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Biomedical subjects

J R Jansen

Publications and source records attributed to J R Jansen.

At least 55 records · Page 3Linked to original sources
PubMed1986

Improvement of cardiac output estimation by the thermodilution method during mechanical ventilation.

The reliability of cardiac output estimation by thermodilution during artificial ventilation was studied in anesthetized pigs at the right side of the heart. The estimates exhibited a cyclic modulation related to the ventilation. The amplitude of the modulation was independent of the level of positive end-expiratory pressure, ventilatory pattern and volemic loading of the animals. However, a non-constant phase relation existed between the ventilatory cycle and the modulation. Single observations at a fixed moment in the ventilatory cycle are therefore not appropriate for estimation of mean cardiac output nor for studying its relative changes. The averaging of estimates spread equally over the ventilatory cycle led to a much larger reduction in the deviation of the averages from the mean cardiac output than an averaging procedure of randomly selected estimates. The accuracy of estimation of mean cardiac output by two estimates equally spread in the ventilatory cycle was equal to the accuracy obtained by averaging five randomly selected estimates. Averaging four estimates, equally spread in the cycle, appeared to be the optimal procedure. For 89% of all averages an accuracy of 5% around the mean was obtained and for 99% an accuracy of +/- 10%.

Anesthesia, General↗
PubMed1986

Suppression of spontaneous breathing during high-frequency jet ventilation. Influence of dynamic changes and static levels of lung stretch.

Conditions which suppress spontaneous breathing activity during high-frequency jet ventilation (HFJV) were analysed in Yorkshire piglets under pentobarbital anesthesia. The highest PaCO2 at which the animals did not breathe against the ventilator (apnea point) was established during different patterns of ventilation, either by changing the minute volume or by adding CO2 to the inspiratory gas. Arterial oxygen tension was maintained throughout the study above 80 mm Hg. An elevation of ventilatory rate increased the apnea point, suggesting a progressive suppression of spontaneous breathing. This suppression did not depend on the amount of lung stretch during insufflation, because at higher rates lower tidal volumes were used. Suppression also appeared to be independent of insufflatory flow, i.e. the velocity of lung stretch. At higher frequencies end-expiratory airway pressure (PEE) increased and there appeared to be a positive relationship between the apnea point and PEE. In a separate series this positive relationship between the apnea point and PEE was confirmed. A hysteresis effect in this relationship, however, suggests that other than jet frequency, lung volume rather than positive end-expiratory pressure (PEEP) is a major determinant of suppression of spontaneous breathing activity during HFJV.

Animals↗
PubMed1986

Random walk type models for indicator-dilution studies: comparison of a local density random walk and a first passage times distribution.

The relative merits of the local density random walk and the first passage times distributions were compared with respect to their practical applicability in cardiovascular research and clinical practice. Open indicator-dilution curves of varying shape were used, and reference values for area and mean transit times were calculated numerically. Curves not perturbed by recirculation were obtained in two different ways. Thermodilution curves were obtained in an animal model at the left and the right side of the heart respectively and conductivity curves with 0.5% NaCl solution as indicator were obtained in a hydrodynamic circulation model. The fits of the two types of distribution were equally accurate for the more symmetrical curves; for very skewed curves the local density random walk fit proved to be more accurate. This result could be related to the greater difference in shape between the first passage times and local density random walk distribution for a large degree of asymmetry. For this reason the local density random walk distribution for fitting indicator-dilution curves was used in a variety of other experimental conditions.

Animals↗
PubMed1985

Mean systemic filling pressure as a characteristic pressure for venous return.

