO2 at a PaCO2 at the value before induction of anaesthesia and 1.5 kPa above and below that value as guided by PetCO2 and measurements will be conducted when PetCO2 has been stable for 5 min. The CO2 reactivity before and during anaesthesia is calculated as the percentage change in internal carotid artery blood flow per kPa change in PaCO2. Analysis of internal carotid blood flow will be after correction for CO2 reactivity.

Blood samples for analysis of markers of MTS (6-keto-prostaglandin-F1, pro-ANP, ACTH, cortisone, IL-1, IL-6, and TNF-α) will be drawn before induction of anaesthesia and 20 and 60 min after the start of surgery. Total amount of blood samples will be no more than 75 ml. Patients will be excluded if the planned surgery is cancelled and excluded patients will be replaced.

Measurements will be conducted and arterial blood drawn at the following time points:

* Before induction of anaesthesia during normoventilation and hyperventilation
* After induction of anaesthesia
* During anaesthesia-induced hypotension (MAP \< 65 mmHg)
* After treatment of anaesthesia-induced hypotension by administration of phenylephrine
* 5 min before and after incision and 0, 20, 40 and 70 min after development of MTS and 20, 40, 60 and 90 min after the start of surgery in patients who did not develop MTS
* During normo-, hyper-, and hypocapnia during anaesthesia in random order

Statistics Trial size: The minimal clinically important difference in internal carotid artery blood flow by treatment of anaesthesia-induced hypotension is considered to be 10%, corresponding to approximately 24 ml/min, and twenty-seven patients were considered required assuming a 42 ml/min SD with a 5% significance level and a power of 80%.

Cerebral Blood Flow During Propofol Anaesthesia

Unilateral internal carotid artery blood flow \[ml/min\] assessed by duplex ultrasound.

Association by multiple regression between changes in unilateral internal carotid artery blood flow \[ml/min\] as outcome variable and changes in mean arterial pressure \[mmHg\] and cardiac output \[l/min\] as covariates.

Internal carotid artery blood flow \[ml/min\] was assessed by duplex ultrasound. Mean arterial pressure \[mmHg\] was recorded by a transducer connected to an arterial line. Cardiac output \[l/min\] was evaluated by pulse contour analysis (Modelflow) that estimates cardiac output by analysis of the arterial pressure curve taking age, gender, height and weigth into account.

Near-infrared spectroscopy determined frontal lobe oxygenation \[%\] as compared between those patients who develop a MTS (defined as flushing within 60 min after the start of surgery) and those who do not. An effect of a MTS was evaluated by a repeated measure mixed model with the fixed effects time point, group according to development of MTS, and interaction between time and group. The reported result is the interaction factor for the time point 0 min after flushing and 20 min after the start of surgery in patients who did not develop MTS.

Forehead skin blood flow \[PU\] assessed by laser Doppler flowmetry as compared between those patients who develop mesenteric traction syndrome (defined as flushing within 60 min after the start of surgery) and those who do not. Laser Doppler flowmetry applies a laser placed on the forehead that penetrates the skin and is scattered with a Doppler shift by the red blood cells and return to a detector that evaluates the amount of backscattered light and Doppler shift. An effect of a MTS was evaluated by a repeated measure mixed model with the fixed effects time point, group according to development of MTS, and interaction between time and group. The reported result is the interaction factor for the time point 0 min after flushing and 20 min after the start of surgery in patients who did not develop MTS.

Forehead skin oxygenation \[%\] assessed by laser Doppler flowmetry as compared between those patients who develop a MTS (defined as flushing within 60 min after the start of surgery) and those who do not. An effect of a MTS was evaluated by a repeated measure mixed model with the fixed effects time point, group according to development of MTS, and interaction between time and group. The reported result is the interaction factor for the time point 0 min after flushing and 20 min after the start of surgery in patients who did not develop MTS.

Unilateral internal carotid artery blood flow \[ml/min\] assessed by duplex ultrasound as compared between those patients who develop a MTS (defined as flushing within 60 min after the start of surgery) and those who do not. An effect of a MTS was evaluated by a repeated measure mixed model with the fixed effects time point, group according to development of MTS, and interaction between time and group. The reported result is the interaction factor for the time point 0 min after flushing and 20 min after the start of surgery in patients who did not develop MTS.

Unilateral internal carotid artery blood flow \[ml/min\] assessed by duplex ultrasound and arterial CO2 tension (PaCO2) \[kPa\] was evaluated by gas analysis. Changes in PaCO2 are guided by evaluation of end-tidal CO2 tension.

The CO2 reactivity to hypocapnia when awake and during anaesthesia is calculated as the percentage change in internal carotid artery blood flow per kPa change in PaCO2. The CO2 reactivity when awake and when anaesthetized is compared.

Heart rate \[bpm\] as recorded continuously by a transducer connected to an arterial line.

Mean arterial pressure \[mmHg\] as recorded continuously by a transducer connected to an arterial line.

Cardiac output \[l/min\] as evaluated continuously by pulse contour analysis of the arterial pressure curve (Modelflow).

Stroke volume \[ml\] as evaluated continuously by pulse contour analysis of the arterial pressure curve (Modelflow).

