The correlation between carotid blood flow and the parameters derived by pulse oximetry plethysmographic waveform during cardiopulmonary resuscitation in a porcine model / 中华急诊医学杂志

Objective:To explore the correlation between carotid blood flow and the parameters derived by pulse oximetry Plethysmographic waveform in cardiopulmonary resuscitation, so as to provide a new index for carotid blood flow monitoring in cardiopulmonary resuscitation.Methods:Seven male domestic pigs were utilized for cardiac arrest model through ventricular fibrillation induced by electrical stimulation. Eight minutes after cardiac arrest, artificial chest compression was given for 4 min, and epinephrine 20 μg/kg was injected intravenously at 2 min after chest compression. The compression frequency, compression depth, right carotid blood flow, pulse oximetry plethysmographic waveform, aortic pressure, right atrium pressure and end tidal carbon dioxide partial pressure were continuously monitored and recorded. From 30 s to 4 min after chest compression, the values of the mean right carotid blood flow, the area under curve (AUC) of pulse oximetry plethysmographic waveform, the mean perfusion index, the mean coronary perfusion pressure and the average end-tidal carbon dioxide partial pressure during 6 s before time point were calculated every 30 s. The correlations between right carotid blood flow and the AUC of pulse oximetry plethysmographic waveform and perfusion index were analyzed respectively.Results:Ventricular fibrillation was induced successfully in seven animals. There were no significant differences in the mean chest compression frequency and depth per min during 4 min of chest compression. Right carotid blood flow at 30 s after chest compression was (92.7±32.7) mL/min, and decreased to (48.5±23.5) mL/min at 1 min after chest compression ( P<0.05). There was no significant difference in blood flow before and after epinephrine injection ( P>0.05). The AUC of the blood oxygen plethysmographic waveform and perfusion index showed synchronous change trends with right carotid blood flow. Both coronary perfusion pressure and end-tidal carbon dioxide partial pressure showed different change trends with right carotid blood flow. There was a positive correlation between the right carotid blood flow and the AUC of blood oxygen plethysmographic waveform ( r=0.66, P<0.01), and also a positive correlation between right carotid blood flow and perfusion index ( r=0.57, P<0.01). Conclusions:Carotid blood flow is positively correlated with the AUC of blood oxygen plethysmographic waveform and perfusion index in a porcine model of cardiopulmonary resuscitation. Real-time monitoring of the two parameters derived by pulse oximetry plethysmographic waveform can reflect the changes of carotid blood flow to a certain extent.

Combined effects of bilateral thoracic sympathectomy and hypercarbia on common carotid blood flow volume in dogs

BACKGROUND: The occurrence of acute hypercarbia during endoscopic thoracic sympathectomy is not rare when CO2 gas is used to collapse lung. Upper thoracic sympathectomy can increases cerebral blood flow (CBF) and hypercarbia also increases CBF. The purpose of this study was to analyze the changes in common carotid blood flow volume (CCBFV) before and after T2 thoracic sympathectomy at normocarbia and hypercarbia. METHODS: In nine anesthetized and mechanically ventilated dogs, we checked CCBFV using an ultrasonic flow probe under four experimental conditions: 1) before T2 sympathectomy at normocarbia, 2) before T2 sympathectomy at hypercarbia, 3) after T2 sympathectomy at normocarbia, and 4) after T2 sympathectomy at hypercarbia. We also measured heart rate, blood pressure and PaCO2 at each time. RESULTS: Hypercarbia increased CCBFV from 105.2 +/- 47.9 ml/min to 192.3 +/- 85.4 ml/min. In T2 sympathectomy/normocarbia state, CCBFV increased to 152.2 +/- 62.0 ml/min. In T2 sympathectomy/hypercarbia state, CCBFV increased to 230.2 +/- 100.1 ml/min. CCBFV in hypercarbia state, sympathectomy state and sympathectomy/hypercarbia state showed significant increases compared with those in baseline (P < 0.05). CCBFV in hypercarbia state and sympathectomy/hypercarbia state showed significant increases compared with those in sympathectomy state (P < 0.05). But CCBFV in hypercarbia state and sympathectomy/hypercarbia did not showed significant differences. CONCLUSIONS: This result suggests that hypercarbia increases CCBFV more than sympathetic denervation and thoracic sympathectomy under hypercarbia condition increases CCBFV more than sympathectomy only.

The Effect of Acute Hemodilution on Carotid Blood Flow, Arterial Blood Gas Analysis and Acid-Base Balance in Rabbits / 대한마취과학회지

BACKGROUND: Hemodilution is known to increase cerebral blood flow, but it is not known why it is. We tried to investigate about these question like above. METHODS: Blood flow were checked on carotid artery after hemodilution by using electromagnetic blood flow-meter in 10 rabbits. Hemodilution was induced as 15 ml of lactated Ringers solution (LR) was infused after removing 5 ml of blood. Hemodilution was done 5 times in each rabbit. At 15 minutes after each hemodilution procedure, blood flow was checked and arterial blood gas analysis, and they compared with control data. The Sigma STAT and one way repeated measured ANOVA in Bonfferoni correction and regression analysis with DBSTAT PC application were used for statical analysis. RESULTS: Hemoglobin concentration and hematocrit in blood according to each hemodilution step decreased. At the same time, carotid blood flow increased following hemodilution. Though PaO2 level was not changed, CaO2 and pH, bicarbonate, and base excess in accordance with hemodilution were decreased. Also carotid blood flow calculated as increase 2.5 ml/min whenever hematocrit decreased 1%. CONCLUSIONS: We concluded as follow. Carotid blood flow increased to 2.5 ml/min (4.7%) whenever hematocrit decreased 1% by hemodilution. Whenever 15 ml of L/R solution was infused for acute hemodilution, carotid blood flow increased, on the contrary, hematocrit and arterial oxygen content decreased. Metabolic acidosis was induced by the large amount of L/R solution and it may be affected to carotid blood flows.

Effects of electrical acupuncture to the stellate ganglion on carotid blood flow, deep tissue temperature, blood pressure and pulse rate in the humans / 全日本鍼灸学会雑誌

Previously we reported effects of acupuncture to the stellate ganglion on measurements of skin electroconductivity by a Neurometer.<br>By using 8 healthy adults and 23 patients, we measured effects of electrical acupuncture to the stellate ganglion on carotid blood flow, deep tissue temperature, blood pressure and pulse rate in order to clarify the influence on functions of the autonomic nervous system.<br>After electrical acupuncture to the right stellate ganglion (SGA), the right and left carotid blood flow decreased with 4-9% and 7-12%, respectively. Deep tissue temperature of the right anterior forearm after SGA showed a little increase (with no significance), while the temperature increased with 0.4-0.7°C after the right stellate ganglion block (SGB). Deep tissue temperature of the left anterior forearm showed no significant change after SGA, while it increased with 0.1-0.3°C significantly after SGB. Systolic blood pressure increased with 2-4mmHg after SGA and this also increased with 9-11mmHg after SGB. Those increases were significant. While the pulse rate decreased (2bpm) significantly after SGA, it increased (4-6bpm) significantly after SGB.<br>Except the decreased pulse rate after SGA, the other data did not support a common hypothesis that electrical acupuncture to the stellate ganglion suppresses the sympathetic system as SGB.