A5021574284- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiovascular Health and Disease Prevention
- Cardiac, Anesthesia and Surgical Outcomes
- Cerebrovascular and Carotid Artery Diseases
- Hemodynamic Monitoring and Therapy
- Optical Imaging and Spectroscopy Techniques
- Acute Ischemic Stroke Management
- Blood Pressure and Hypertension Studies
- Heart Rate Variability and Autonomic Control
- Neurosurgical Procedures and Complications
- Anesthesia and Neurotoxicity Research
- Intracranial Aneurysms: Treatment and Complications
- Cerebrospinal fluid and hydrocephalus
- Respiratory Support and Mechanisms
- Cardiovascular Syncope and Autonomic Disorders
- Airway Management and Intubation Techniques
- Venous Thromboembolism Diagnosis and Management
- Thyroid Disorders and Treatments
- Tracheal and airway disorders
- Anesthesia and Pain Management
- Anesthesia and Sedative Agents
- Cardiovascular Function and Risk Factors
- Traumatic Brain Injury Research
- Intensive Care Unit Cognitive Disorders
- Spaceflight effects on biology
University of Amsterdam
2011-2025
Amsterdam University Medical Centers
2018-2025
Barro Colorado Island
2022
Amsterdam UMC Location University of Amsterdam
2008-2021
University Medical Center Groningen
2020
Radboud University Nijmegen
2020
Radboud University Medical Center
2020
Maastricht University
2020
Erasmus MC
2020
University of Michigan
2020
If invasive measurement of arterial blood pressure is not warranted, finger cuff technology can provide continuous and noninvasive monitoring. Finger radial artery pressures differ; Nexfin® (BMEYE, Amsterdam, The Netherlands) measures uses physiologic reconstruction methodologies to obtain values comparable pressures.Intra-arterial (IAP) Nexfin (NAP) were measured in cardiothoracic surgery patients, because are available. NAP-IAP differences analyzed during 30 min. Tracking was quantified by...
Background— In patients with a malignant hypertension, immediate parenteral treatment blood pressure–lowering agents such as intravenous sodium nitroprusside (SNP) is indicated. this study, we evaluated static and dynamic cerebral autoregulation (CA) during acute pressure lowering SNP in these patients. Methods Results— 8 mean arterial (MAP) >140 mm Hg grade III or IV hypertensive retinopathy at hospital admission, middle artery velocity (MCA V) were monitored. Dynamic CA was expressed...
We addressed whether dynamic cerebral autoregulation (dCA) is affected in middle artery (MCA) territory (MCAS) and lacunar ischemic stroke (LS).Blood pressure (MAP) MCA velocity (V) were measured 10 patients with large MCAS (National Institutes of Health Stroke score, 17+/-2; mean+/-SEM), LS (score, 9+/-1), reference subjects. dCA was evaluated time (delay the Vmean counter-regulation during changes MAP) frequency domains (cross-spectral Vmean-to-MAP phase lead).In subjects, latencies for...
Background Up to two-thirds of patients are either dependent or dead 3 months after thrombectomy for acute ischemic stroke (AIS). Loss cerebral autoregulation may render with AIS vulnerable decreases in mean arterial pressure (MAP). Objective To determine whether a fall MAP during intervention under general anesthesia (GA) affects functional outcome. Methods This subgroup analysis included from the MR CLEAN trial treated GA. The investigated variables were difference between at baseline and...
Type 2 diabetes is associated with an increased risk of endothelial dysfunction and microvascular complications impaired autoregulation tissue perfusion. Both disease cardiovascular autonomic neuropathy may affect cerebral autoregulation. In the present study, we tested hypothesis that, in absence neuropathy, subjects DM+ (Type complications) but intact DM- without complications). Dynamic steady-state cerebrovascular response to postural change were studied DM-, CTRL (healthy control)...
This study assessed the value of cerebral near-infrared spectroscopy (NIRS) and transcranial Doppler (TCD) in relation to electroencephalography (EEG) changes for detection hypoperfusion necessitating shunt placement during carotid endarterectomy (CEA).This was a prospective cohort study. Patients with sufficient TCD window undergoing CEA from February 2009 June 2011 were included. All patients continuously monitored NIRS EEG. An intraluminal placed, selectively determined by predefined EEG...
<b><i>Background:</i></b> Cerebral hyperperfusion syndrome (CHS) after carotid endarterectomy (CEA) is a potential life-threatening complication. Therefore, early identification and treatment of patients at risk essential. CHS can be predicted by doubling postoperative transcranial Doppler (TCD)-derived mean middle cerebral artery blood velocity (<i>V</i><sub>mean</sub>) compared to preoperative values. However, in approximately 15% CEA...