Guyton's theory on venous return, implying a linear relationship between blood flow and central venous pressure, was tested in an intact circulation after thoracotomy and airtight chest closure. In eleven Yorkshire pigs (approx. 10 kg) we measured flow in the pulmonary artery and aorta and pressure in the central veins and aorta during pentobarbital anesthesia and mechanical ventilation. To change central venous pressure different lung volumes were randomly applied at intervals of 5 min in a series of inspiratory hold procedures of 7.2 s. During these short periods hemodynamic steady state circumstances were met without involvement of cardiovascular control mechanisms. We confirmed the linear relationship between venous return and central venous pressure and derived mean systemic filling pressure from the regression equation. Mean systemic filling pressure was on average 10.5 +/- 2.3 (SD) mm Hg. The time dependent changes during the inspiratory hold procedure showed that the increase in central venous pressure was the primarily dependent variable, followed by a decrease in venous return and right ventricular output. After a delay of 2-4 heart beats also a decrease in left ventricular output and aortic pressure occurred. Subsequently, the lower venous return during inspiratory hold was mainly sustained by the lower aortic pressure, but nevertheless fulfilled the linear relationship mentioned above. For analysis of flow and pressure changes in the systemic circulation during changes of central venous pressure a tube of constant flow resistance was used as a conceptual mode.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Hemodynamic effects of PEEP applied as a ramp in normo-, hyper-, and hypovolemia.

Nonlinear hemodynamic responses on positive end-expiratory pressure (PEEP) have been attributed to a rise of mean central venous pressure (Pcv), to compensatory cardiovascular control mechanisms, and to the occurrence of a lung stretch depressor reflex above a threshold lung stretch. We tested the hypothesis that the contribution of each of these mechanisms is dependent on the preexisting volemic load. PEEP was applied as a continuous rise (ramp) in piglets in three different volemic loads. In the normovolemic circulation cardiac output (CO) decreased nonlinearly in three phases during the PEEP ramp up to 15 cmH2O. CO decreased gradually in phase I, followed by a sharp decrease in phase II between a PEEP of 3 and 9 cmH2O and again a more gradual decrease in phase III up to a PEEP of 15 cmH2O. Heart rate (HR) and mean aortic pressure (PaO) also decreased during phase II, indicating the predominance of a lung stretch depressor reflex. In the hypervolemic circulation (loading 15 ml . kg-1 dextran) only phases I and II were observed with the onset of phase II at a higher level of PEEP (6 cmH2O). More lung stretch appeared to be necessary to elicit the lung stretch depressor reflex. In the hypovolemic circulation (hemorrhage 15 ml . kg-1) CO decreased linearly, Pao was stable after an initial decrease, and HR increased continuously, indicating a predominance of cardiovascular compensatory mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Variability in the time interval between tricuspid and mitral valve closure in Ebstein's anomaly.

The time interval between mitral and tricuspid valve closure was measured from M-mode echocardiograms in patients with Ebstein's anomaly. It was found that this time interval demonstrated a range of values within each patient. The use of different transducer positions on the chest wall was found to be the predominant factor. There was no correlation between the measured time interval, its variability, and the moment of measurement during breathing. However, a period of breathholding significantly reduced the variability. This study indicates that a wide range of time intervals might be measured in a single patient. We conclude therefore, that this parameter should be used with great care in the diagnosis of Ebstein's anomaly.

Ebstein Anomaly↗
PubMed1984

Contribution of lung stretch depressor reflex to nonlinear fall in cardiac output during PEEP.

The hypothesis that lung stretch reflexes elicit negative cardiovascular effects during positive end-expiratory pressure (PEEP) application in a ramp procedure up to 15 cmH2O was tested in piglets under steady-state anesthesia and muscle relaxation. The effects of lung stretch on hemodynamics were studied by comparing the differences in responses during PEEP application with two different tidal volumes. In both ventilatory conditions cardiac output and aortic pressure decreased nonlinearly in three phases with the rise of PEEP: a gradual decrease in phase I, a sharp decrease in phase II, and again a more gradual decrease in phase III. Heart rate decreased significantly in phase II. In the series with the larger tidal volume, implying more lung stretch during insufflation, phase II was between a PEEP of 2.6 and 9 cmH2O. In the series with the smaller tidal volume, phase II occurred between 5.7 and 10.5 cmH2O. To assess the contribution of lung stretch reflexes to the decrease in cardiac output we also related cardiac output to the changes in central venous pressure. Again a nonlinear response was observed, indicating that an additional effect besides the rise in mean central venous pressure was involved in the decrease in cardiac output. During ventilation with the smaller tidal volume, phase II of the decrease in cardiac output was also shifted to higher values of mean central venous pressure, which only could be ascribed to the differences in lung stretch at insufflation. It appeared that under circumstances of artificial ventilation the onset of the reflex is determined by a characteristic threshold of lung stretch.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