Rigshospitalet, Denmark

Patients undergoing oesophageal- or ventricular resection (n=30)

Study of cerebral blood flow: Measurements are conducted from before induction of anaesthesia and until 2 hours after the start of surgery and include internal carotid artery blood flow, mean arterial pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, forehead skin blood flow and haemoglobin concentrations, depth of anaesthesia, and frontal lobe, skin, and muscle oxygenation. Further measurements are conducted during hyperventilation before induction of anaesthesia and during hypo-, normo- and hypercapnia during anaesthesia.

Blood samples are obtained from the arterial line for evaluation of the arterial CO2 tension and markers of mesenteric traction syndrome. Total volume of blood sampled is less than 75 ml.

Study of Cerebral Blood Flow

Age, Categorical

Age, Continuous

Sex: Female, Male

Race (NIH/OMB)

Denmark

Region of Enrollment

Internal carotid artery blood flow during anesthesia-induced hypotension

Niels D. Olesen

Changes in Internal Carotid Artery Blood Flow by Treatment of Anaesthesia-induced Hypotension

Changes in Internal Carotid Artery Blood Flow by Induction of Anaesthesia.

Association by Multiple Regression Between Changes in Internal Carotid Artery Blood Flow, Mean Arterial Pressure and Cardiac Output by Treatment of Anaesthesia-induced Hypotension.

Changes in Frontal Lobe Oxygenation by Development of Mesenteric Traction Syndrome (MTS).

Changes in Forehead Skin Blood Flow by Development of Mesenteric Traction Syndrome (MTS).

Changes in Forehead Skin Oxygenation by Development of Mesenteric Traction Syndrome (MTS).

Changes in Internal Carotid Artery Blood Flow by Development of Mesenteric Traction Syndrome (MTS).

Comparison of reactivity to hypocapnia when awake and during anaesthesia was evaluated by a linear mixed model with the relative change in ICA flow as outcome and fixed effects were the change in PaCO2 and an interaction factor for the difference between awake and anaesthesia. The reported result is the interaction factor.

Changes in the CO2 Reactivity of the Internal Carotid Artery From Before to After Induction of Anaesthesia.

Changes in Heart Rate From Baseline Before Induction of Anaesthesia.

Changes in Mean Arterial Pressure From Baseline Before Induction of Anaesthesia.

Changes in Cardiac Output From Baseline Before Induction of Anaesthesia.

Changes in Stroke Volume From Baseline Before Induction of Anaesthesia.

Overall Study

Respiratory Tract (Lung and Bronchial) Diseases

Lung Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Ya-Jung Cheng

Non-intubated thoracoscopic surgery has been proved as an adequate alternative for management of many lung conditions such as pneumothorax , lung volume reduction, pulmonary metastasectomy, removal of lung nodules, segmentectomy and lobectomy. However, the hemodynamic changes during one lung ventilation have not been fully investigated. The goals of this study are to compare the changes of hemodynamics (including blood pressure, heart rate, cardiac output, pulse pressure variation, fluid responsiveness) during one lung ventilation between conventional intubated and non-intubated vedio-assisted thoracoscopic (VATS) operations.

Non-intubated vedio-assisted thoracoscopic (VATS) is proved safely performed as well as traditional intubated VATS. However, the differences of hemodynamic changes and fluid responsiveness during one lung ventilation(OLV) between these two groups were rarely reported. For complete lung collapse, spontaneous negative pressure respiration must be well maintained on non-intubated VATS. In comparison, positive pressure ventilation on dependent lung was applied during OLV in intubated VATS. This study planned to compared the changes of hemodynamics (including blood pressure, heart rate, cardiac output) during OLV between groups. As functional hemodynamic monitoring (FloTrac system) was mostly utilized with positive pressure ventilation, the applicability of FloTrac in non- intubated VATS was also testified. In this study, we also measure the fluid responsiveness by FloTrac system with rapid infusion (within 10 minutes) of 10 mL/kg crystalloid fluid. We planned to compare the changes on cardiac output and the fluid responsiveness during OLV between these two groups.

Hemodynamic Changes During One Lung Ventilation in Non-intubated Vedio-assisted Thoracoscopic Operations

Hemodynamic Changes and Fluid Responsiveness During One Lung Ventilation: Comparison in Non-intubated and Intubated Vedio-assisted Thoracoscopic Operations

record the stroke volume and cardiac output during two lung ventilation till 15 minutes after one lung ventilation

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
HaemoDYNAMICs in Primary and Secondary Hypertension	NCT01742702	Primary Hyperte... Secondary Hyper... Aortic Stenosis Renal Insuffici...	Nitroglycerin 0... Salbutamol 400 ... L-arginine (10 ... Liquorice (2 we... Small milk case... Bisoprolol (5 m...	18 Years - 99 Years	Tampere University
Vascular Changes During Colorectal Surgery	NCT02136277	Patients Underg...	Hartmann's solu...	18 Years - 80 Years	University of Nottingham
Cerebral Blood Flow During Propofol Anaesthesia	NCT02951273	Gastrointestina...	Study of cerebr...	18 Years -	Rigshospitalet, Denmark
Hemodynamic Changes During One Lung Ventilation in Non-intubated Vedio-assisted Thoracoscopic Operations	NCT02123173	Lung Neoplasms		20 Years - 70 Years	National Taiwan University Hospital
Vascular Changes During Colorectal Surgery	NCT02136277	Patients Underg...	Hartmann's solu...	18 Years - 80 Years	University of Nottingham

Spots Global Cancer Trial Database for cardiac output