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Biomedical subjects

U Dinnar

Publications and source records attributed to U Dinnar.

34 records · Page 2Linked to original sources
PubMed1985

Intrathoracic and abdominal pressure variations as an efficient method for cardiopulmonary resuscitation: studies in dogs compared with computer model results.

Intrathoracic pressure variations are currently proposed as the main flow-generation mechanisms in standard and modified cardiopulmonary resuscitation (CPR) techniques. A method of changing pressure within the thorax and abdomen without any degree of heart compression was developed and tested in dogs. Intrathoracic and abdominal pressure waves were induced by cyclic inflation and deflation of the lungs and of perithoracic and periabdominal balloons. Various modes of CPR, depending on the rate of cycling, the use of a periabdominal balloon inflation, and a delay between the abdominal and thoracic pressure waves, were studied during ventricular fibrillation. During artificial systole (high intrathoracic pressure phase), the pressure which developed in the right ventricle (96.7 +/- 20.5 mmHg) was higher than the pressure in the aorta (89.3 +/- 20.5 mmHg, p less than 0.001). In artificial diastole (low intrathoracic pressure phase), the right ventricular pressure (11.7 +/- 2.6 mmHg) was lower than the aortic pressure (17.5 +/- 3.3 mmHg, p less than 0.001). The average flow in the carotid artery was 21.7 +/- 7.8 ml . min-1, which was 18 +/- 6% of the baseline carotid flow before CPR. Three different factors were found to improve the efficiency of CPR: periabdominal balloon inflation simultaneous with the intrathoracic pressure waves; increased frequency of the pressure waves from 60 to 100 cycles per minute; and inflation of the periabdominal balloon 50 to 100 ms before the thoracic balloon. Blood-gas and acid-base balance analysis during CPR revealed well-oxygenated arterial blood with a marked respiratory alkalosis and a slowly developing metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1985

A numerical simulation of the flow in a T-type bifurcation and its application to an "end to side" fistula.

Some recent surgical procedures such as arteriovenous fistula, or coronary and cerebral by-passes were observed to yield counterdirectional branching blood flows. There is a lack of knowledge about the role of the counterdirectional flow ratio, the angle of anastomosis and the shear stresses in the process of thrombogenesis that leads to shunt occlusion. The program developed to simulate these hemodynamic conditions uses an efficient numerical scheme for the solution of the 2-D Navier-Stokes equations and can be easily adapted to flows in other geometrical configurations.

Arteriovenous Shunt, Surgical↗
PubMed1984

Cardiopulmonary resuscitation by intrathoracic pressure variations--in vivo studies and computer simulation.

The effect of intrathoracic pressure variations on the hemodynamics of dogs with cardiac arrest were studied experimentally and simulated on a computer. High intrathoracic pressure (up to 90 mm Hg) was generated by lung inflation with passive and active modes of external fixation. Abdominal binding was found to be essential for the generation of high intrathoracic pressure. Remarkable Doppler flow signals were detected over the femoral artery with each lung inflation. Blood gases measured after 30 minutes of cardiac fibrillation in dogs together with intrathoracic pressure variations showed well oxygenated arterial blood with metabolic acidosis. A computer model was used to explore the effects of intrathoracic pressure variations over a large range of parameters. For intrathoracic pressure of 50/0 mm Hg. the mathematical model predicted maximal flow of 663 ml/min, occurring at a rate of 115 cpm, with a duty cycle of 58%. The heart showed only minor volume changes during the cycle, indicating its main function as a passive conduit during cardiopulmonary resuscitation. The data show that intrathoracic pressure variation with no direct heart compression can cause systemic blood flow of the magnitude occurring in most cardiopulmonary resuscitation techniques.

Animals↗
PubMed1983

Pulsatile flow in tapered tubes: a model of blood flow with large disturbances.

Blood flow-through segments of large arteries of man, between adjacent bifurcations, can be modeled as pulsatile flow in tapered converging tubes, of small angle of convergence, up to 2 deg. Assuming linearity, rigid tube and homogeneous Newtonian fluid, the physiological flow field is governed by the Navier-Stokes equation with dominant nonlinear and unsteady terms. Analytical solution of this problem is presented based on an integral method technique. The solution shows that even for small tapering the flow pattern is markedly different from the flow obtained for a uniform tube. The periodic shear stresses at the wall and pressure gradients increase both in their mean value and amplitude with increased distance downstream. These results are highly significant in the process of atherogenesis.

