Influência da dexmedetomidina/atropina sobre as alterações da variação de pulso induzidas pela hemorragia seguida por reposição volêmica em cães anestesiados com isoflurano

Pós-graduação em Anestesiologia - FMB

Laser ultrasonics system for measurement of speed of sound in gases

In this work we developed a setup to measure the speed of sound in gases using a laser ultrasonics system. The mentioned setup is an all optical system composed by a Q-switched Nd:YAG laser to generate the sound waves, and a fiber optical microphone to detect them. The Nd:YAG provided a laser pulse of approximately 420 mJ energy and 9 ns of pulse width, at the wavelength of 1064 nm. The pulsed laser beam, focused by a positive lens, was used to generate an electrical breakdown (in the gas) which, in turn, generates an sound wave that traveled through a determined distance and reached the fiber optical microphone. The resulting signal was acquired in an oscilloscope and the time difference between the optical pulse and the arrival of the sound waves was used to calculate the speed of sound, since the distance was known. The system was initially tested to measure the speed of sound in air, at room pressure and temperature and it presented results in agreement with the theory, showing to be suitable to measure the speed of sound in gases. © 2012 American Institute of Physics.

Continuous measurement of cerebral oxygen saturation (rSO 2) for assessment of cardiovascular status during hemorrhagic shock in a swine model

Background: Early trauma care is dependent on subjective assessments and sporadic vital sign assessments. We hypothesized that near-infrared spectroscopy-measured cerebral oxygenation (regional oxygen saturation [rSO 2]) would provide a tool to detect cardiovascular compromise during active hemorrhage. We compared rSO 2 with invasively measured mixed venous oxygen saturation (SvO2), mean arterial pressure (MAP), cardiac output, heart rate, and calculated pulse pressure. Methods: Six propofol-anesthetized instrumented swine were subjected to a fixed-rate hemorrhage until cardiovascular collapse. rSO 2 was monitored with noninvasively measured cerebral oximetry; SvO2 was measured with a fiber optic pulmonary arterial catheter. As an assessment of the time responsiveness of each variable, we recorded minutes from start of the hemorrhage for each variable achieving a 5%, 10%, 15%, and 20% change compared with baseline. Results: Mean time to cardiovascular collapse was 35 minutes ± 11 minutes (54 ± 17% total blood volume). Cerebral rSO 2 began a steady decline at an average MAP of 78 mm Hg ± 17 mm Hg, well above the expected autoregulatory threshold of cerebral blood flow. The 5%, 10%, and 15% decreases in rSO 2 during hemorrhage occurred at a similar times to SvO2, but rSO 2 lagged 6 minutes behind the equivalent percentage decreases in MAP. There was a higher correlation between rSO 2 versus MAP (R =0.72) than SvO2 versus MAP (R =0.55). Conclusions: Near-infrared spectroscopy- measured rSO 2 provided reproducible decreases during hemorrhage that were similar in time course to invasively measured cardiac output and SvO2 but delayed 5 to 9 minutes compared with MAP and pulse pressure. rSO 2 may provide an earlier warning of worsening hemorrhagic shock for prompt interventions in patients with trauma when continuous arterial BP measurements are unavailable. © 2012 Lippincott Williams & Wilkins.