Functional development of the parasympathetic innervation of the sino-auricular node in newborn rabbits, cats and guinea pigs.

The effects of supramaximal vagus nerve stimulation on heart rate were studied in newborn rabbits, cats and guinea pigs. The analysis of the stimulus-effect curve revealed that the earlier proposed relationship: log If/IO = H.f (IO is the steady state PP-interval before and If during stimulation, f is the stimulus frequency, and H the slope of the line) accurately summarizes the relation in rabbits, while with minor deviations it also holds for newborn cats and guinea pigs. Thus, the vagus effect for each nerve and animal is characterized by the slope of the line, H. In rabbits and cats the vagus effect decreased during the first postnatal week to about 1/3 and 1/5 of the initial value at birth. Guinea pigs, however, did not show such a postnatal change of the vagus effect. In comparison with rabbits and cats these animals are born at a relatively late ontogenetic stage. Therefore, we hypothesized that the decrease in vagus effect is related to the stage of development and occurs mainly before birth in this species.

Aging↗
PubMed1983

Attenuation of the negative chronotropic effect of myelinated fibers by nonmyelinated fibers in the vagus nerve of the rabbit.

In the adult rabbit, both myelinated and nonmyelinated efferent fibers travel from the cervical vagus nerve to the sinoauricular node. The myelinated fibers convey the negative chronotropic effect. The influence of the nonmyelinated fibers was studied. Stimulation (4/sec) of the myelinated fibers, while the compound action potential was monitored continuously, caused a slowing of the heart rate. Subsequent activation of the non-myelinated fibers attenuated this negative chronotropic effect. Stimulation of adrenergic fibers was excluded, based on data from histochemical studies and the effects of blockade of beta- and muscarinic receptors. The lengthening of the RR interval during activation of the myelinated fibers alone was about 3.5 times larger than during activation of all fiber groups. When the conduction of the myelinated fibers was blocked (anodal block), activation of the nonmyelinated fibers did not show any effect on heart rate. It was concluded that the negative chronotropic effect is conducted via small myelinated fibers and that the nonmyelinated fibers modulate the effect of these cardiomotor fibers, without having an effect on heart rate on their own. This modulation is effected either via a presynaptic mechanism on preganglionic fibers or via an interaction with postganglionic neurons. The nonmyelinated fibers constitute a novel peripheral system to modulate heart rate.

Adrenergic Fibers↗
PubMed1982

Developmental morphometry and physiology of the rabbit vagus nerve.

The morphological and physiological features of the rabbit vagus nerve were studied at different ages after birth. The total fibre count is about 37,500 of which at birth 1-2% and in the adult animal approximately 10% are myelinated. In the postnatal period the cross-sectional area of the vagus grows to 5 times its perinatal size due to an increase of endoneural collagen, fibre growth and myelinization. The myelinization is most pronounced in the first 2 weeks after birth, axonal growth is predominant thereafter. The available data suggest that the begin of myelinization as well as the subsequent development of the myelin sheath are not dependent on axonal size. There seems to be no fundamental difference between the morphological development of the vagus and other peripheral nerves, e.g. the sciatic nerve of the rat. At birth the vagus nerve contains 2 fibre groups as can be measured from the compound action potential with conduction velocities of 11.4 and 0.9 m.s-1 respectively. Upon subsequent development the conduction velocity of these fibres increases to 31.9 and 1.2 m.s-1 in full-grown animals. THe compound action potential of the adult nerve implies 2 additional fibre groups with conduction velocities of 12.3 and 4.6 m.s-1 respectively. These two fibre populations develop gradually from 1 to 2 weeks after birth and arise probably from the slowest conducting, non-myelinated or C-fibres. It is concluded that the functional innervation of the sinoauricular node may be operational at birth as far as the cervical vagus nerve is concerned.

