Made available in DSpace on 2014-06-11T19:22:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2001Bitstream added on 2014-06-13T19:27:33Z : No. of bitstreams: 1 paivafilho_o_me_botfm.pdf: 504699 bytes, checksum: 1172b273f934761c359be9d53a5db958 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A detecção da hipovolemia insidiosa no intra-operatório é difícil devido a pouca especificidade dos sinais clínicos e hemodinâmicos. Estudos introduziram um novo método para avaliação da pré-carga, baseados na análise da variação da pressão sistólica (VPS) durante a ventilação mecânica. O presente estudo tem por objetivo avaliar se a VPS e sua derivada delta down (ddown) são indicadoras precoces de hipovolemia e guias de reposição volêmica com solução hiperosmótica e hiperoncótica no cão anestesiado submetido a hipovolemia. Doze cães sem raça definida, anestesiados com propofol, fentanil, rocurônio e isoflurano, e esplenectomizados, foram submetidos a sangramentos parciais de 5% da volemia até se atingir a retirada total de 20% da volemia (14 ml.kg-1). Após cada momento foram realizadas análises hemodinâmicas, respiratórias e sangüíneas. Em seguida, os cães foram submetidos à reposição volêmica com solução de NaCl a 7,5% em dextran 70 a 3,75% (4 ml.kg-1) em 10 minutos e novas análises foram realizadas aos 5 e 30 minutos após a reposição volêmica. A freqüência cardíaca não apresentou alteração... / The insidious hypovolemia detection in the intraoperative is difficult due to little specificity of clinical and hemodynamic signs. Studies introduced a new method for preload evaluation, based on systolic pressure variation analysis (SPV) during mechanical ventilation. The present study aims to evaluate if SPV and its derived delta down (ddown) are early indicator of hypovolemia, and guides of volemic replacement with hyperosmotic and hyperoncotic solution in anesthetized dogs submitted to hypovolemia. Twelve mogrel dogs, anesthetized with propofol, fentanyl, rocuronium and isoflurane, were submitted to graded haemorrhage of 5% of its volemia to reach the total of 20% of volemia (14 ml.kg-1). After every haemorrhage period, hemodynamic, ventilatory and blood atributes were studied. Imediately after, the dogs were submitted to volemic replacement with 7.5% NaCl solution in 3,75% dextran 70 (4 ml.kg-1) in 10 minutes, and the atributes were studied after 5 and 30 minutes following the volemic replacement. Heart rate was not changed significantly. Mean arterial pressure decreased significantly during haemorrhage, and increased... (Complete abstract, click electronic access below)

Orientador: José Reinaldo Cerqueira Braz / Resumo: A detecção da hipovolemia insidiosa no intra-operatório é difícil devido a pouca especificidade dos sinais clínicos e hemodinâmicos. Estudos introduziram um novo método para avaliação da pré-carga, baseados na análise da variação da pressão sistólica (VPS) durante a ventilação mecânica. O presente estudo tem por objetivo avaliar se a VPS e sua derivada delta down (ddown) são indicadoras precoces de hipovolemia e guias de reposição volêmica com solução hiperosmótica e hiperoncótica no cão anestesiado submetido a hipovolemia. Doze cães sem raça definida, anestesiados com propofol, fentanil, rocurônio e isoflurano, e esplenectomizados, foram submetidos a sangramentos parciais de 5% da volemia até se atingir a retirada total de 20% da volemia (14 ml.kg-1). Após cada momento foram realizadas análises hemodinâmicas, respiratórias e sangüíneas. Em seguida, os cães foram submetidos à reposição volêmica com solução de NaCl a 7,5% em dextran 70 a 3,75% (4 ml.kg-1) em 10 minutos e novas análises foram realizadas aos 5 e 30 minutos após a reposição volêmica. A freqüência cardíaca não apresentou alteração... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The insidious hypovolemia detection in the intraoperative is difficult due to little specificity of clinical and hemodynamic signs. Studies introduced a new method for preload evaluation, based on systolic pressure variation analysis (SPV) during mechanical ventilation. The present study aims to evaluate if SPV and its derived delta down (ddown) are early indicator of hypovolemia, and guides of volemic replacement with hyperosmotic and hyperoncotic solution in anesthetized dogs submitted to hypovolemia. Twelve mogrel dogs, anesthetized with propofol, fentanyl, rocuronium and isoflurane, were submitted to graded haemorrhage of 5% of its volemia to reach the total of 20% of volemia (14 ml.kg-1). After every haemorrhage period, hemodynamic, ventilatory and blood atributes were studied. Imediately after, the dogs were submitted to volemic replacement with 7.5% NaCl solution in 3,75% dextran 70 (4 ml.kg-1) in 10 minutes, and the atributes were studied after 5 and 30 minutes following the volemic replacement. Heart rate was not changed significantly. Mean arterial pressure decreased significantly during haemorrhage, and increased... (Complete abstract, click electronic access below) / Mestre

The purpose of this study was to determine if a relationship existed between the change in serum osmolality in the chronic renal failure patient on hemodialysis and the number of clinical symptoms of the dialysis disequilibrium syndrome experienced during hemodialysis. The study was conducted at the Renal Dialysis Unit of an urban medical center located in a southeastern city. Data were collected from May 25, 1978 to June 30, 1978. Data were obtained during 28 hemodialysis procedures performed on 11 subjects. Serum osmolality measurements were collected prior to initiation of the dialysis procedure, at half-hour intervals during dialysis, and prior to termination of dialysis. Clinical symptoms which occurred during dialysis were recorded by the patients and nursing personnel. The hypothesis was that the number of clinical symptoms of the dialysis disequilibrium syndrome experienced by the chronic renal failure patient during hemodialysis will increase as the serum osmolality decreases.

