1990 Fiscal Year Final Research Report Summary
Cardiodynamic Study on the Low Pressure System Under Anesthesia
| Project/Area Number |
63480355
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
麻酔学
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| Research Institution | Kurume University |
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Principal Investigator |
MUTEKI Takesuke Kurume University School of Medicine Professor, 医学部, 教授 (60080917)
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| Co-Investigator(Kenkyū-buntansha) |
TAKAGI Toshiaki University of Occupational and Environmental Health, School of Medicine, Lecture, 講師 (90098864)
SHIMIZU Daiidhiro Kurume University School of Medicine Lecturer, 医学部, 講師 (70131761)
UEDA Naoyuki Kurume University School of Medicine Lecturer, 医学部, 講師 (70148831)
TSUDA Hideaki Kurume University School of Medicine Associate Professor, 医学部, 助教授 (10080920)
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| Project Period (FY) |
1988 – 1990
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| Keywords | venous return / mean circulatory filling pressure / graphic analysis / vasodilator / cardiodynamics / pulsed doppler flowmetry / alpha-ANP / venous return resistance |
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| Research Abstract |
Our research work has been aimed to document clinical significance of Venous Return (VR) mechanism in circulatory management for critically ill and surgical patients. In order to extend clinical significance of monitoring of Central Venous Pressure (CVP) and its waveforms, electromechanical analysis of CVP waveforms was made with an aid of fiber optic technique and microcomputer under critical care, and clinical measurement of mean circulatory filling pressure (Pms) was newly accomplished by graphic analysis. Venous Return Resistance (VRR) was then calculated by the equation of Pms - CVP/VR. Rvr was changed correlatively by a decrease of Pms than that of CVP and was reduced in higher cardiac out group under circulatory management with vasodilator such as GTN and PGE_1. Cardiodynamic analysis of venous return flow during closed chest cardiac massage was carried out and regurgitant fraction of venous return flow to RV was found in closed - chest cardiac massage with a fundamental study o
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n changes of blood flow and dimension of inferior caval vein with use of pulsed doppler flow/dimension system. It was therefore suggested that closed chest cardiac massage should be carefully performed in order to maintain cardiac output efficiently during restricted time in cardiac resuscitation.
Interrelation between right cardiac hemodynamics and plasma levels of alpha - ANP was investigated in three groups of mongrel dogs under various modes of mechanical ventilation. HFJV improved diuretic function, while CPPV impaired a release of alpha - ANP. HFJV also facilitated cardiodynamic performance of the right heart and increased urinary output under elevated intra - thoracic pressure. These results suggested that facilitatory action on venous return to the heart and a secretion of alpha - ANP may contribute to improve diuretic function during HFJV, where as continuous distention of the lung under CPPV may impair venous return and secretion of alpha - ANP, and consequently, may depress diuretic functions. Our research work pertaining to venous return hemodynamics particularly suggested that clinical measurement of Pms and Rvr in surgical patients is useful in order to develop a new aspect of circulatory management during anesthesia. Less
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