Hypotension during fluid-restricted abdominal surgery: effects of norepinephrine treatment on regional and microcirculatory blood flow in the intestinal tract

Vasopressors, such as norepinephrine, are frequently used to treat perioperative hypotension. Increasing perfusion pressure with norepinephrine may increase blood flow in regions at risk. However, the resulting vasoconstriction could deteriorate microcirculatory blood flow in the intestinal tract and kidneys. This animal study was designed to investigate the effects of treating perioperative hypotension with norepinephrine during laparotomy with low fluid volume replacement.

Aortic flow patterns resulting from right axillary artery cannulation

Right axillary artery (RAA) cannulation is increasingly used in cardiac surgery. Little is known about resulting flow patterns in the aorta. Therefore, flow was visualized and analyzed. A mock circulatory circuit was assembled based on a compliant transparent anatomical silicon aortic model. A RAA cannula was connected to a continuous flow rotary blood pump (RBP), pulsatile heart action was provided by a pneumatic ventricular assist device (PVAD). Peripheral vascular resistance, regional flow and vascular compliance were adjusted to obtain physiological flow and pressure waveforms. Colorants were injected automatically for flow visualization. Five flow distributions with a total flow of 4 l/min were tested (%PVAD:%RBP): 100:0, 75:25, 50:50, 25:75, 0:100. Colorant distribution was assessed using quantitative 2D image processing. Continuous flow from the RAA divided in a retrograde and an antegrade portion. Retro- to antegrade flow ratio increased with increasing RAA-flow. At full RBP support flow was stagnant in the ascending aorta. There were distinct flow patterns between the right- and left-sided supra-aortic branches. At full RBP support retrograde flow was demonstrated in the right carotid and right vertebral arteries. Further studies are needed to confirm and evaluate the described flow patterns.

Added mass and wave radiation damping for flow-induced rotational vibrations of skinplates of hydraulic gates

One observed vibration mode for Tainter gate skinplates involves the bending of the skinplate about a horizontal nodal line. This vibration mode can be approximated as a streamwise rotational vibration about the horizontal nodal line. Such a streamwise rotational vibration of a Tainter gate skinplate must push away water from the portion of the skinplate rotating into the reservoir and draw water toward the gate over that portion of the skinplate receding from the reservoir. The induced pressure is termed the push-and-draw pressure. In the present paper, this push-and-draw pressure is analyzed using the potential theory developed for dissipative wave radiation problems. In the initial analysis, the usual circular-arc skinplate is replaced by a vertical, flat, rigid weir plate so that theoretical calculations can be undertaken. The theoretical push-and-draw pressure is used in the derivation of the non-dimensional equation of motion of the flow-induced rotational vibrations. Non-dimensionalization of the equation of motion permits the identification of the dimensionless equivalent added mass and the wave radiation damping coefficients. Free vibration tests of a vertical, flat, rigid weir plate model, both in air and in water, were performed to measure the equivalent added mass and the wave radiation damping coefficients. Experimental results compared favorably with the theoretical predictions, thus validating the theoretical analysis of the equivalent added mass and wave radiation damping coefficients as a prediction tool for flow-induced vibrations. Subsequently, the equation of motion of an inclined circular-arc skinplate was developed by incorporating a pressure correction coefficient, which permits empirical adaptation of the results from the hydrodynamic pressure analysis of the vertical, flat, rigid weir plate. Results from in-water free vibration tests on a 1/31-scale skinplate model of the Folsom Dam Tainter gate are used to demonstrate the utility of the equivalent added mass coefficient.

INVESTIGATION OF INTRAOCULAR PRESSURE AS A PREDICTOR OF TRAUMATIC EYE INJURIES

Eye injuries are a large societal problem in both the military and civilian sectors. Eye injury rates are increasing in recent military conflicts, and there are over 1.9 million eye injuries in the United States civilian sector annually. In order to develop a better understanding of eye injury risk, several previous studies have developed eye injury criteria based on projectile characteristics. While these injury criteria have been used to estimate eye injury potential of impact scenarios, they require that the mass, size and velocity of the projectile are known. It is desirable to develop a method to assess the severity of an eye impact in environments where it would be difficult or impossible to determine these projectile characteristics. The current study presents a measurement technique for monitoring intraocular pressure of the eye under impactloading. Through experimental tests with a custom pressure chamber, a subminiature pressure transducer was validated to be thermally stable and suitable for testing in an impact environment.Once validated, the transducer was utilized intraocularly, inserted through the optic nerve, to measure the pressure of the eye during blunt-projectile impacts. A total of 150 impact tests were performed using projectiles ranging from 3.2 mm to 17.5 mm in diameter. Investigation of the relationship between projectile energy and intraocular pressure lead to the identification of at least two distinct trends. Intraocular pressure and normalized energy measurements indicated a different response for penetrating-type globe rupture injuries with smaller diameter (d < 1 cm)projectiles, and blunt-type globe rupture injuries with larger diameter (d > 1 cm) projectiles. Furthermore, regression analysis indicates that relationships exist between intraocular pressureand projectile energy that may allow quantification of eye injury risk based on pressure data, and also that intraocular pressure measurements of impact may lead to a better understanding of thetransition between penetrating and blunt globe rupture injury mechanisms.