Made available in DSpace on 2016-12-08T16:24:08Z (GMT). No. of bitstreams: 1 PGCA09MA059.pdf: 445333 bytes, checksum: b9ef6ff2e7ede4892d205c57c8f68e79 (MD5) Previous issue date: 2009-02-19 / The aim of this study was to compare the volume expansion on the extracellular space with hydroxyethylstarch 130/0.4 (HES 130/0.4) alone or in association with hypertonic solution (NaCl 7.5%), in cats under general anesthesia with isoflurane and submitted to experimental hipovolemia. Twelve adult domestic short hair cats, with an average weight of 3.07 ± 0.56 Kg were used in this study. The cats were mask-induced with isoflurane on oxygen, intubated, and then connected to a non-rebreathing system. After surgical preparation, they were kept on isoflurane at 1MAC and ventilated to maintain the EtCO2 around 35 45 mm/Hg. After 30 minutes of stabilization, hypovolemia was induced by withdrawal of 30 mL/kg of blood from the femoral artery and then, one hour later allocated in two different groups: HSG (hypertonic saline group, n=6), which received 4ml/Kg of 7.5% NaCl, and HSCG (hypertonic saline, associated to HES 130/0,4 group n=6) which received 4ml/Kg of 7.5% NaCl associated with 30 ml/Kg of HES 130/0.4. After the treatments, cardiovascular and hemogasometric parameters were evaluated for 120 minutes (T120). Systolic blood pressure (SAP), diastolic blood pressure (DAP), mean arterial pressure (MAP) were significantly higher after volemic expansion on HSG at T0. From T45 until T120 SAP, DAP and MAP were significantly higher in HSCG when comparing to HSG. Central venous pressure (CVP) was higher in HSCG up to T60. There were no significant differences between groups on heart rate, respiratory rate, values of Na+, K+, the base excess, bicarbonate, hemoglobin saturation, glucose, PaCO2, PaO2 and pH. The administration of 7.5% of NaCl, promoted a faster increase in MAP, SAP and DAP in cats with induced hypovolemia and this effects were maintained for 30 minutes. On the other hand, the administration of HES 130/0.4 associated with 7.5% NaCl promoted a delayed reestablishment (after 30 minutes) of MAP, SAP and DAP in cats with induced hypovolemia, lasting up to T120. The combination of HES 130/0.4 and NaCl 7.5% promoted an significant increase on CVP for up to 60 minutes after the treatment / Objetivou-se comparar a expansão volêmica do hidroxietilamido 130/0,4 (HES 130/0,4) isolado ou em associação com solução salina hipertônica (NaCl 7,5%) em gatas com hipovolemia induzida, sob anestesia geral inalatória com isoflurano. Foram utilizadas 12 gatas, sem raça definida (SRD), adultas com peso médio de 3,07±0,56 Kg. Os animais foram induzidos a anestesia geral com isoflurano a 5V%, intubados e conectados a um sistema sem reinalação de gases. Após preparação cirúrgica, foram mantidos sob anestesia com isoflurano a 1 CAM sob ventilação controlada, ciclada a pressão, para padronização do CO2 expirado em 35-45 mmHg. Aguardou-se um período de 30 minutos para estabilização do plano anestésico. Subsequentemente, iniciou-se a fase de hipovolemia, através da retirada de 30 ml/Kg de sangue pela artéria femoral. Após 60 minutos da estabilização do quadro de hipovolemia as gatas foram alocadas aleatoriamente em dois grupos: GSH (grupo solução hipertônica, n=06) os quais receberam na fase de expansão volêmica NaCl 7,5% isolada, na dose de 4ml/Kg, e GSHC (grupo salina hipertônica associado ao colóide, n=06), receberam NaCl 7,5% na mesma dose citada associado ao HES 130/0,4 na dose de 30 ml/Kg. Após o tratamento foram avaliados os efeitos cardiovasculares e hemogasométricos por até 120 minutos (T120). As pressões arteriais média (PAM), sistólica (PAS) e diastólica (PAD) foram maiores logo após a expansão volêmica (T0) para o GSH. De T45 até T120 a PAM, PAS e PAD foram maiores para o GSHC em comparação ao GSH. A pressão venosa central (PVC) foi maior no GSHC até T60. Não foram observadas diferenças entre grupos para frequência cardíaca e respiratória, íon sódio, potássio, déficit de base, bicarbonato, saturação de oxigênio na hemoglobina, glicose, PaCO2, PaO2 e pH. Conclui-se que a administração de NaCl 7,5% isoladamente, aumenta rapidamente a PAM, PAS e PAD em gatos com hipovolemia induzida, mantendo este efeito por apenas 30 minutos. A administração de hidroxietilamido associado à NaCl 7,5% promove reestabelecimento mais tardio (após 30 minutos), porém mais duradouro (até 120 minutos) da PAM, PAS e PAD em gatas com hipovolemia induzida. A administração de HES 130/0,4 associada à NaCl 7,5% promove aumento acentuado da PVC por até 60 minutos após a administração