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Biomedical subjects

Yuji Kadoi

Publications and source records attributed to Yuji Kadoi.

9 recordsLinked to original sources
PubMed2003

Comparative effects of propofol versus fentanyl on cerebral oxygenation state during normothermic cardiopulmonary bypass and postoperative cognitive dysfunction.

BACKGROUND: The purpose of this study was to examine the comparative effects of propofol and fentanyl on cerebral oxygenation during normothermic cardiopulmonary bypass and postoperative cognitive dysfunction. METHODS: One hundred eighty patients scheduled for elective coronary artery bypass grafting were randomly divided into two groups: propofol group (n = 90) and fentanyl group (n = 90). After induction of anesthesia, a fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to monitor jugular venous oxygen hemoglobin saturation continuously. Hemodynamic measurements and arterial and jugular venous blood gases were measured at seven time points. All patients underwent a battery of neurologic and neuropsychological tests on the day before the operation and at 6 months after the operation. RESULTS: Cerebral desaturation (defined as a jugular venous oxygen hemoglobin saturation value less than 50%) during cardiopulmonary bypass was more frequent in the fentanyl group than in the propofol group. Cerebral desaturation time (duration when jugular venous oxygen hemoglobin saturation was less than 50%) and the ratio of cerebral desaturation time to total cardiopulmonary bypass time in the fentanyl group differed significantly from those in the propofol group (fentanyl group: 27 +/- 14 minutes, 20% +/- 9%; propofol group: 18 +/- 11 minutes, 14% +/- 7%, respectively, p < 0.05). There was no significant difference in postoperative cognitive dysfunction at 6 months after operation between the two groups (propofol group: 5 of 77, 6%; fentanyl group: 5 of 75, 7%). CONCLUSIONS: Propofol preserved cerebral oxygenation state estimated by jugular venous oxygenation during cardiopulmonary bypass compared with the fentanyl group. However, propofol did not affect postoperative cognitive dysfunction.

Aged↗
PubMed2003

End-tidal carbon dioxide monitoring stabilized hemodynamic changes during ECT.

Accumulation of carbon dioxide (CO2) can disturb systemic and cerebral hemodynamics in patients receiving electroconvulsive therapy (ECT). The purpose of this study was to identify the effects of end-tidal CO2 monitoring on hemodynamic changes in patients who received ECT under propofol anesthesia. ECT was prescribed to 40 patients under propofol anesthesia. Ventilation was assisted using a face mask and 100% oxygen, with or without end-tidal CO2 monitoring. Heart rate was significantly increased in patients without end-tidal CO2 monitoring at 1 to 5 minutes after electrical stimulation (p < 0.01). Mean arterial blood pressure and middle cerebral artery blood flow velocity in the group without end-tidal CO2 monitoring were significantly larger than the values in the group with the monitor at 1 to 5 minutes after electrical stimulation. Arterial CO2 tension in the group without end-tidal CO2 monitoring was larger than the value in the group with the monitoring at 1 minute (45+/-5 mm Hg with the monitor and 56+/-8 without the monitor) and 5 minutes (37+/-4 mm Hg with the monitor and 51+/-8 without the monitor) after electrical stimulation (p < 0.01). Application of end-tidal CO2 monitoring is considered beneficial for safe and effective anesthesia management of patients undergoing ECT, especially patients with an intracranial disorder or ischemic heart disease.

Adult↗
PubMed2003

[The differential effects of isoproterenol on +dp/dt max and -dp/dt max under volatile anesthetics in rat].

BACKGROUND: The purpose of this study is to examine the effects of isoproterenol on +dp/dt max and -dp/dt max under volatile anesthetics in rat. METHODS: Firstly, under different halothane or isoflurane (0, 0.5 MAC, 1.0 MAC, 2.0 MAC) concentrations, hemodynamic parameters were recorded simultaneously. Secondly, under different halothane or isoflurane concentrations (0, 0.5 MAC, 1.0 MAC, 2.0 MAC), the inotropic response to isoproterenol was also studied with cumulative (0, 5, 50, 100, 500, 1000 pg) concentrations and hemodynamic parameters were simultaneously recorded. RESULTS: There were significant decreases in +dp/dt max and -dp/dt max in halothane and isoflurane treated rats. The decreases in +dp/dt max and -dp/dt max were greater in halothane treated rats than those in isoflurane treated rats (P < 0.05) under 2 MAC halothane. The responses of +dp/dt max and -dp/dt max to 500 and 1000 pg isoproterenol were significantly reduced by 2 MAC halothane compared with the control (P < 0.05). There were no significant changes in +dp/dt max and -dp/dt max by administration of isoproterenol under isoflurane anesthesia. CONCLUSIONS: Isoflurane has less effects on +dp/dt max and -dp/dt max, compared with halothane. It is possible that halothane, but not isoflurane, has some effects on the responsiveness to isoproterenol.

