Management of the systemic cardiovascular parameters by means of monitoring the peripheral arterial pressure after intravenous volume load and acute blood loss

In acute experiments on 23 male Wistar rats a direct detection of blood pressure in the carotid and femoral arteries was provided before and after intravenous infusion of dextran solution and acute blood loss. Harmonic analysis was applied to the resulting pulse wave curve for the estimation of generalized (GTF) and individual transfer functions (iTF) in concern with changes if the circulating blood volume. Analysis of the results showed that in a case of fluid volume load or alternatively a withdrawal of blood from the vascular system, the use of GTF for management central blood pressure according to the study of peripheral vascular pressure is impossible because of a large estimation error revealed by the comparison of the pressure curves and absolute values of the blood pressure, measured directly or reconstructed with the use of GTF. Application of iTF for the reconstruction of central blood pressure curve according to the study of peripheral vascular pressure is acceptable due to lack of a statistically significant difference between estimated pressure curves and directly measured absolute values of blood pressure.

передаточные функции, системное артериальное давление, полиглюкин, кровопотеря, acute blood loss, circulating blood volume, dextran solution, systemic arterial pressure, transfer functions

1. Report of the AVMA Panel on Euthanasia // J. Am. Vet. Med. Assoc. 2001. № 5 (218). P. 669-696.

2. Балуева Т. В. и др. Оценка параметров системной гемодинамики по данным исследования периферических сосудов // Регионарное кровообращение и микроциркуляция. 2011. № 2 (38). С. 79-84.

3. Балуева Т. В. и др. Оценка параметров системной гемодинамики по данным исследования периферических сосудов после введения вазоактивных препаратов // Регионарное кровообращение и микроциркуляция. 2012. № 3 (43). С. 57-63.

4. Братусь В. Д., Шерман Д. М. Геморрагический шок: патофизиологические и клинические аспекты. Киев: Наукова думка, 1989. 304 с.

5. Каро К. и др. Механика кровообращения / пер. с англ. М.: Мир, 1981. 621 с.

6. Кобалава Ж. Д. и др. Артериальная гипертония: ключи к диагностике и лечению. М.: ГЭОТАР-Медиа, 2009. 864 с.

7. Ноздрачев А. Д., Поляков Е. Л. Анатомия крысы (лабораторные животные). СПб.: Лань, 2004. 464 с.

8. Осадчий Л. И. и др. Системные сосудистые реакции на увеличение объемной скорости кровотока // Физиолог. журн. СССР им. И. М. Сеченова. 1980. № 10 (66). С. 1481-1487.

9. Шендеров С. М., Рогоза А. Н. Миогенный тонус и механика кровеносных сосудов // Физиология человека и животных. М.: ВИНИТИ, 1979. Т. 23. С. 3-45.

10. Altman P. L. et al. Handbook of circulation. Philadelphia; London, 1959. 393 p.

11. Bein B. et al. Comparison of esophageal Doppler, pulse contour analysis, and real-time pulmonary artery thermodilution for the continuous measurement of cardiac output // J. Cardiothorac. Vasc. Anesth. 2004. № 2 (18). P. 185-189.

12. Bein B. et al. The reliability of pulse contour-derived cardiac output during hemorrhage and after vasopressor administration // Anesth. Analg. 2007. № 1 (115). P. 107-113.

13. Buhre W. et al. Comparison of cardiac output assessed by pulse-contour analysis and thermodilution in patients undergoing minimally invasive direct coronary artery bypass grafting // J. Cardiothorac. Vasc. Anesth. 1999. № 4 (13). P. 437-440.

14. Cameron J. D. et al. Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension // J. Am. Coll. Cardiol. 1998. № 5 (35). P. 1214-1220.

15. Chen-Huan C. et al. Estimation of Central Aortic Pressure. Waveform by Mathematical Transformation of Radial Tonometry Pressure // Circulation. 1997. № 7 (95). P. 1827-1836.

16. Cockburn J. A. et al. Differential effects of beta-adrenoreceptor antagonists on central and peripheral blood pressure at rest and during exercise // Br. J. Clin. Pharmacol. 2010. № 4 (69). P. 329-335.

