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- Amoroso, Matteo, 1984, et al.
(författare)
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The effect of hemodilution on free flap survival: A systematic review of clinical andexperimental studies.
- 2020
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Ingår i: Clinical hemorheology and microcirculation. - 1875-8622. ; 75:4, s. 457-466
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Forskningsöversikt (refereegranskat)abstract
- Acute normovolemic hemodilution (ANH) has been proposed as a microsurgical technique to improve blood flow in free flaps.Here, we present the first systematic review of clinical and experimental studies on the effect of ANH.We performed a systematic literature search of PubMed, Medline, the Cochrane Library, Google Scholar, and ClinicalTrials.gov using search strategies and a review process in agreement with the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. PICO criteria were defined before bibliometric processing of the retrieved articles, which were analyzed with the SYRCLE RoB tool for risk of bias and the GRADE scale for level of evidence.We retrieved 74 articles from the literature search, and after processing according to PICO criteria, only four articles remained, all of which were experimental. The rating for risk of bias was uncertain according to SYRCLE RoB results, and the level of evidence was low according to GRADE evaluation.There is no clinical evidence for the effect of ANH on microcirculation in free flaps, and experimental studies provide weak evidence supporting the use of hemodilution in reconstructive microsurgery.
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| 5. |
- Baskurt, Oguz, et al.
(författare)
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New guidelines for hemorheological laboratory techniques
- 2009
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Ingår i: Clinical hemorheology and microcirculation. - 1386-0291 .- 1875-8622. ; 42:2, s. 75-97
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Tidskriftsartikel (refereegranskat)abstract
- This document, supported by both the International Society for Clinical Hemorheology and the European Society for Clinical Hemorheology and Microcirculation, proposes new guidelines for hemorheological methods used in experimental and clinical studies. It is based on a similar document entitled: "Guidelines for measurement of blood viscosity and erythrocyte deformability" published in 1986 by the Expert Panel on Blood Rheology of the International Committee for Standardization in Hematology. Recent methods techniques and instruments, as well as new approaches to interpretation of results, are added to these new guidelines; wide spread adoption should improve comparability between hemorheological laboratories and increase the reliability of rheological tests.
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| 6. |
- Fredly, Siv, et al.
(författare)
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Skin microcirculation in healthy term newborn infants - assessment of morphology, perfusion and oxygenation
- 2015
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Ingår i: Clinical hemorheology and microcirculation. - : IOS Press. - 1386-0291 .- 1875-8622. ; 59:4, s. 309-322
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Tidskriftsartikel (refereegranskat)abstract
- Despite microcirculations fundamental role, assessments of its function are limited. We explored the applicability of Computer Assisted Video Microscope (CAVM), Laser Doppler Perfusion Measurements (LDPM) and Diffuse Reflectance Spectroscopy (DRS) to study skin microvascular morphology, perfusion and oxygen saturation in twenty-five healthy newborns day 1-3 of life. Results: Day 1-3 (mean (SD)): Microvascular density (CAVM; number of microvessels crossing a grid of lines/mm line, c/mm): Chest: 11.3 (1.5), 11.0 (1.7), 10.7 (1.6). Hand: 13.2 (2.0), 13.2 (1.9), 12.4 (1.6). Capillary density was significantly higher in the hand than in the chest each day (p less than 0.001). Perfusion (LDPM; arbitrary units): Chest: 109.1 (26.0), 101.4 (24.6), 100.8 (25.3). Hand: 58.9 (17.5), 54.3 (15.8), 46.9 (14.8). Perfusion was significantly higher in the chest than in the hand each day (p less than 0.01). Microvascular oxygen saturation (DRS; %): Chest: 88.1 (5.2), 87.8 (10.0), 86.7 (9.0). Hand: 79.9 (15.2), 82.7 (11.8), 82.2 (12.1) (p less than 0.05). Capillary flow velocities (CAVM) were similar in the chest and hand: 60-70% capillaries had "continuous high flow" and 30-40% "continuous low flow". Multimodal skin microvascular assessments with CAVM, LDPM and DRS are feasible with reproducible data in newborns. The hand has lower perfusion, higher capillary density and higher oxygen extraction than the chest.
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| 7. |
- Hadimeri, Ursula, et al.
