Brachial artery peak velocity variation to predict fluid responsiveness in mechanically ventilated patients

INTRODUCTION Although several parameters have been proposed to predict the hemodynamic response to fluid expansion in critically ill patients, most of them are invasive or require the use of special monitoring devices. The aim of this study is to determine whether noninvasive evaluation of respiratory variation of brachial artery peak velocity flow measured using Doppler ultrasound could predict fluid responsiveness in mechanically ventilated patients. METHODS We conducted a prospective clinical research in a 17-bed multidisciplinary ICU and included 38 mechanically ventilated patients for whom fluid administration was planned due to the presence of acute circulatory failure. Volume expansion (VE) was performed with 500 mL of a synthetic colloid. Patients were classified as responders if stroke volume index (SVi) increased >or= 15% after VE. The respiratory variation in Vpeakbrach (DeltaVpeakbrach) was calculated as the difference between maximum and minimum values of Vpeakbrach over a single respiratory cycle, divided by the mean of the two values and expressed as a percentage. Radial arterial pressure variation (DeltaPPrad) and stroke volume variation measured using the FloTrac/Vigileo system (DeltaSVVigileo), were also calculated. RESULTS VE increased SVi by >or= 15% in 19 patients (responders). At baseline, DeltaVpeakbrach, DeltaPPrad and DeltaSVVigileo were significantly higher in responder than nonresponder patients [14 vs 8%; 18 vs. 5%; 13 vs 8%; P < 0.0001, respectively). A DeltaVpeakbrach value >10% predicted fluid responsiveness with a sensitivity of 74% and a specificity of 95%. A DeltaPPrad value >10% and a DeltaSVVigileo >11% predicted volume responsiveness with a sensitivity of 95% and 79%, and a specificity of 95% and 89%, respectively. CONCLUSIONS Respiratory variations in brachial artery peak velocity could be a feasible tool for the noninvasive assessment of fluid responsiveness in patients with mechanical ventilatory support and acute circulatory failure. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT00890071.

Transient flow of the oil-refrigerant mixture through the radial clearance in rolling piston compressors

Unsteady flow of oil and refrigerant gas through radial clearance in rolling piston compressors has been modeled as a heterogeneous mixture, where the properties are determined from the species conservation transport equation coupled with momentum and energy equations. Time variations of pressure, tangential velocity of the rolling piston and radial clearance due to pump setting have been included in the mixture flow model. Those variables have been obtained by modeling the compression process, rolling piston dynamics and by using geometric characteristics of the pump, respectively. An important conclusion concerning this work is the large variation of refrigerant concentration in the oil-filled radial clearance during the compression cycle. That is particularly true for large values of mass flow rates, and for those cases the flow mixture cannot be considered as having uniform concentration. In presence of low mass flow rates homogeneous flow prevail and the mixture tend to have a uniform concentration. In general, it was observed that for calculating the refrigerant mass flow rate using the difference in refrigerant concentration between compression and suction chambers, a time average value for the gas concentration should be used at the clearance inlet.

Development of a non-intrusive system to monitor radial pulse wave velocity

Understanding arterial distensibility has shown to be important in the pathogenesis of cardiovascular abnormalities like hypertension. It is also known that arterial pulse wave velocity (PWV) is a measure of the elasticity or stiffness of peripheral arterial blood vessels. However, it generally requires complex instrumentations to have an accurate measurement and not suited for continual monitoring. In this paper, it describes a simple and non-intrusive method to detect the cardiovascular pulse from a human wrist above the radial artery and a fingertip. The main components of this proposed method are a piezoelectric transducer and a photo-plethysmography circuitry. 5 healthy adults (4 male) with age ranging from 25 to 38 years were recruited. The timing consistency of the detected pulsations is first evaluated and compared to that obtained from a commercial electrocardiogram. Furthermore, the derived PWV is then assessed by the predicted values attained from regression equations of two previous similar studies. The results show good correlations (p < 0.05) and similarities for the former and latter respectively. The simplicity and non-invasive nature of the proposed method can be attractive for even younger or badly disturbed patients. Moreover, it can be used for prolonged monitoring for the comfort of the patients.