17. Critchley L. A. Self-calibrating pulse contour cardiac output: do validation studies really show its clinical reliability? // Crit. Care. 2009. № 2 (13). R. 32.

18. Della Rocca G. et al. Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique // Br. J. Anaesth. 2002. № 3 (88). P. 350-356.

19. Dieter R. S. et al. Flow dynamics and arterial physiology // Peripheral Arterial Disease. The McGraw-Hill Companies, 2009. P. 93-113.

20. Dobrin P. B. Mechanical properties of arteries / P. B. Dobrin // Physiol. Rev. 1978. № 2 (58). P. 397-460.

21. Edwards D. G. Wave reflection and central aortic pressure are increased in response to static and dynamic muscle contraction at comparable workloads // J. Appl. Physiol. 2008. № 2 (104). P. 439-445.

22. Godje O. et al. Reliability of a new algorithm for continuous cardiac output determination by pulse-contour analysis during hemodynamic instability // Crit. Care. Med. 2002. № 1 (30). P. 52-58.

23. Guyton A. C. Kidneys and fluids in pressure regulation. Small volume but large pressure changes // Hypertension. 1992. № 1 (19). P. 2-8.

24. Guyton A. C., Granger H. J. , Coleman T. G. Autoregulation of the total systemic circulation and its relation to control of cardiac output and arterial pressure // Circ. Res. 1971. № 1 (28). P 93-97.

25. Guyton A. C. Arterial Pressure and Hypertension. Philadelphia: WB Saunders Co, 1980. P. 564.

26. Kjeldsen S. E. et al. Effects of losartan on cardiovascular morbidity and mortality in patients with isolated systolic hypertension and left ventricular hypertrophy: a Losartan Intervention for Endpoint // JAMA. 2002. № 12 (288). P. 1491-1498.

27. Nelson M. R. et al. Noninvasive measurement of central vascular pressures with arterial tonometry: clinical revival of the pulse pressure waveform? // Mayo Clin. Proc. 2010. № 5 (85). P. 460-472.

28. O’Rourke M. F., Pauca A., Jiang X. J. Pulse wave analysis // Br. J. Clin. Pharmacol. 2001. № 6 (51). P. 507-522.

29. Rauch H. et al. Pulse contour analysis versus thermodilution in cardiac surgery patients // Acta. Anaesthesiol. Scand. 2002. № 4 (46). P. 424-429.

30. Rodig G. et al. Continuous cardiac output measurement: pulse contour analysis vs thermodilution technique in cardiac surgical patients // Br. J. Anaesth. 1999. № 4 (82). P. 525-530.

31. Sander M. et al. Pulse contour analysis after normothermic cardiopulmonary bypass in cardiac surgery patients // Crit. Care. 2005. № 6 (9). R. 729-734.

32. Schram M. T. et al. Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study // Hypertension. 2004. № 2 (43). P. 176-181.

33. Soderstrom S. et al. Can a clinically useful aortic pressure wave be derived from a radial pressure wave? // Br. J. Anaesth. 2002. № 4 (88). P. 481-488.

34. Takazawa K. et al. Assessment of vasoactive agents and vascular aging by the second derivative of photoplethysmogram waveform // Hypertension. 1998. № 2 (32). P. 365-370.

35. Waal E. E. et al. Validation of a new arterial pulse contour-based cardiac output device // Crit. Care Med. 2007. № 8 (35). P. 1904-1909.

36. Wilkinson I. B. et al. Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia // J. Am. Coll. Cardiol. 2002. № 6 (39). P. 1005-1011.

37. Wing L. M. et al. A comparison of outcomes with angiotensin-converting-enzyme inhibitors and diuretics for hypertension in the elderly // N. Engl. J. Med. 2003. № 7 (348). P. 583-592.

38. Zollner C. et al. Beat-to-beat measurement of cardiac output by intravascular pulse contour analysis: a prospective criterion standard study in patients after cardiac surgery // J. Cardiothorac. Vasc. Anesth. 2000. № 2 (12). P. 125-129.