Intraoperative blood pressure lability in patients requiring blood transfusions after bariatric surgery

2018 ◽  
Vol 14 (11) ◽  
pp. S113
Author(s):  
Lee Ying ◽  
Matthew Hubbard ◽  
Saber Ghiassi ◽  
Kurt Roberts ◽  
Andrew J Duffy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Blood Transfusions ◽  
Blood Pressure Lability

Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery

2019 ◽  
Vol 29 (6) ◽  
pp. 1990-1994
Author(s):  
Lee D. Ying ◽  
Andrew J. Duffy ◽  
Kurt E. Roberts ◽  
Saber Ghiassi ◽  
Matthew O. Hubbard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Postoperative Hemorrhage ◽  
Blood Pressure Lability

scholarly journals Improved blood pressure, nitric oxide and asymmetric dimethylarginine are independent after bariatric surgery

2012 ◽  
Vol 49 (6) ◽  
pp. 589-594 ◽  
Author(s):  
R Patle ◽  
S Dubb ◽  
J Alaghband-Zadeh ◽  
R A Sherwood ◽  
F Tam ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Asymmetric Dimethylarginine ◽  
Obese Patients ◽  
Endogenous Inhibitor ◽  
Nitrite Concentration ◽  
Plasma Adma ◽  
Adma Concentration

Background Obesity is associated with hypertension, but the exact mechanism is not fully understood. Bariatric surgery significantly decreases weight and blood pressure (BP). Low plasma nitric oxide (NO) and raised asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO, concentrations are associated with both obesity and hypertension. Correlations between the changes in these parameters were studied after bariatric surgery. Methods Weight, BP, plasma ADMA and NO were measured in 29 obese patients (24 female, 5 male) before and six weeks after bariatric surgery. Results Patients were 39.2 ± 1.2 (mean ± SEM) years old and weighed 126 ± 3 kg. Six weeks after the surgery, patients had lost 10 ± 0.7 kg ( P < 0.0001) and mean arterial pressure (MAP) decreased by 11 ± 1.0 mmHg ( P < 0.0001). The plasma ADMA concentration decreased by 24 ± 2% from 5 ± 0.4 to 4.0 ± 0.3 μmol/L ( P < 0.0001). The plasma total nitrite concentration increased by 15 ± 1% from 51.4 ± 2.6 to 60 ± 3 μmol/L ( P < 0.0001). The correlation between the decrease of ADMA and increase of NO subsequent to weight loss was significant ( P < 0.0001). However, MAP was not correlated to the changes in ADMA or NO. Conclusions After bariatric surgery, beneficial changes in BP, NO and ADMA occur, but our findings suggest that these BP changes are independent of changes in the NO–ADMA axis. Other causes for the changes in BP should therefore be considered.

Invasive and Concomitant Noninvasive Intraoperative Blood Pressure Monitoring

2011 ◽  
Vol 115 (5) ◽  
pp. 973-978 ◽  
Author(s):  
David B. Wax ◽  
Hung-Mo Lin ◽  
Andrew B. Leibowitz
Keyword(s):  
Blood Pressure ◽  
Odds Ratio ◽  
Blood Pressure Monitoring ◽  
Antihypertensive Agents ◽  
Blood Transfusions ◽  
Blood Products ◽  
Pressure Monitoring ◽  
Antihypertensive Medications ◽  
Hypertensive Patients ◽  
Simultaneous Measurements

Background Noninvasive (NIBP) and intraarterial (ABP) blood pressure monitoring are used under different circumstances and may yield different values. The authors endeavored to characterize these differences and hypothesized that there could be differences in interventions associated with the use of ABP alone ([ABP]) versus ABP in combination with NIBP ([ABP+NIBP]). Methods Simultaneous measurements of ABP and NIBP made during noncardiac cases were extracted from electronic anesthesia records; the differences were subjected to regression analysis. Records of blood products, vasopressors, and antihypertensives administered were also extracted, and associations between the use of these therapies and monitoring strategy ([ABP] vs. [ABP+NIBP]) were tested using univariate, multivariate, and propensity score matched analyses. Results Among 24,225 cases, 63% and 37% used [ABP+NIBP] and [ABP], respectively. Systolic NIBP was likely to be higher than ABP when ABP was less than 111 mmHg and lower than ABP otherwise. Among patients with hypotension, transfusion occurred in 27% versus 43% of patients in the [ABP+NIBP] versus [ABP] group, respectively (odds ratio = 0.4; 95% CI 0.35-0.46), and 7% versus 18% of patients in the [ABP+NIBP] versus [ABP] group received vasopressor infusions, respectively (P &lt; 0.01). Among hypertensive patients, 12% versus 44% of those in the [ABP+NIBP] versus [ABP] group received antihypertensive agents, respectively (P &lt; 0.01). Conclusions NIBP was generally higher than ABP during periods of hypotension and lower than ABP during periods of hypertension. The use of NIBP measurements to supplement ABP measurements was associated with decreased use of blood transfusions, vasopressor infusions, and antihypertensive medications compared with the use of ABP alone.

