Tetsuo Hatanaka

Vertebral Artery Pseudoaneurysm: A Rare Complication of Internal Jugular Vein Catheterization

ercutaneous catheterization of the internal jugular vein is widely practiced for central venous P access and flow-directed pulmonary artery catheter placement. This approach has many wellknown advantages over the subclavian route (1). It also has the potential for several critical complications, especially accidental arterial puncture. We report a case of vertebral artery pseudoaneurysm caused by internal jugular vein puncture.

Cardiovascular changes during continuous hyperthermic peritoneal perfusion

Changes in blood temperature, hemodynamics, and oxygen transport were evaluated in 11 patients during continuous hyperthermic peritoneal perfusion (CHPP), a technique in which the peritoneal cavity is perfused continuously with heated solution to treat intraperitoneal cancer. CHPP was undertaken 46.8 min after the resection of cancer. Blood temperature, measured with a thermistor of a pulmonary artery catheter, reached 39.2°C. Heart rate increased to 100.7 ± 21.4 bpm (mean ± SD) and the cardiac index to 4.61 ± 0.80 L·min−1.m−2. Mean arterial pressure decreased to 75.5 ± 10.8 mm Hg and systemic vascular resistance index to 1239 ± 394 dynes·s°Cm−5μM2. Oxygen consumption greatly increased to 139.1 ± 35.2 mL·min−1.m−2, concurrently with a smaller increase in oxygen delivery to 619.7 ± 83.7 mL·min−1.m∼2 and a slight increase in oxygen extraction. Pulmonary oxygenation capacity was also disturbed. Although these cardiovascular changes were mainly due to systemic hyperthermia, other changes may be caused by splanchnic heating, abdominal distention, and pharmacologic action of methoxamine, propranolol, diltiazem, and fentanyl.

Oxygen Transport and Hemodynamics During Retrograde Whole-Body Perfusion

The changes in oxygen transport and hemodynamics during retrograde whole-body extracorporeal perfusion (retro-ECC) were studied in six mongrel dogs. Oxygen consumption during retro-ECC, in which the blood flow rate was set at 25% and 50% of the flow during antegrade extracorporeal perfusion (ante-ECC), respectively, was relatively high compared with that during ante-ECC. These changes were caused by an increase in the oxygen extraction ratio to 71.5% +/- 8.2% and 51.2% +/- 12.4% during retro-ECC/25% and retro-ECC/50%, respectively. Thus, tissue perfusion was apparently well maintained by retrograde perfusion on the basis of the oxygen transport data. However, central venous pressure increased markedly to 29.5 +/- 11.6 mmHg and 56.2 +/- 24.5 mmHg during retro-ECC/25% and retro-ECC/50%, respectively, because of massive venous congestion caused by insufficient arterial return of perfused blood. The great venous compliance and increased systemic vascular resistance were the main causes of circulatory failure during retro-ECC. The risk of serious complications owing to the venous congestion must be considered during retrograde perfusion, especially during the clinical application of retrograde cerebral perfusion.

Changes of oxygen transport variables and serum lactate during open-chest cardiac massage in dogs

AbstractThe aim of this study was to investigate the influence of critically low cardiac output (CO) upon oxygen transport. We especially focused on the changes of mixed venous oxygen saturation (S−vO2) in the presence of oxygen consumption (

Pressure Pulse Transmission Ratio (PPTR) of Inferior Vena Cava and the Blood Volume Status

\dot VO_2

A Lethal Complication of Internal Jugular Vein Catheterization

) debts. Additionally, we examined the correlation between the cumulative oxygen deficit (Def

Appropriate use of fresh frozen plasma

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