Continuous wrist blood pressure measurement with ultrasound

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Blood pressure is an important parameter for the development of cardiovascular disease. By monitoring the blood pressure over 24 hours hypertension can be detected and treatment can be started. A new noninvasive long term blood pressure measurement method measures the blood pressure continuously on the wrist using ultrasound, a small balloon and a controller. The pressure is controlled with a voice coil actuator. The wrist blood pressure changes during motion. These movements are assessed with a water filled tube to calibrate the measurement to aortic blood pressure

Continuous wrist blood pressure measurement with ultrasound

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Blood pressure is an important parameter for the development of cardiovascular disease. By monitoring the blood pressure over 24 hours hypertension can be detected and treatment can be started. A new noninvasive long term blood pressure measurement method measures the blood pressure continuously on the wrist using ultrasound, a small balloon and a controller. The pressure is controlled with a voice coil actuator. The wrist blood pressure changes during motion. These movements are assessed with a water filled tube to calibrate the measurement to aortic blood pressure

Effect of daptomycin and vancomycin on Staphylococcus epidermidis biofilms: An in vitro assessment using fluorescence in situ hybridization

Colonization of in-dwelling catheters by microbial biofilms is a major concern in patient health eventually leading to catheter-related blood stream infections. Biofilms are less susceptible to standard antibiotic therapies that are effective against planktonic bacteria. Standard procedure for the detection of microorganisms on the catheter tip is culture. However, viable but non-culturable cells (VBNCs) may be missed. The aim of this study was to evaluate the use of fluorescence in situ hybridization (FISH) as an indicator to visualize and quantify the effect of the antibiotics daptomycin and vancomycin on biofilms in situ. We established an in vitro catheter biofilm model of Staphylococcus epidermidis biofilms on polyurethane catheters. Biofilm activity was measured by FISH and correlated to colony forming units (CFU) data. Digital image analysis was used for quantification of total biofilm mass and the area of the FISH positive biofilm cells. FISH showed a pronounced effect of both antibiotics on the biofilms, with daptomycin having a significantly stronger effect in terms of both reduction of biofilm mass and number of FISH-positive cells. This supports the anti-biofilm capacity of daptomycin. Interestingly, neither antibiotic was able to eradicate all of the FISH-positive cells. In summary, FISH succeeded in visualization, quantification, and localization of antibiotic activity on biofilms. This technique adds a new tool to the arsenal of test systems for anti-biofilm compounds. FISH is a valuable complementary technique to CFU since it can be highly standardized and provides information on biofilm architecture and quantity and localization of survivor cells

In-vivo coronary flow profiling based on biplane angiograms: influence of geometric simplifications on the three-dimensional reconstruction and wall shear stress calculation

Abstract Background Clinical studies suggest that local wall shear stress (WSS) patterns modulate the site and the progression of atherosclerotic lesions. Computational fluid dynamics (CFD) methods based on in-vivo three-dimensional vessel reconstructions have recently been shown to provide prognostically relevant WSS data. This approach is, however, complex and time-consuming. Methodological simplifications are desirable in porting this approach from bench to bedside. The impact of such simplifications on the accuracy of geometry and wall shear stress calculations has to be investigated. Methods We investigated the influence of two methods of lumen reconstruction, assuming circular versus elliptical cross-sections and using different resolutions for the cross-section reconstructions along the vessel axis. Three right coronary arteries were used, of which one represented a normal coronary artery, one with "obstructive", and one with "dilated" coronary atherosclerosis. The vessel volume reconstruction was performed with three-dimensional (3D) data from a previously validated 3D angiographic reconstruction of vessel cross-sections and vessel axis. Results The difference between the two vessel volumes calculated using the two evaluated methods is less than 1 %. The difference, of the calculated pressure loss, was between 2.5% and 8.5% for the evaluated methods. The distributions of the WSS histograms were nearly identical and strongly cross-correlated (0.91–0.95). The good agreement of the results was confirmed by a Chi-square test. Conclusion A simplified approach to the reconstruction of coronary vessel lumina, using circular cross-sections and a reduced axial resolution of about 0.8 mm along the vessel axis, yields sufficiently accurate calculations of WSS.</p

Blood pressure measurement on the cheek

In a large group of patients, it is impossible to measure blood pressure using an upper arm cuff. An alternative, non-invasive method of blood pressure measurement is required for patients with severe limb deformities or obesity, for amputees, and in the emergency medicine. The device proposed here measures blood pressure in the cheek using a small pressure pad and a pump to occlude the cheek artery – arteria facialis – and assesses blood flow with an infrared light source and a detector. The infrared light signal is analysed to assess the systolic and diastolic blood pressure of the patient. Manual evaluation of the light intensity signal showed a good agreement between cheek blood pressure measurement and a reference measurement using an upper arm cuff

Bacterial biofilms in infective endocarditis: an in vitro model to investigate emerging technologies of antimicrobial cardiovascular device coatings

Objective: In spite of the progress in antimicrobial and surgical therapy, infective endocarditis (IE) is still associated with a high morbidity and mortality. IE is characterized by bacterial biofilms of the endocardium, especially of the aortic and mitral valve leading to their destruction. About one quarter of patients with formal surgery indication cannot undergo surgery. This group of patients needs further options of therapy, but due to a lack of models for IE prospects of research are low. Therefore, the purpose of this project was to establish an in vitro model of infective endocarditis to allow growth of bacterial biofilms on porcine aortic valves, serving as baseline for further research. Methods and results: A pulsatile two-chamber circulation model was constructed that kept native porcine aortic valves under sterile, physiologic hemodynamic and temperature conditions. To create biofilms on porcine aortic valves the system was inoculated with Staphylococcus epidermidis PIA 8400. Aortic roots were incubated in the model for increasing periods of time (24 h and 40 h) and bacterial titration (1.5 × 104 CFU/mL and 1.5 × 105 CFU/mL) with 5 L cardiac output per minute. After incubation, tissue sections were analysed by fluorescence in situ hybridization (FISH) for direct visualization of the biofilms. Pilot tests for biofilm growth showed monospecies colonization consisting of cocci with time- and inocula-dependent increase after 24 h and 40 h (n = 4). In n = 3 experiments for 24 h, with the same inocula, FISH visualized biofilms with ribosome-containing, and thus metabolic active cocci, tissue infiltration and similar colonization pattern as observed by the FISH in human IE heart valves infected by S. epidermidis. Conclusion: These results demonstrate the establishment of a novel in vitro model for bacterial biofilm growth on porcine aortic roots mimicking IE. The model will allow to identify predilection sites of valves for bacterial adhesion and biofilm growth and it may serve as baseline for further research on IE therapy and prevention, e.g. the development of antimicrobial transcatheter approaches to IE

Viscoelastic behaviour of human blood and polyacrylamide model fluids for heart valve testing

New heart valves and other cardiovascular assist systems have to be tested for hydrodynamic performance. In place of human blood simple model fluids like glycerol solutions are employed often due to ethical and practical reasons. But blood exhibits complex non-Newtonian and viscoelastic behaviour. Rheological blood properties are reviewed based on literature and own experimental results. Furthermore we studied polymer solutions with respect to blood-like flow behaviour. Rheology was assessed by means of the low shear rotational viscometer (LS 40, Mettler-Toledo, Switzerland) under stationary and dynamic shear conditions (variation of frequency and angular displacement)