ABSTRACT
Objective To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes.Methods From October 2012 to October 2017,200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group,and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group.The independent risk factors of the children in the observation group were analyzed,and the difference of the maximum systolic blood flow velocity (SV),the diastolic maximum flow velocity (DV),the systolic and diastolic velocity ratio (S/D),the resistance index (RI),and the pulsatile index (PI) were compared between the two groups.Results Neonatal asphyxia,preterm birth,acidosis,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage.The bleeding side SV and DV of the observation group were higher than those of the control group,with statistically significant difference (P ＜ 0.001).In the observation group,the bleeding side SV and DV were higher than those of the healthy side,with statistically significant difference (P ＜0.001).There was no significant difference in bleeding side SV,DV,S/D,RI and PI in 110 cases of single side ependymal hemorrhage (P ＞ 0.05).Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound,and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity,so as to prevent the further aggravation of subependymal hemorrhage
ABSTRACT
Objective To investigate the effect of fluid resuscitation on hemodynamics in dogs with hemorrhagic shock at the initial stage of getting high altitude. Method he models of severe hemohagic shock were established in 13 mongrel dogs after they were brought to the high altitude a/ea and were mndondvvided inIo 3 group: LR group(n=3),6% HES group(n=5)and control group(n=5).The dogs in LR group wefe intravenously infused with lactated Ringers solution in 1.5 limes exsanguinated volume;those in 6% HES group were given hydroxyethyl starch in equal volume of exsanquination. A drop of solution waft noven to dogs in con,trol group.One hour after restritation,lactated Ringers solution waft infused at 5 Ilps as maintenance dose.The hemodynmnic variables were recorded.Results All animals in control group died two hour later.In LR group,the hemedynamie variables including MAP,CO,PAWP,CVP,LVSWI and RVSWI two hours after infiion were signifieantly higher than those.one hour after infusion(P<0.05),while HR,SVRd PVR were significantly lower(P<0.05).In dogs of 6% HES group,CO,PAP,PAWP,CVP,SVR and PVR two hours after infusion were significantly higher than those one hour after infusion(P<0.05),but MAP.HR.CI,LVSWI and RVSWI were not significantly different(P>0.05).Conclusions All of three doith hen rhagic shock would die(3/3)at the initial stage of being brought to high altitude alles without fluid resuscitation. Fluid resuscitation with LR solution 1.5 times the exsanquinated volume was effective and safe. The infusion of 6% hydroxyethyl starch at equal volume of exsanqination may easily cause heart failure or pulmonary edema.