Anesthetics, Inhalation↗
PubMed2002

G-protein coupled receptor kinase 2 is altered during septic shock in rats.

BACKGROUND: One of the key mechanisms leading to beta-adrenergic receptor-specific desensitization is the phosphorylation of agonist-occupied receptors by the specific beta-adrenergic receptor kinase (GRK2). The present study examines whether GRK2 is altered during septic shock in rats. MATERIALS AND METHODS: Male Wistar rats (7 weeks) weighing between 250 and 300 g were anesthetized with pentobarbital (10 mg/kg ip). Escherichia coli endotoxin (10 mg/kg in 0.3 mL of saline) or saline (0.3 ml) was injected intravenously via the dorsal vein. Hemodynamic parameters and humoral mediators were measured at 2 h after the administration of endotoxin. The hearts were immediately excised to examine beta-adrenergic receptor density and GRK2 level. We also studied the inotropic response to isoproterenol at the same time in other animals. RESULTS: Myocardial beta-adrenergic receptor density in the membrane fraction was decreased after an intravenous administration of 10 mg/kg LPS (LPS group: baseline value; 82 +/- 11 fmol/mg protein; 120 min after LPS; 58 +/- 11 fmol/mg protein, P < 0.05). GRK2 levels in the membrane and cytosolic fraction of the control group did not change. In the LPS group, GRK2 levels in the membrane fraction were increased at 60 and 120 min after the treatment (60 min; control, 4.5 +/- 0.4; pithed control, 4.4 +/- 0.6; LPS group, 6.2 +/- 0.3; pithed LPS group, 5.5 +/- 0.4; 120 min: control, 4.4 +/- 0.3; pithed control, 4.9 +/- 0.7; LPS group, 7.1 +/- 0.3; pithed LPS group, 5.9 +/- 0.4; densitometric unit, respectively: P < 0.05). CONCLUSIONS: GRK2 levels in the membrane fraction are increased during septic shock in rats. GRK2 might play a role in the impairment of the beta-adrenergic receptor signal transduction system.

Adrenergic beta-Agonists↗
PubMed2002

Slow rewarming has no effects on the decrease in jugular venous oxygen hemoglobin saturation and long-term cognitive outcome in diabetic patients.

UNLABELLED: The purpose of this study was to examine the effects of rewarming rate on internal jugular venous oxygen hemoglobin saturation (SjvO(2)) during the rewarming period, and long-term cognitive outcome in diabetic patients. We studied 30 diabetic patients scheduled for elective coronary artery bypass graft surgery. As a control, 30 age-matched nondiabetic patients were identified. The diabetic patients were randomly divided into two groups: the Slow Rewarming group (n = 15) (mean rewarming speed: 0.22 degrees +/- 0.07 degrees C/min, mean +/- SD) or the Standard Rewarming group (Standard group) (n = 15) (mean rewarming speed: 0.46 degrees +/- 0.09 degrees C/min, mean +/- SD). After the induction of anesthesia, a fiberoptic oximetry catheter was inserted into the right jugular bulb to monitor SjvO(2) continuously. Hemodynamic variables and arterial and jugular venous blood gases were measured at nine time points. All patients underwent a battery of neurologic and neuropsychologic tests on the day before the operation and at 4 mo after surgery. The SjvO(2) values in the Standard group were decreased during the rewarming period compared with at the induction of anesthesia (P < 0.05). There was a significant difference in the SjvO(2) value in the Control group between standard rewarming and slow rewarming during rewarming periods (Standard Control group: 51% +/- 8%, Slow Control groups: 58% +/- 5%) (P < 0.05). However, there was no difference in the SjvO(2) value in diabetic patients between standard rewarming and slow rewarming during the rewarming period. The rewarming rates (odds ratio: 0.8; 95% confidence interval: 0.5-1.3; P = 0.6) had no correlation with cognitive impairment at 4 mo after the surgery. Diabetes (odds ratio: 1.6; 95% confidence interval: 0.9-2.6; P = 0.04) was a factor in relation to cognitive impairment at 4 mo after the surgery. We concluded that a slow rewarming rate had no effects on the reduction in SjvO(2) value and long-term cognitive outcome in diabetic patients. IMPLICATIONS: We examined the effects of rewarming rate on internal jugular venous oxygen hemoglobin saturation in diabetic and nondiabetic patients during the rewarming period and long-term cognitive outcome. Slow rewarming could not prevent the frequency of the reduction in internal jugular venous oxygen hemoglobin saturation and adverse cognitive outcome in diabetic patients.

Aged↗
PubMed2002

Increasing mean arterial blood pressure has no effect on jugular venous oxygen saturation in insulin-dependent patients during tepid cardiopulmonary bypass.