Abundance variations in the globular cluster M71 (NGC 6838)

Context. Abundance variations in moderately metal-rich globular clusters can give clues about the formation and chemical enrichment of globular clusters. Aims. CN, CH, Na, Mg and Al indices in spectra of 89 stars of the template metal-rich globular cluster M71 are measured and implications on internal mixing are discussed. Methods. Stars from the turn-off up to the Red Giant Branch (0.87 < log g < 4.65) observed with the GMOS multi-object spectrograph at the Gemini-North telescope are analyzed. Radial velocities, colours, effective temperatures, gravities and spectral indices are determined for the sample. Results. Previous findings related to the CN bimodality and CN-CH anticorrelation in stars of M71 are confirmed. We also find a CN-Na correlation, and Al-Na, as well as an Mg(2)-Al anticorrelation. Conclusions. A combination of convective mixing and a primordial pollution by AGB or massive stars in the early stages of globular cluster formation is required to explain the observations.

New measurements of radial velocities in clusters of galaxies-V

As a part of our galaxy-cluster redshift survey, we present a set of 79 new velocities in the 4 clusters Abell 376, Abell 970, Abell 1356, and Abell 2244, obtained at Haute-Provence observatory. This set now completes our previous analyses, especially for the first two clusters. Data on individual galaxies are presented, and we discuss some cluster properties. For A376, we obtained an improved mean redshift (z) over bar = 0.04750 with a velocity dispersion of sigma(V) = 860 km s(-1). For A970, we have (z) over bar = 0.05875 with sigma(V) = 881 km s(-1). We show that the A1356 cluster is not a member of the ""Leo-Virgo"" supercluster at a mean redshift (z) over bar = 0.112 and should be considered just as a foreground group of galaxies at (z) over bar = 0.0689, as well as A1435 at (z) over bar = 0.062. We obtain (z) over bar = 0.09962 for A2244 with sigma(V) = 965 km s(-1). The relative proximity of clusters A2244 and A2245 ((z) over bar = 0.08738, sigma(V) = 992 km s(-1)) suggests that these could be members of a supercluster that would include A2249; however, from X-ray data there is no indication of interaction between A2244 and A2245.

Low-amplitude variations detected by CoRoT in the B8IIIe star HD 175869

Context. The origin of the short-term variability in Be stars remains a matter of controversy. Pulsations and rotational modulation are the components of the favored hypothesis. Aims. We present our analysis of CoRoT data of the B8IIIe star HD 175869 observed during the first short run in the center direction (SRC1). Methods. We review both the instrumental effects visible in the CoRoT light curve and the analysis methods used by the CoRoT Be team. We applied these methods to the CoRoT light curve of the star HD 175869. A search for line-profile variations in the spectroscopic data was also performed. We also searched for a magnetic field, by applying the LSD technique to spectropolarimetric data. Results. The light curve exhibits low-amplitude variations of the order of 300 mu mag with a double wave shape. A frequency within the range determined for the rotational frequency and 6 of its harmonics are detected. The main frequency and its first harmonic exhibit amplitude variations of a few days. Other significant frequencies of low-amplitude from 25 to a few mu mag are also found. The analysis of line profiles from ground-based spectroscopic data does not detect any variation. In addition, no Zeeman signature was found. Conclusions. Inhomogeneities caused by stellar activity in or just above the photosphere are proposed to produce the photometric variability detected by CoRoT in the Be star HD 175869. The hypothesis that non-radial pulsations are the origin of these variations cannot be excluded.

Radial variation of the wood anatomical structure of Gmelina arborea trees from different climatic and management conditions in Costa Rica

The evaluations of the effect of the climatic conditions and of the intensity of forest management in the trunk of the Gmelina arborea Linn. Roxb. trees are restricted to its physical-mechanical properties and use. The present work has as objective to study the radial variations of the wood anatomy of the gmelina trees sampled in plantations of 30 sites in Costa Rica, characterized by two climatic conditions (tropical dry and humid) and three intensities of forest management (intensive, moderate and without management). The results of the analyses demonstrated the existence of radial variation of the different anatomical parameters, except for the fiber lumen diameter and multiple vessels in the wood of the gmelina trees. For the wood anatomical elements, fibers (width, lumen diameter, and length), vessels (multiple vessels, diameter and frequency) and radial parenchyma (height) relationships were observed with the climate (tropical humid and dry). The radial variations of the wood anatomical elements were, also, influenced by the management regimes of the gmelina trees.

