7 research outputs found

    Predictors of rethrombosis and death in patients with COVID-19 after lower limb arterial thrombectomy for acute ischemia

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    Aim. To identify predictors of rethrombosis and death in patients with coronavirus disease (COVID-19) after thrombectomy for acute lower limb ischemia.Material and methods. For the period from April 2020 to January 2022, 189 pa tients with acute arterial lower limb thrombosis and acute lower limb ischemia were included in this study. In all cases, a positive polymerase chain reaction test for SARS-CoV-2 was obtained. According to chest multislice computed tomography, bilateral multisegmental pneumonia was identified as follows: 76 patients — grade 2 (25-50% of lung tissue involvement); 52 patients — grade 3 (50-75%); 61 patients — grade 4 (>75%). Breathing was carried out as follows: in 88 patients — spontaneous; in 42 — with oxygen administration by nasal cannula; 26 — non-invasive ventilation; 33 had artificial ventilation. All acute arterial thromboses developed within the hospital at 4,5±1,5 days after hospitalization. The time between the onset to diagnosis verification was 27,8±5,0 min. The revascularization strategy was established by a multidisciplinary team meeting. The interval between the development of acute ischemia symptoms and surgery was 45,9±6,3 minutes. Thrombectomy was performed according to the standard technique, under local and/or intravenous anesthesia, using 3F-7F Fogarty catheters.Results. Retrombosis developed in 80,4% of cases 6,4±5,1 hours after surgery. In 59,8% of cases, retrombectomy turned out to be ineffective and the patient underwent limb amputation. In 65,6% of patients, a death was established due to multiple organ dysfunction. Among them, limb amputation was performed in 103 patients. Binary logistic regression identified following predictors of retrombosis/ death: age over 70 years (odds ratio (OR), 30,73; 95% confidence interval (CI), 11,52-33,7), obesity (OR, 15,53; 95% CI, 6,41-78,19), diabetes (OR 14,21; 95% CI, 5,86-49,21), vasopressor support (OR 8,55; 95% CI, 4,94-17,93), mechanical ventilation (OR 7,39; 95% CI, 4,81-16,52).Conclusion. Predictors of retrombosis and death in patients with COVID-19 after lower limb arterial thrombectomy are age over 70 years, obesity, diabetes, vasopressor support, and mechanical ventilation

    Effect of Stride Length Alterations on Heart Rate and Ratings of Perceived Exertion During Treadmill Running

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    Advisor: David S. SenchinaThis study describes results of exercise physiology research intended to examine the effects of running at normal, less than normal, and greater than normal stride length on heart rate (HR) and rating of perceived exertion (RPE). The objective of this study was to determine how running above or below the natural stride length influences HR and RPE, and we hypothesized that any aberrations to normal stride patterns would result in increases in both HR and RPE. Three males and three females of moderate fitness were asked to run on a treadmill for three 10-minute periods, each separated by 10 minutes of recovery. The first trial allowed volunteers to select their own stride, while the remaining runs were conducted with a metronome set at either 15% above or 15% below their normal gait. A significant increase was found in HR at both above- or below-normal stride length. RPE was increased during the below-normal stride length trial compared to other trials. We concluded that altering the normal stride length results in increased cardiac exertion and further studies into the negative physiological consequences of this are warranted.Drake University, College of Arts and Sciences, Department of Biolog
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