Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain-gauge transducers.

BackgroundMonitoring of intracranial pressure (ICP) is a critical component in the management of intracranial hypertension. Safety, efficacy, and optimal location of microsensor devices have not been defined in dogs.Hypothesis/objectiveAssessment of ICP using a microsensor transducer is feasible in anesthetized and conscious animals and is independent of transducer location. Intraparenchymal transducer placement is associated with more adverse effects.AnimalsSeven adult, bred-for-research dogs.MethodsIn a prospective investigational study, microsensor ICP transducers were inserted into subdural and intraparenchymal locations at defined rostral or caudal locations within the rostrotentorial compartment under general anesthesia. Mean arterial pressure and ICP were measured continuously during physiological maneuvers, and for 20 hours after anesthesia.ResultsBaseline mean ± SD values for ICP and cerebral perfusion pressure were 7.2 ± 2.3 and 78.9 ± 7.6 mm Hg, respectively. Catheter position did not have a significant effect on ICP measurements. There was significant variation from baseline ICP accompanying physiological maneuvers (P < .001) and with normal activities, especially with changes in head position (P < .001). Pathological sequelae were more evident after intraparenchymal versus subdural placement.Conclusions and clinical importanceUse of a microsensor ICP transducer was technically straightforward and provided ICP measurements within previously reported reference ranges. Results support the use of an accessible dorsal location and subdural positioning. Transient fluctuations in ICP are normal events in conscious dogs and large variations associated with head position should be accounted for when evaluating animals with intracranial hypertension

Клиническое значение параметров капиллярного русла, вариабельности сердечного ритма, компьютерной бронхофонографии в дифференциальной диагностике заболеваний, сопровождающихся длительным кашлем у детей