Sequential Changes of Longitudinal and Radial Myocardial Deformation Indices in the Healthy Neonate Heart

Background: Significant hemodynamic changes, including preload and afterload modifications, occur during the transition from the fetal to the neonatal environment. The ductus arteriosus closes, pulmonary vascular resistance decreases, and pulmonary blood flow increases. Strain rate (SR) and strain (e) have been proposed as ultrasound indices for quantifying regional wall deformation. This study was designed to determine if these indices can detect variations in regional deformation between early and late neonatal periods. Methods: Data were obtained from 30 healthy neonates (15 male). The initial study was performed at a mean age of 20.1614 hours (exam 1) and the second at 31.962.9 days (exam 2). Apical and parasternal views were used to quantify regional left ventricular (LV) and right ventricular (RV) longitudinal and radial SR and e, and systolic, early, and late diastolic values were calculated from these curves. A paired-samples t test was performed comparing the two groups. Results: Compared with exam 1, LV radial deformation showed significant reductions in peak systolic e in the basal and mid segments (51615% vs 4669%, P < .01). LV longitudinal deformation behaved similarly, showing significant peak systolic e reductions in all measured segments. Systolic SR showed reductions only in the basal and apical segments of the lateral wall and in the mid portion of the inferior wall (-1.9 +/- 0.5 vs -1.7 +/- 0.3 s(-1) and -1.9 +/- 0.4 vs -1.7 +/- 0.2 s(-1), respectively, P = .03). RV longitudinal free and inferior wall systolic SR and e values were significantly higher in exam 2. Conclusions: LV peak systolic e decreases in exam 2 were possibly due to afterload increase and preload decrease. The lower RV initial deformation indices could be attributed to increased afterload caused by physiologic pulmonary hypertension or immature RV contractile properties. SR seemed to be a more robust index than e and less influenced by preload and afterload hemodynamic alteration. (J Am Soc Echocardiogr 2010;23:294-300.)

Lack of Circadian Variation of Pulse Wave Velocity Measurements in Healthy Volunteers

Arterial stiffness is an independent marker of cardiovascular events. Pulse wave velocity (PWV) is a validated method to detect arterial stiffness that can be influenced by several factors including age and blood pressure. However, it is not clear whether PWV could be influenced by circadian variations. In the present study, the authors measured blood pressure and carotid-femoral PWV measurements in 15 young healthy volunteers in 4 distinct periods: 8 am, noon, 4 pm, and 8 pm. No significant variations of systolic (P=.92), mean (P=.77), and diastolic (P=.66) blood pressure among 8 am (113 +/- 15, 84 +/- 8, 69 +/- 6 mm Hg), noon (114 +/- 13, 83 +/- 8, 68 +/- 6 mm Hg), 4 pm (114 +/- 13, 85 +/- 8, 70 +/- 7 mm Hg), and 8 pm (113 +/- 7, 83 +/- 10, 68 +/- 7 mm Hg), respectively, were observed. Similarly, carotid-femoral PWV did not change among the periods (8 am: 7.6 +/- 1.4 m/s, noon: 7.4 +/- 1.1 m/s, 4 pm: 7.6 +/- 1.0 m/s, 8 pm, 7.6 +/- 1.3 m/s; P=.85). Considering all measurements, mean blood pressure significantly correlated with PWV (r=.31; P=.016). In young healthy volunteers, there is no significant circadian variation of carotid-femoral PWV. These findings support the concept that it does not appear mandatory to perform PWV measurements at exactly the same period of the day. J Clin Hypertens (Greenwich). 2011;13:19-22. (c) 2010 Wiley Periodicals, Inc.

Seismic attenuation and velocity dispersion in heterogeneous partially saturated porous rocks