UNLABELLED: Preexisting diabetes mellitus is one of the major factors related to adverse postoperative neurological disorders after cardiac surgery. In previous reports, we found that diabetic patients more often experienced cerebral desaturation than nondiabetic patients during normothermic cardiopulmonary bypass (CPB). The purpose of this study was to examine the effects of increasing mean arterial blood pressure (MAP) by the administration of phenylephrine on internal jugular venous oxygen hemoglobin saturation (SjvO2) during tepid CPB in diabetic patients. We studied 20 diabetic patients scheduled for elective coronary artery bypass graft surgery and, as a control, 20 age-matched nondiabetic patients. After the induction of anesthesia, a fiberoptic oximetry catheter was inserted into the right jugular bulb to monitor SjvO2. After measuring the baseline partial pressure of the arterial and jugular venous blood gases and cardiovascular hemodynamic values, MAP was increased by the repeated administration of a 10-microg bolus of phenylephrine until it reached 100% of baseline values. There was a significant difference in SjvO2 value between the Diabetic and CONTROL GROUPs after the administration of phenylephrine (Diabetic group, 56% +/- 6%; CONTROL GROUP: 60% +/- 4%) (P < 0.05). There was a significant difference in the arterial-jugular oxygen content difference value between the Diabetic and CONTROL GROUPs after the administration of phenylephrine (diabetic group, 4.9% +/- 0.6%; CONTROL GROUP, 4.5% +/- 0.4%) (P < 0.05). We subdivided the Diabetic group into three groups (Diet Therapy group [n = 4], Glibenclamide group [n = 10], and Insulin-Dependent group [n = 6]). There was a significant difference in the mean slopes of SjvO2 versus cerebral perfusion pressure for increasing cerebral perfusion pressure between the Insulin-Dependent group and the other groups (Dunnett test: P = 0.04). Increasing MAP had no effects on the SjvO2 value in insulin-dependent patients during tepid CPB. IMPLICATIONS: We examined the effects of increasing mean arterial blood pressure (MAP) by the administration of phenylephrine on internal jugular venous oxygen saturation (SjvO2) during tepid cardiopulmonary bypass in diabetic patients and found that increasing MAP had no effect on the SjvO2 value in insulin-dependent patients.

Adrenergic alpha-Agonists↗
PubMed2002

Impairment of hepatosplanchnic oxygenation and increase of serum hyaluronate during normothermic and mild hypothermic cardiopulmonary bypass.

UNLABELLED: Hepatic sinusoidal endothelial cells (SECs) are more vulnerable to hypoxia or hypothermia than hepatocytes. To test the hypothesis that hepatic venous desaturation during cardiopulmonary bypass (CPB) leads to impairment of SEC function, we studied the plasma kinetics of endogenous hyaluronate (HA), a sensitive indicator of SEC function, and hepatosplanchnic oxygenation during and after CPB. Twenty-five consecutive patients scheduled for elective coronary artery bypass graft surgery, who underwent normothermic (>35 degrees C; n = 15) or mild hypothermic (32 degrees C; n = 10) CPB participated in this study. A hepatic venous catheter was inserted into each patient to monitor hepatosplanchnic oxygenation and serum levels of HA concentration. Hepatic venous oxygen saturation decreased essentially to a similar degree during normothermic and mild hypothermic CPB. Hepatosplanchnic oxygen consumption and extraction increased during normothermic (P < 0.05), but not mild hypothermic, CPB. Both arterial and hepatic venous HA concentrations showed threefold increases during and after CPB in both groups. A positive correlation was found between hepatosplanchnic oxygen consumption and arterial HA concentrations during CPB, suggesting a role of changes in hepatosplanchnic oxygen metabolism in the mechanisms of increases in serum HA concentrations. The failure of the liver to increase HA extraction to a great degree suggests that a functional impairment of the SEC may contribute to the observed increase of serum HA. IMPLICATIONS: Hepatic sinusoidal endothelial cells (SECs) are pivotal in the regulation of sinusoidal blood flow. This study showed that SEC function might be impaired during and after cardiopulmonary bypass, irrespective of the temperature management.

Aged↗
PubMed2002

[The effects of prostaglandin E1 on systemic and cerebral oxygenation before and during cardiopulmonary bypass].

The purpose of this study was to examine the effects of a small dose of prostaglandin E1 on systemic and cerebral oxygenation. Thirty patients for coronary artery bypass graft surgery were randomly divided into two groups: Group 1 received PGE1 25 ng.kg-1.min-1. Group 2 received PGE1 50 ng.kg-1.min-1. After measuring baseline hemodynamics and mixed (SvO2) and juglar (SjvO2) venous oxygen saturations, administration of PGE1 at a rate of 25 ng.kg-1.min-1 or 50 ng.kg-1.min-1 was started before and during CPB. In group 2, mean arterial pressure (MAP) decreased during CPB, while in group 1, MAP was unchanged during CPB. There was no change in SjvO2 both in group 1 and group 2 before and during CPB. The administration of PGE1 at a rate of 25 ng.kg-1.min-1 during CPB was suitable for the maintenance of SvO2 and SjvO2.

Aged↗