THE HIGHER CALF PRESSURE INDUCED BY WEARING GRADUATED ELASTIC COMPRESSION STOCKING INCREASES CALF VENOUS COMPLIANCE / 体力科学

The purpose of the present study was to clarify effect of increase in calf pressure on calf venous compliance. The calf pressures were increased by wearing elastic compression stockings with different pressures (Calf pressure 0, 12, 17, 21 mmHg). Healthy twelve people (six men and six women, 43.3±15.3 years) volunteered to participate in this study. Changes in calf venous volume during spine rest were measured by mercury plethysmography. We analyzed the calf venous compliance by inflating the venous collecting cuff to 60 mmHg for 7 min, then decreasing cuff pressure at 1 mmHg/sec (over 1 min) to 0 mmHg, using cuff pressure as an estimate of venous pressure. This method produced pressure-volume curves fitting the quadratic regression (Δlimb volume)=β₀+β₁·(cuff pressure)+β₂·(cuff pressure)², where Δ is change. The higher calf venous compliance and volume were observed in with the higher pressure stocking. These results suggest that higher calf pressure induced by wearing elastic compression stocking increases calf venous compliance and maximum venous outflow.

The Effect of Thiopental Sodium, Etomidate and Propofol on Systemic Vascular Resistance and Venous Capacitance during Cardiopulmonary Bypass / 대한마취과학회지

BACKGROUND: The focus of this study is the effects of thiopental sodium, etomidate and propofol on systemic vascular resistance and venous capacitance during cardiopulmonary bypass with constant pump flow. METHODS: Thirty patients (ASA III) scheduled for open heart surgery were randomly divided into three groups. Anesthesia was induced with thiopental sodium 5 mg/kg, fentanyl 5 microgram/kg and vecuronium 1 mg/kg. CPB was conduced with a membrane oxygenator using non-pulsatile flow and moderate hypothermia. When rectal temperature and pump flow had been stable for 5 min, patients randomly received thiopental sodium 4 mg/kg, etomidate 0.3 mg/kg and propofol 2 mg/kg. Perfusion pressure and pump flow were measured 0, 1, 3, 5, 10, 15, 20 and 30 min after administration. RESULTS: The systemic vascular resistance index (SVRI) decreased to 84.3% of the control values after thiopental sodium 4 mg/kg, to 74.7% of the control after etomidate 0.3 mg/kg and to 79.8% of the control after propofol 2 mg/kg. SVRI returned to control value levels 3 min after the administration of thiopental sodium, 20 min after etomidate, and 5 min after propofol. Thiopental sodium, etomidate and propofol reduced venous reservoir volume 1 min after injection and the reduction was sustained throughout the all period of the cardiopulmonary bypass. CONCLUSIONS: The results indicate that thiopental sodium, etomidate and propofol dilate both resistance and capacitance vessels, but there was no correlation between the two vessels.

Vasodilator Properties of Nitroglycerin, Isosorbide Dinitrate and Chlorpromazine during Cardiopulmazine during Cardiopulmonaty Bypass / 대한마취과학회지

In a placebo-controlled trial, we have studied the vasodilator properties of bolus dose of nitroglycerin, isosorbide dinitrate and chlorpromazine in 38 patients during cardiopulmonary bypass with a constant pump flow. Mean arterial pressure and blood volume of the venous reservoir were recorded for 10 min after drug administration to detect changes in arteriolar resistance and venous capacitance, respectively. Nitroglycerin, 2.5 ug/kg, decreased arterial pressure, but the effect lasted for 3 minutes. Chlorpromazine, 0.1 mg/kg, decreased arterial pressure for 9 minutes. Isosorbide dinitrate, 20 ug/kg, had no significant change on arterial pressure. The venous capacitance-increasing effects of nitroglycerin and chlorpromazine were significant for 4 minutes after the bolus. Thereafter the effect of nitroglycerin began to decline, while that of chlorpromazine significantly continued. Isosorbide dinitrate had no significant change on venous reservoir level. The SVR reduction effects of nitroglycerin was significant for 3 minutes, chlorpromazine decreased SVR for over 10 minutes. In conclusion chlorpromazine effect on arterial pressure and venous capacitance was more potent and longer than nitroglycerin and isosorbide dinitrate. Nitroglycerin and chlorpromazine effect on preload and afterload were significant after bolus dose.

Vasodilating Effect of Sodium Nitroprusside, Nitroglycerin, and Isosorbide Dinitrate during Cardiopulmonary Bypass / 대한마취과학회지

We have studied the vasodilating effect of bolus doses of sodium nitroprusside (SNP), nitro- glycerin (NTG), and isosorbide dinitrate (ISDN) in 40 patients during cardiopulmonary bypass with a constant pump flow. Blood volume of the venous reservoir and mean arterial pressure were recorded for 10 minutes after drug administration to detect changes in venous capacitance and arteriolar resistance. SNP 500 ug decreased mean blood pressure significantly more than NTG and ISDN compared with placebo. NTG 500 ug decreased mean blood pressure transiently at 1-4 min but significantly reduced reservoir blood volume. ISDN 500 ug increased mean blood pressure after drug administration, decreased reservoir blood volume less than NTG. We could conclude that SNP was more effective arteriolar vasodilator than NTG and ISDN, but NTG and ISDN were effective as a venodilator during cardiopulmonary bypass.