(författare)
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A single treatment, using Far Infrared light improves blood flow conditions in arteriovenous fistula
- 2017
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Ingår i: Clinical hemorheology and microcirculation. - : IOS Press. - 1386-0291 .- 1875-8622. ; 66:3, s. 211-217
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A native arteriovenous fistula (AVF) is recommended for angio access in patients on chronic hemodialysis (HD). Fistula patency has been improved by exposure to Far Infrared light (FIR).OBJECTIVE: To investigate whether a single FIR treatment could alter blood velocity, AVF diameter or inflammatory markers. METHODS: Thirty patients with a native AVF in the forearm were included. Each patient was his/her own control. Ultrasound (US) examinations were performed before and after a single FIR treatment.RESULTS: A single FIR treatment resulted in a significant increase in blood velocity over the AV fistula from a mean of 2.1 +/- 1.0 m/s to 2.3 +/- 1.0 m/s (p = 0.02). The diameter of the arterialized vein became wider; 0,72 cm +/- 0.02 to 0,80 cm +/- 0.02, (p = 0.006). The increase in fistula blood velocity correlated positively with base line serum-urate p = 0.004) and the increase in venous diameter with the base line plasma orosomucoid concentration (p = 0.005).CONCLUSIONS: This study shows that a single FIR treatment significantly increased AVF blood velocity and vein diameter. Thus, one FIR treatment can help maturation of AVF in the early postoperative course.
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| 8. |
- Hahn, Robert G., et al.
(författare)
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Biomarkers of endothelial injury in plasma are dependent on kidney function
- 2019
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Ingår i: Clinical hemorheology and microcirculation. - : IOS PRESS. - 1386-0291 .- 1875-8622. ; 72:2, s. 161-168
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Injury (shedding) of the endothelial glycocalyx layer, which alters local blood flow and microvascular permeability, is assessed by measuring components of this layer in circulating blood. The influence of renal function on their concentrations is unknown. METHODS: Plasma and urine concentrations of three shedding products (syndecan-1, hyaluronic acid, and heparan sulfate) and creatinine were measured over 5 hours in 15 healthy volunteers and 15 postoperative patients; this guaranteed a spread of kidney functions. Renal clearances were calculated. RESULTS: Low renal clearances of syndecan-1 (mean 3.5 mL/min) and hyaluronic acid (0.8 mL/min) correlated inversely with the 6-fold variability in the plasma concentrations of these substances (r = -0 . 45 and-0.49). Low creatinine clearance correlated inversely (r = -0.60) and plasma creatinine directly (r = 0.52) with the two-fold variability in heparan sulfate, which was the only shedding substance that also correlated with C-reactive protein (r= 0.51) and, therefore, showed higher concentrations after surgery. CONCLUSIONS: The present explorative study suggests that a 6-fold variability in the plasma concentrations of three commonly measured endothelial shedding products can be understood by the kidneys ability to excrete them. This finding has implications when interpreting results of studies where shedding is assessed.
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| 10. |
- Lind, Lars, et al.
(författare)
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Shear stress in the common carotid artery is related to both intima-media thickness and echogenecity : the prospective investigation of the vasculature in Uppsala seniors study
- 2009
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Ingår i: Clinical hemorheology and microcirculation. - 1386-0291 .- 1875-8622. ; 43:4, s. 299-308
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Tidskriftsartikel (refereegranskat)abstract
- It has previously been shown that the degree of shear stress (SS) in the carotid artery is related to both plaque occurrence and intima-media thickness (IMT). Since the echogenecity also is an important feature of plaques, we investigated if a reduced shear stress also is related to the echolucency of plaque and the intima-media complex. In the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study, a population-based study of 1016 subjects aged 70, left common carotid artery diameter, IMT, the grey scale median (GSM) of the intima-media complex (IM-GSM) and the blood flow velocity were measured by ultrasound. Occurrence of plaque was noted, and the echogenecity of the plaques was visually estimated by the Gray-Weale classification. Shear stress was inversely related to both IMT and IM-GSM (p=0.0084 and p=0.003, respectively), independently of gender and coronary risk, estimated by the Framingham risk score. Shear stress was lower in subjects with carotid plaque (44% of the sample) than in those without (p=0.0013), and was inversely related to the echogenecity in the subjects with plaque (p=0.0092), independently of gender and coronary risk. A low shear stress in the common carotid artery was associated with both a thick IMT and an echolucent intima-media complex. A similar picture was seen when overt plaques were evaluated, suggesting that shear stress is of importance for both the extent and composition of atherosclerosis.
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