Regional blood flow during cardiopulmonary resuscitation in dogs

To determine differences in regional blood flow during cardiopulmonary resuscitation (CPR) versus normal cardiac function, we measured regional blood flow to sev~ral organs in 19 pentobarbital-anesthetized dogs (6-12 kg). Regional blood flow was measured during sinus rhythm in 5 dogs and during electrically induced ventricular fibrillation with CPR in the other 14 dogs. Regional blood flow and cardiac output were measured using radioactively labelled polystyrene microspheres of 15 ±3P diameter, injected into the left ventricle. Adequacy of microsphere mixing at low cardiac outputs was verified by comparing flow rates to paired organs. Cardiac output was 175 ml/kg/min during sinus rhythm versus 47 ml/kg/min during CPR. Flow to all organs sampled was less during CPR, but the relative decrease varied widely. The ratios of regional blood flow during CPR to regional blood flow during sinus rhythm were 90% for brain, 35% for heart, 15% for kidneys, 17% for adrenal glands, 14% for pancreas, 3% for spleen, and 33% for small intestine. These results provide baseline values for regional blood flow during CPR which can be used to evaluate alternative CPR techniques and/or drugs which may improve perfusion of vital organs during CPR

Viscoelasticity and metastability limit in supercooled liquids

A supercooled liquid is said to have a kinetic spinodal if a temperature Tsp exists below which the liquid relaxation time exceeds the crystal nucleation time. We revisit classical nucleation theory taking into account the viscoelastic response of the liquid to the formation of crystal nuclei and find that the kinetic spinodal is strongly influenced by elastic effects. We introduce a dimensionless parameter \lambda, which is essentially the ratio between the infinite frequency shear modulus and the enthalpy of fusion of the crystal. In systems where \lambda is larger than a critical value \lambda_c the metastability limit is totally suppressed, independently of the surface tension. On the other hand, if \lambda < \lambda_c a kinetic spinodal is present and the time needed to experimentally observe it scales as exp[\omega/(\lambda_c-\lambda)^2], where \omega is roughly the ratio between surface tension and enthalpy of fusion

Influence of Adrenergic Drugs Upon Vital Organ Perfusion During CPR

To determine whether adrenergic drugs administered during cardiopulmonary resuscitation (CPR) alter the distribution of artificial card:l.ac output, we measu red regional blood flow and cardiac output using radioactive microspheres in 12 dogs. Ventricular fibrillation was induced electrically and CPR was immediately begun with a mechanical chest compressor and ventilator (Thurn per ( R) ) at 60 compressions/min, with a ventilation:compression ratio of 1:5, a compression duration of 0.5 sec, and a ventilation pressure of 20 em H 2 o. Compression force was sufficient to develop 40-50 mmHg peak intraesophageal pressure. After 30 sec of CPR, either 0.9% saline vehicle or 50 ug/kg of epinephrine, phenylephrine, or isoproterenol was administered through a central venous catheter. One minute later, microspheres were injected into the left ventricle. After 250 sec of CPR the ventricles were defibrillated electrically. Twenty minute recovery periods were interposed between each drug injection. accord:l.ng Each dog recei.ved to predetermlned all three drugs and saline sequence. Following saline, epinephrine, phenylephrine, and isoproterenol treatment respectively, cardiac output averaged 392, 319, 255, and 475 ml/min; bratn blood flow averaged 37, 54, 2 9 \u27 and 28 ml/min; heart blood flow averaged 25, 79, 26, and IS ml/min; and kidney blood flow averaged 44, 4, 16, and 29 ml/min. Epinephrine improved blood flow t6 the brain, probably because of its alpha adrenergic activity. Epinephrine improved blood flow to the heart during CPR much more than the other agents, probably because of its combined alpha and beta adrenergic activity. This effect may explain its superiority in restoring circulation after prolonged arrest and resuscitation. Isoproterenol should not be used in CPR because it shunts blood away from vital organs

Regular and Chaotic Motion in General Relativity: The Case of a Massive Magnetic Dipole

Circular motion of particles, dust grains and fluids in the vicinity of compact objects has been investigated as a model for accretion of gaseous and dusty environment. Here we further discuss, within the framework of general relativity, figures of equilibrium of matter under the influence of combined gravitational and large-scale magnetic fields, assuming that the accreted material acquires a small electric charge due to interplay of plasma processes and photoionization. In particular, we employ an exact solution describing the massive magnetic dipole and we identify the regions of stable motion. We also investigate situations when the particle dynamics exhibits the onset of chaos. In order to characterize the measure of chaoticness we employ techniques of Poincar\'e surfaces of section and of recurrence plots.Comment: 11 pages, 6 figures, published in the proceedings of the conference "Relativity and Gravitation: 100 Years after Einstein in Prague" (25. - 29. 6. 2012, Prague