Intraoperative and postoperative hypotension are associated with morbidity mortality. The Hypotension Prediction (HYPE) trial showed that the Index (HPI) reduced depth duration of intraoperative (IOH), without excess use intravenous fluid, vasopressor, and/or inotropic therapies. We hypothesised HPI-guided haemodynamic care would reduce severity in PACU.This was a sub-study HYPE study, which 60 adults undergoing elective noncardiac surgery were allocated randomly to or standard care. Blood...
Patients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive radial artery (BPrad) in setting.In 25 consecutive patients (median age 71 yr) scheduled for and receiving general anaesthesia, BPfin BPrad were monitored simultaneously ipsilaterally during the 30-min period surrounding cross-clamping. Validation was...
To maintain adequate perfusion, cerebral blood flow (CBF) is preserved by changes in cerebrovascular resistance (CVR) inversely related to fluctuations mean arterial pressure (MAP). It has been hypothesised that during progressive hypotension, a lower limit of autoregulation (LLCA) reached beyond which dilation becomes exhausted and CBF starts decrease together with BP. We tested this hypothesis assessing CVR above below the LLCA. Radial pressure, thermodilution cardiac output (CO), middle...
In man assuming the upright position, end-tidal P(CO(2)) (P(ETCO(2))) decreases. With rising interest in cerebral autoregulation during posture change, which is known to be affected by P(ETCO(2)), we sought determine factors leading hypocapnia standing up from supine position. To study contribution of an increase tidal volume (V(T)) and breathing frequency, a decrease stroke (SV), ventilation-perfusion (V/Q) gradient functional residual capacity (FRC) developed mathematical model lung follow...
Vasovagal syncope is the most common cause of transient loss consciousness, and recurrent vasovagal fainting has a profound impact on quality life. Physical countermaneuvers are applied as means tertiary prevention but have so far only proven useful at onset faint. This placebo-controlled crossover study tested hypothesis that leg crossing increases orthostatic tolerance. Nine naïve healthy subjects [6 females, median age 25 yr (range 20-41 yr), mean body mass index 23 (SD 2)] were subjected...
In patients with malignant hypertension, immediate blood pressure reduction is indicated to prevent further organ damage. Because cerebral autoregulatory capacity impaired in these patients, a pharmacologically induced decline of reduces flow the danger hypoperfusion. We compared transcranial Doppler–determined middle artery velocity during lowering sodium nitroprusside that labetalol. Therefore, 15 fulfilling World Health Organization criteria for beat-to-beat mean arterial pressure,...
In the upright position, cerebral blood flow is reduced, maybe because arterial carbon dioxide partial pressure (Pa(CO(2))) decreases. We evaluated time-dependent influence of a reduction in Pa(CO(2)), as indicated by end-tidal Pco(2) tension (Pet(CO(2))), on perfusion during head-up tilt. Mean pressure, cardiac output, middle artery mean velocity (MCA V(mean)), and dynamic autoregulation at supine rest 70 degrees tilt were determined free breathing with Pet(CO(2)) clamped to level. The...
Low central venous pressure (low-CVP) is the clinical standard for fluid therapy during major liver surgery. Although goal-directed (GDFT) has been associated with reduced morbidity and mortality in abdominal surgery, concerns remain on blood loss when applying GDFT This randomized trial compared outcomes of low-CVP resections.In this surgeon- patient-blinded RCT, patients undergoing open resections (≥3 segments) were between (n = 20) or 20). Primary outcome was intraoperative loss....
ABSTRACT Acute short‐term changes in blood pressure (BP) and cardiac output (CO) affect cerebral flow (CBF) healthy subjects. As yet, however, we do not know how spontaneous fluctuations BP CO influence circulation throughout 24 h. We performed simultaneous monitoring of BP, systemic haemodynamic parameters velocity the middle artery (MCAV) seven subjects during a 24‐h period. Finger was recorded continuously h by Portapres bilateral MCAV measured transcranial Doppler (TCD) first 15 min...
Reduction in plasma volume is a major contributor to orthostatic tachycardia and hypotension after spaceflight. We set out determine time- frequency-domain baroreflex (BRS) function during preflight baseline venous occlusion postflight stress, testing the hypothesis that reduction central blood could mimic response. In five cosmonauts, we measured finger arterial pressure noninvasively supine upright positions. Preflight measurements were repeated using thigh cuffs impede return “trap” an...