The concept that a specific level of central venous pressure (CVP) limits man's adjustment to heat stress has been debated. Evidence was presented that identifies a true limit of adjustment as being more related to factors affecting evaporative cooling, such as level of hydration, release of active vasodilation substance (AVS), and sweat gland fatigue. However, it was conceded that decreases in...

A variety of procedures were used to change hemodynamics acutely and thereby to produce changes in blood volume. Changes in plasma specific gravity showed no relation to those in aortic pressure or total peripheral resistance, but were related to central venous pressure. The simultaneous cell fraction tended to vary reciprocally with the plasma specific gravity, indicating a bulk transfer of ei...

The aim of the study was to assess the effect of commonly used intravertebral anesthesia on bone cement implantation syndrome (BCIS) in aged patients undergoing hemiarthroplasty.The medical records of 1210 aged patients receiving hemiarthroplasty under intravertebral anesthesia were retrospectively reviewed. Anesthesia charts for all patients were reviewed for central venous pressure, mean arte...

Hemodynamic monitoring is used to identify deviations from hemodynamic goals and to assess responses to therapy. To accomplish these goals one must understand how the circulation is regulated. In this review I begin with an historical review of the work of Arthur Guyton and his conceptual understanding of the circulation and then present an approach by which Guyton's concepts can be applied at ...

Activity in Patients With Vasovagal Syncope To the Editor: In their study, “Dysfunctional Baroreflex Regulation of Sympathetic Nerve Activity in Patients With Vasovagal Syncope,” Béchir et al1 implied a unilateral causal relationship between reduction of arterial baroreflex control of heart rate and increase of muscle sympathetic nerve activity (MSNA) in patients with syncope. The authors concl...

PURPOSE OF REVIEW Echocardiography has become more widely available to noncardiologists because of the technological advances in smaller, multipurpose ultrasound units with basic cardiac capabilities. In this review, we discuss the type of clinical information a trained intensivist can hope to obtain from bedside echocardiography and suggest the ways in which this complements traditional hemody...

Background: Neonatal intensive care unit (NICU)Conventionally, Central Venous Pressure (CVP) monitoring has beenused by intensivists to measure intravascular volume. However, it is an invasive procedure resulting in many complications. Non-invasive ultrasonographic measurement of inferior vena cava collapsibility index (IVC-CI) is a promising alternative. Therefore, this study wasconducte...

We have investigated, in 13 artificially ventilated and anaesthetized patients, the cardiovascular effects of peritoneal insufflation of carbon dioxide preparatory to laparoscopy. Stepwise increases of intra-abdominal pressure up to a maximum of 25 cm H(2)O were accompanied by increases of airway pressure, intrathoracic pressure, central venous pressure, and femoral venous pressure and by signs...

Definitions of shock and resuscitation endpoints traditionally focus on blood pressures and cardiac output. This carries a high risk of overemphasizing systemic hemodynamics at the cost of tissue perfusion. In line with novel shock definitions and evidence of the lack of a correlation between macro- and microcirculation in shock, we recommend that macrocirculatory resuscitation endpoints, parti...

Maintaining the optimal blood pressure is an important aspect of preventing acute kidney injury (AKI), especially for vasopressor-dependent patients. Although mean arterial pressure (MAP) has played an important role in previous trials for prevention of AKI, there is little evidence that MAP actually reflects organ perfusion. In fact, several studies have suggested that perfusion pressure, incl...