Differential diagnosis of the causes of prolonged cough is difficult because of its multifactorial nature. Diagnostics in case of a cough that persists for more than 4 weeks is based on clinical data, but sometimes it is not enough to establish a diagnosis. This issue led to the development of algorithms based on additional diagnostic criteria evaluated with modern non-invasive functional methods for diagnosing diseases accompanied by a prolonged cough in children.Aim. To determine the differential diagnostic value of the functional parameters of the capillary bed, respiratory tract, and autonomic nervous system in children with diseases accompanied by a prolonged cough (more than 4 weeks).Methods. 238 children aged from 2 to 17 years with prolonged cough were examined in inpatient or outpatient settings and divided into 4 groups: Group 1 (n = 68) - patients with acute or exacerbation of the chronic infectious upper respiratory tract diseases; Group 2 (n = 53) - patients with lower respiratory tract infection; Group 3 (n = 39) - patients with allergic rhinitis; Group 4 (n = 78) - patients with bronchial asthma. All patients underwent standard clinical examination. The diagnostic test also included functional assessment of microcirculation, autonomic nervous system, and respiratory system via computer capillaroscopy of the nail bed, evaluation of heart rate variability, and computer bronchophonography.Results. Patients with allergic diseases of the respiratory tract, especially with asthma, show a change in all parts of the capillary bed and a significant increase in the zone of perivascular edema in combination with parasympathicotonia, in contrast to children with infectious diseases of the respiratory system, who showed a change in microcirculation parameters mainly in the venous capillaries in combination with sympathicotonia. In addition, children with prolonged coughing, regardless of its origin, showed functional changes in the high-frequency acoustic parameters of the respiratory system in the form of an increase in the coefficient of the high-frequency acoustic component of breathing (ф3), which indicates bronchial hyperreactivity.Conclusion. The functional parameters of the microvasculature, autonomic nervous system, and respiratory tract can be used as additional differential diagnostic criteria and included in algorithms for diagnosing respiratory diseases of various origins in childhood, contributing to the early detection of the pathology and timely targeted therapy.Дифференциальная диагностика причин затяжного (ЗК) и хронического (ХК) кашля у детей затруднительна ввиду его многофакторности. Основу диагностики при длительном (> 4 нед.) кашле составляют клинико-анамнестические данные, которых порой недостаточно для установления диагноза. Этим обусловлена разработка алгоритмов, основанных на информативных дополнительных диагностических критериях, полученных при помощи современных неинвазивных функциональных методов диагностики заболеваний, сопровождающихся ЗК и ХК в детском возрасте.Целью исследования явилось определение дифференциально-диагностического значения функциональных параметров капиллярного русла, внешнего дыхания и вегетативной нервной системы (ВНС) у детей при заболеваниях, сопровождающихся длительным (> 4 нед.) кашлем.Материал и методы. В условиях поликлиники и стационара обследованы пациенты (n = 238; возраст — 2 года — 17 лет) с ЗК и ХК, которые были распределены на 4 группы: 1-я (n = 68) — дети с острым или обострением хронического заболевания ЛОР-органов инфекционного генеза; 2-я (n = 53) — дети с острой респираторной инфекцией нижних дыхательных путей; 3-я а (n = 39) — дети с аллергическим ринитом; 4-я (n = 78) — дети с бронхиальной астмой. Наряду с общепринятыми клиническими методами исследования у всех пациентов с длительным кашлем определялись функциональные показатели микроциркуляторного русла, ВНС и дыхательной системы при помощи компьютерной капилляроскопии ногтевого ложа, оценки вариабельности сердечного ритма и компьютерной бронхофонографии.Результаты. Установлено, что для пациентов с аллергическими заболеваниями респираторного тракта, особенно при БА, характерно изменение всех отделов капиллярного русла и значительное увеличение зоны периваскулярного отека в сочетании с парасимпатикотонией, в отличие от такового у детей с инфекционно-воспалительными заболеваниями органов дыхания, для которых свойственно изменение параметров микроциркуляции преимущественно в венозном отделе капилляров в сочетании с симпатикотонией. Кроме того, при длительном кашле вне зависимости от его генеза у детей выявлены функциональные изменения акустических показателей дыхательной системы в высокочастотном диапазоне в виде увеличения уровня коэффициента (ф3) акустического компонента работы дыхания в высокочастотном диапазоне, что свидетельствует о наличии бронхиальной гиперреактивности.Заключение. Функциональные параметры микроциркуляторного русла, ВНС и дыхательной системы могут быть использованы в качестве дополнительных дифференциально-диагностических критериев и включены в алгоритмы диагностики заболеваний органов дыхания различного генеза в детском возрасте, что может способствовать раннему выявлению данной патологии и назначению своевременной целенаправленной терапии

Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain-gauge transducers.

BackgroundMonitoring of intracranial pressure (ICP) is a critical component in the management of intracranial hypertension. Safety, efficacy, and optimal location of microsensor devices have not been defined in dogs.Hypothesis/objectiveAssessment of ICP using a microsensor transducer is feasible in anesthetized and conscious animals and is independent of transducer location. Intraparenchymal transducer placement is associated with more adverse effects.AnimalsSeven adult, bred-for-research dogs.MethodsIn a prospective investigational study, microsensor ICP transducers were inserted into subdural and intraparenchymal locations at defined rostral or caudal locations within the rostrotentorial compartment under general anesthesia. Mean arterial pressure and ICP were measured continuously during physiological maneuvers, and for 20 hours after anesthesia.ResultsBaseline mean ± SD values for ICP and cerebral perfusion pressure were 7.2 ± 2.3 and 78.9 ± 7.6 mm Hg, respectively. Catheter position did not have a significant effect on ICP measurements. There was significant variation from baseline ICP accompanying physiological maneuvers (P < .001) and with normal activities, especially with changes in head position (P < .001). Pathological sequelae were more evident after intraparenchymal versus subdural placement.Conclusions and clinical importanceUse of a microsensor ICP transducer was technically straightforward and provided ICP measurements within previously reported reference ranges. Results support the use of an accessible dorsal location and subdural positioning. Transient fluctuations in ICP are normal events in conscious dogs and large variations associated with head position should be accounted for when evaluating animals with intracranial hypertension