Animals↗
PubMed1975

The role of the surrounding tissue in the propagation of waves through the arterial system.

A theoretical analysis of the flow in arteries is presented, taking into consideration the role played by the surrounding tissues in determining the speed of propagatoion and the damping of the blood pressure pulse. This study was undertaken (a) to exhibit a method of computing the flow properties with a more nearly accurate model, (b) to see if the displacement on the skin would be related to the arterial wall displacement, and hence to pressure, velocity and flow rate of blood in the artery, and if it is likely to be measurable. It was found that the pressure of the 'viscous' part in the surrounding tissue increases the pulse velocity and the damping of the wave over the values found by other models which considered only thick-walled elastic tubes with no surrounding tissue. This study also shows that measurements on the skin can provide information about changes in arterial circulation due to diseases such as: edema, arteriosclerosis and others where the Young's modulus for either the arterial wall or the surrounding tissues is altered.

Arteries↗
PubMedDate not supplied

Blood gas and acid-base balance during cardiopulmonary resuscitation by intrathoracic and abdominal pressure variations.

The blood gases and acid-base balance in a modified cardiopulmonary resuscitation (CPR) technique, based on intrathoracic and abdominal pressure variations by means of circumferential chest and abdominal balloon inflation, were examined in seven mongrel dogs. CPR proceeded for periods lasting 30 min or more and was monitored by measurements of aortic and right ventricular pressures and carotid blood flow during the compression (artificial systole) and the relaxation phase (artificial diastole). The carotid blood flow was 21.7 +/- 7.8 (mean +/- SD) ml/min, which was 0.18 +/- 0.6 (mean +/- SD) of the baseline mean carotid flow. Arterial blood was well oxygenated throughout the experiments, and low PCO2 levels (5-9 mm Hg) caused an initial severe alkalosis (pH = 7.94). However, a gradual decline in the pH was observed, reaching a value of 7.34 +/- 0.11 in the arterial blood after 30 min of CPR. The venous blood had a very low oxygen content (less than 25.5%) with a low PO2 and a normal PCO2 (43.7 +/- 7.3 mm Hg) throughout the experiment. A gradually developing metabolic acidosis was reflected in the pH values, and an increase in base deficit from 2.25 +/- 5.6 meq/1 prior to CPR to 16.7 +/- 3.2 meq/1 after 30 min of CPR was observed. High arteriovenous differences in oxygen content (greater than 66.4%) and CO2 tension (30.1-41.5 mm Hg) with a slowly developing metabolic acidosis were noted. Thus, CPR by thoracic and abdominal pressure variations is associated with a slowly developing metabolic acidosis which is the result of the combination of hyperventilation and a low perfusion state.

Abdomen↗
PubMedDate not supplied

Low positive end expiratory pressures improve the left ventricular workload versus coronary blood flow relationship.

Positive end expiratory pressure (PEEP) has desirable effects on blood oxygenation. Nonetheless, PEEP ventilation has an adverse cardiovascular response which limits its utilization. We have studied the effect of PEEP ventilation on the relationship between coronary flow (CBF) to left ventricular workload. In the closed chest of surgically instrumented dogs, increasing PEEP caused a significant decrease in aortic, left ventricular pressures and aortic flow. The coronary blood flow decreased by 5% for PEEP values of 4 cm of H2O and by 25% for 14 cm of H2O of PEEP. The left ventricular (dP/dt)max was markedly decreased. Following the application of 16 cm H2O of PEEP, the predicted myocardial oxygen consumption using Kreb's equation decreased by 42% of base line values, p less than 0.001. The ratio of CBF to predicted oxygen consumption increased with higher PEEP values, a 84% increment at 16 cm H2O of PEEP relative to zero PEEP (p less than 0.001). Our results suggest that PEEP may have beneficial effects on the relationship between CBF and the predicted myocardial oxygen consumption, and therefore may minimize hypoxic myocardial situations. Further studies that will directly measure the myocardial oxygen consumption are essential before clinical conclusions can be drawn from our results.

Animals↗