Using a numerical approach, we explore wave-induced fluid flow effects in partially saturated porous rocks in which the gas-water saturation patterns are governed by mesoscopic heterogeneities associated with the dry frame properties. The link between the dry frame properties and the gas saturation is defined by the assumption of capillary pressure equilibrium, which in the presence of heterogeneity implies that neighbouring regions can exhibit different levels of saturation. To determine the equivalent attenuation and phase velocity of the synthetic rock samples considered in this study, we apply a numerical upscaling procedure, which permits to take into account mesoscopic heterogeneities associated with the dry frame properties as well as spatially continuous variations of the pore fluid properties. The multiscale nature of the fluid saturation is taken into account by locally computing the physical properties of an effective fluid, which are then used for the larger-scale simulations. We consider two sets of numerical experiments to analyse such effects in heterogeneous partially saturated porous media, where the saturation field is determined by variations in porosity and clay content, respectively. In both cases we also evaluate the seismic responses of corresponding binary, patchy-type saturation patterns. Our results indicate that significant attenuation and modest velocity dispersion effects take place in this kind of media for both binary patchy-type and spatially continuous gas saturation patterns and in particular in the presence of relatively small amounts of gas. The numerical experiments also show that the nature of the gas distribution patterns is a critical parameter controlling the seismic responses of these environments, since attenuation and velocity dispersion effects are much more significant and occur over a broader saturation range for binary patchy-type gas-water distributions. This analysis therefore suggests that the physical mechanisms governing partial saturation should be accounted for when analysing seismic data in a poroelastic framework. In this context, heterogeneities associated with the dry frame properties, which do not play important roles in wave-induced fluid flow processes per se, should be taken into account since they may determine the kind of gas distribution pattern taking place in the porous rock.

Radial displacement of a fluid annulus in a rotating Hele¿Shaw cell

The radial displacement of a fluid annulus in a rotating circular Hele-Shaw cell has been investigated experimentally. It has been found that the flow depends sensitively on the wetting conditions at the outer interface. Displacements in a prewet cell are well described by Darcy's law in a wide range of experimental parameters, with little influence of capillary effects. In a dry cell, however, a more careful analysis of the interface motion is required; the interplay between a gradual loss of fluid at the inner interface, and the dependence of capillary forces at the outer interface on interfacial velocity and dynamic contact angle, result in a constant velocity for the interfaces. The experimental results in this case correlate in the form of an empirical scaling relation between the capillary number Ca and a dimensionless group, related to the ratio of centrifugal to capillary forces, which spans about three orders of magnitude in both quantities. Finally, the relative thickness of the coating film left by the inner interface, alpha i, is obtained as a function of Ca.

The measurement of ice velocity, mass balance and thinning-rate on Johnsons Glacier, Livingston Island, South Shetland Islands, Antarctica

A network of twenty stakes was set up on Johnsons Glacier in order to determine its dynamics. During the austral summers from 1994-95 to 1997-98, we estimated surface velocities, mass balances and ice thickness variations. Horizontal velocity increased dow nstream from 1 m a- 1 near the ice divides to 40 m a- 1 near the ice terminus. The accumulation zone showed low accumulation rates (maximum of 0,6 m a- 1 (ice)), whereas in the lower part of the glacier, ablation rates were 4,3 m a- 1 (ice). Over the 3-year study period, both in the accumulation and ablation zones, we detected a reduction in the ice surface level ranging from 2 to 10 m from the annual ve rt ical velocities and ice-thinning data, the mass balance was obtained and compared with the mass balance field values, resulting in similar estimates. Flux values were calculated using cross-section data and horizontal velocities, and compared with the results obtained by means of mass balance and ice thinning data using the continuity equation. The two methods gave similar results.

Bernoulli correction to viscous losses: Radial flow between two parallel discs

For a massless fluid (density = 0), the steady flow along a duct is governed exclusively by viscous losses. In this paper, we show that the velocity profile obtained in this limit can be used to calculate the pressure drop up to the first order in density. This method has been applied to the particular case of a duct, defined by two plane-parallel discs. For this case, the first-order approximation results in a simple analytical solution which has been favorably checked against numerical simulations. Finally, an experiment has been carried out with water flowing between the discs. The experimental results show good agreement with the approximate solution

Radial displacement of a fluid annulus in a rotating Hele-Shaw cell

The radial displacement of a fluid annulus in a rotating circular HeleShaw cell has been investigated experimentally. It has been found that the flow depends sensitively on the wetting conditions at the outer interface. Displacements in a prewet cell are well described by Darcy"s law in a wide range of experimental parameters, with little influence of capillary effects. In a dry cell, however, a more careful analysis of the interfacemotion is required; the interplay between a gradual loss of fluid at the inner interface, and the dependence of capillary forces at the outer interface on interfacial velocity and dynamic contact angle, result in a constant velocity for the interfaces. The experimental results in this case correlate in the form of an empirical scaling relation between the capillary number Ca and a dimensionless group, related to the ratio of centrifugal to capillary forces, which spans about three orders of magnitude in both quantities. Finally, the relative thickness of the coating film left by the inner interface is obtained as a function of Ca.