Action Potentials↗
PubMed1982

Hemodynamic effects of positive end-expiratory pressure applied as a ramp.

Hypotheses on the decrease in cardiac output due to positive end-expiratory pressure (PEEP) were tested during positive-pressure ventilation by application of PEEP from 0 to 15 cmH2O as a ramp input function, i.e., a continuous rise. Yorkshire pigs (n = 47, 5-7 wk old) were used under steady-state anesthesia (pentobarbital) and muscle relaxation. Cardiac output decreased nonlinearly in three distinct phases, I up to PEEP 3 cmH2O, II from 3 to 10 cmH2O, and III above 10 cmH2O, with the sharpest decline occurring in phase II. This three-phase cardiac output decrease was more pronounced when the individual responses were normalized to the inflection points between the phases. Heart rate did not change when related to PEEP, but when normalized to the inflection points a significant increase was observed in the phase I and III, whereas in phase II a decrease was evident. Based on a diversity of hemodynamic responses myocardial depression and right ventricular afterload were rejected as major causal mechanisms for the decrease of cardiac output. We hypothesized that the nonlinear response of cardiac output on PEEP is due to a combination of three types of mechanisms. First, the rise of central venous pressure with PEEP decreases cardiac output linearly. Second, the concomitant fall of arterial pressure elicits compensatory mechanisms, which flatten the slope of this venous return curve. Finally, above 3 cmH2O PEEP a lung stretch reflex is elicited, which performs an inhibitory effect on the circulation, causing the steeper fall in cardiac output as well as the decrease in heart rate in phase II.

Animals↗
PubMed1981

Thermodilution technique for measurement of cardiac output during artificial ventilation.

The feasibility of using the thermodilution method to monitor cardiac output during artificial ventilation was studied in anesthetized pigs. Normal saline (0.5 ml) at room temperature was injected into the left ventricle or the right atrium. The dilution curves were detected in the aortic arch and the pulmonary artery, respectively. The ventilation rate was 10 cycles/min at end-expiratory pressures of 0, 5, 10, and 15 cmH2O. For each level, 50 measurements of cardiac output were performed at regular intervals over the ventilatory cycle. The order of measurements were randomly selected. The average of each series of 50 measurements showed excellent correlation with the estimates of cardiac output based on the direct Fick method for oxygen. The maximum difference between the values of cardiac output randomly measured by the thermodilution method was 40% for the left side of the heart and 70% for the right side. However, when the values of cardiac output were sorted according to the specific phases of the respiratory cycle, there was a systematic variation with a small random error. For the left side of the heart, a satisfactory moment of injection for estimation of mean cardiac output appeared to be at the end of the spontaneous expiration. On the other hand, the analysis of cardiac output values at the right side did not reveal any satisfactory moment for injectate administration under changing circumstances, e.g., positive end-expiratory pressure.

Animals↗
PubMed1978

A non-invasive determination of lung perfusion compared with the direct Fick method.

In 5 young pigs (7--9 kg each) data on effective lung perfusion were obtained using a sinusoidal forcing function in the inspired halothane concentration. These data were compared with the cardiac output measured by the direct Fick method for oxygen, corrected for venous admixture. To produce different levels of cardiac output during each experiment the respiratory and circulatory conditions were changed. For the 5 experiments taken together, the mean of the ratios between the non-invasively obtained effective lung perfusion and the venous admixture corrected Fick data was 1.01 (SD = 0.14, n = 55) with r = 0.92.

Animals↗