Influence of interposed ventilation pressure upon artificial cardiac output during cardiopulmonary resuscitation in dogs

This study was conducted to determine the effects of high pressure interposed ventilations during cardiopulmonary resuscitation (CPR). Cardiac output was measured by a modified indicator dilution technique in eight anesthetized, intubated mongrel dogs. Positive pressure ventilations (12/min, 80% O2) were interposed after every five chest compressions (performed at 62/min) by a mechanical chest compressor (Thumper®). On repeated trials in the same animal, ventilation pressures from 10-50 cm of H2O were tested in randomized sequence, while the technique of chest compression was held constant. Arterial blood gases immediately after resuscitation were monitored. Increasing ventilation pressure had surprisingly little effect on cardiac output during CPR, although blood gases were profoundly altered. For ventilation pressures of 10, 20, 30, 40, and 50 cm of H2O, producing mean tidal volumes 23, 38, 61, 83, and 94 ml/kg; cardiac output remained nearly constant, averaging 21, 25, 23, 26, and 24 ml/min/kg. Corresponding mean post-resuscitation pH was 7.24, 7.41, 7.51, 7.56, and 7.53; PCO2 was 41, 26, 18, 16, and 15 torr. The post-resuscitation arterial oxygen tension was greater than 100 torr at all ventilation pressures except 10 cm of H2O. Interposed ventilations of pressure and volume more than adequate to prevent acidosis during CPR did not impair artificial cardiac output. If anything, cardiac output was slightly improved by more forceful ventilation

Modelling Relevance towards Multiple Inclusion Criteria when Ranking Patients

In the medical domain, information retrieval systems can be used for identifying cohorts (i.e. patients) required for clinical studies. However, a challenge faced by such search systems is to retrieve the cohorts whose medical histories cover the inclusion criteria specified in a query, which are often complex and include multiple medical conditions. For example, a query may aim to find patients with both 'lupus nephritis' and 'thrombotic thrombocytopenic purpura'. In a typical best-match retrieval setting, any patient exhibiting all of the inclusion criteria should naturally be ranked higher than a patient that only exhibits a subset, or none, of the criteria. In this work, we extend the two main existing models for ranking patients to take into account the coverage of the inclusion criteria by adapting techniques from recent research into coverage-based diversification. We propose a novel approach for modelling the coverage of the query inclusion criteria within the records of a particular patient, and thereby rank highly those patients whose medical records are likely to cover all of the specified criteria. In particular, our proposed approach estimates the relevance of a patient, based on the mixture of the probability that the patient is retrieved by a patient ranking model for a given query, and the likelihood that the patient's records cover the query criteria. The latter is measured using the relevance towards each of the criteria stated in the query, represented in the form of sub-queries. We thoroughly evaluate our proposed approach using the test collection provided by the TREC 2011 and 2012 Medical Records track. Our results show significant improvements over existing strong baselines

Relationship of blood pressure and flow during CPR to chest compression amplitude: Evidence for an effective compression threshold

This study was conducted to investigate the importance of the depth of chest compression in producing effective cardiopulmonary resuscitation (CPR) in animals, as indicated by cardiac output and mean arterial blood pressure. Cardiac output was measured by a modified indicator dilution technique in 8 anesthetized dogs, 6 to 12 kg body weight, during repeated 2-minute episodes of electrically induced ventricular fibrillation and CPR provided by a mechanical chest compressor and ventilator (Thumper®). Chest compression exceeding a threshold value (x0) between 1.5 and 3.0 cm was required in each animal to produce measurable cardiac output. In particular, cardiac output (CO) was linearly related to chest compression depth (x) by an expression of the form CO = a(x-x0) for x \u3e x0, and CO = 0 for x £ x0. The mean value of x0 was 2.3 cm. A similar threshold for measurable blood pressure was observed in 7 of the 8 dogs, with a mean value of 1.8 cm. For chest compression of 2.5 cm or greater, relatively modest increases in chest compression depth caused relatively large changes in cardiac output

Surface Layers in General Relativity and Their Relation to Surface Tensions

For a thin shell, the intrinsic 3-pressure will be shown to be analogous to -A, where A is the classical surface tension: First, interior and exterior Schwarzschild solutions will be matched together such that the surface layer generated at the common boundary has no gravitational mass; then its intrinsic 3-pressure represents a surface tension fulfilling Kelvin's relation between mean curvature and pressure difference in the Newtonian limit. Second, after a suitable definition of mean curvature, the general relativistic analogue to Kelvin's relation will be proven to be contained in the equation of motion of the surface layer.Comment: 12 pages, LaTeX, no figur