Omentin-1 Changes following Biliopancreatic Diversion and Relationship with Cardiovascular Risk Factors

2018 ◽  
Vol 73 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Daniel Antonio de Luis ◽  
Susana García Calvo ◽  
Juan Jose Lopez Gomez ◽  
Olatz Izaola ◽  
David Primo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Biliopancreatic Diversion ◽  
Fat Mass ◽  
Fasting Blood Glucose ◽  
Fasting Insulin ◽  
Post Surgery ◽  
Biliopancreatic Diversion Surgery

Introduction: Omentin-1 might play a role in the pathogenesis of insulin resistance and obesity. The aim of the present study was to evaluate the influence of weight loss after biliopancreatic diversion on serum omentin-1 concentrations. Material and Methods A Caucasian population of 24 morbid obese patients was analyzed before and after 12 months of a biliopancreatic diversion surgery. Biochemical and anthropometric evaluation were realized at basal visit and at 12 months. Body weight, fat mass, waist circumferences, blood pressure, fasting blood glucose, fasting insulin, insulin resistance (HOMA-IR), lipid concentrations and omentin-1 were measured. Results: After bariatric surgery and in both gender groups (males vs. females); BMI, weight, fat mass, waist circumference, blood pressure, glucose , total cholesterol, LDL cholesterol, triglycerides, HOMA-IR and fasting insulin decreased in a statistical manner from basal values. Omentin-1 levels increased after bariatric surgery and in both gender the improvement was similar (males vs. females); (delta: –87.1 ± 19.0 ng/dL; p = 0.02 vs. –93.8 ± 28.1 ng/dL; p = 0.03). In the multiple regression analysis adjusted by age and sex; BMI kg/m2 (Beta –0.32: 95% CI –3.98 to –0.12) and insulin UI/L (Beta –0.41: 95% CI –8.38 to –0.16) remained in the model with basal omentin-1 levels as dependent variable. The regression model with post-surgery omentin-1 levels as dependent variable showed as independent variables BMI kg/m2 (Beta –0.13: 95% CI –7.69 to –0.09) and insulin UI/L (Beta –0.24: 95% CI –5.69 to –0.08), too. Conclusion: This study showed a significant increase in omentin-1 levels after weight loss secondary biliopancreatic diversion surgery. A weak negative correlation with BMI and basal insulin levels was detected.

Standardized Autonomic Testing in Patients With Probable Radiation-Induced Afferent Baroreflex Failure

Hypertension ◽  
2021 ◽  
Author(s):  
Guillaume Lamotte ◽  
Elizabeth A. Coon ◽  
Mariana D. Suarez ◽  
Paola Sandroni ◽  
Eduardo Benarroch ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Sweat Test ◽  
Plasma Norepinephrine ◽  
Pressure Monitoring ◽  
Autonomic Testing ◽  
Baroreflex Failure ◽  
Radiation Induced ◽  
Thermoregulatory Sweat Test ◽  
Blood Pressure Lability

Injury of the afferent limb of the baroreflex from neck radiation causes radiation-induced afferent baroreflex failure (R-ABF). Identification and management of R-ABF is challenging. We aimed to investigate the pattern of autonomic dysfunction on standardized autonomic testing in patients with probable R-ABF. We retrospectively analyzed all autonomic reflex screens performed at Mayo Clinic in Rochester, MN, between 2000 and 2020 in patients with probable R-ABF. Additional tests reviewed included ambulatory blood pressure monitoring, plasma norepinephrine, and thermoregulatory sweat test. We identified 90 patients with probable R-ABF. Median total composite autonomic severity score (range, 0–10) was 7 (interquartile range, 6–7). Cardiovascular adrenergic impairment was seen in 85 patients (94.4%), increased blood pressure recovery time after Valsalva maneuver in 71 patients (78.9%; median 17.4 seconds), and orthostatic hypotension in 68 patients (75.6%). Cardiovagal impairment was demonstrated by abnormal heart rate responses to deep breathing (79.5%), Valsalva ratio (87.2%), and vagal baroreflex sensitivity (57.9%). Plasma norepinephrine was elevated and rose appropriately upon standing (722–1207 pg/mL). Ambulatory blood pressure monitoring revealed hypertension, postural hypotension, hypertensive surges, tachycardia, and absence of nocturnal dipping. Blood pressure lability correlated with impaired vagal baroreflex function. Postganglionic sympathetic sudomotor function was normal in most cases; the most frequent thermoregulatory sweat test finding was focal neck anhidrosis (78.9%). Standardized autonomic testing in R-ABF demonstrates cardiovascular adrenergic impairment with orthostatic hypotension, blood pressure lability, and elevated plasma norepinephrine. Cardiovagal impairment is common, while sudomotor deficits are limited to direct radiation effects.

A187 Correlation between Reduction of Renal Sinus Fat and Improvement of Blood Pressure after Bariatric Surgery.

2019 ◽  
Vol 15 (10) ◽  
pp. S58-S60
Author(s):  
Carlos Rivera ◽  
Mauricio Sarmiento-Cobos ◽  
Lisandro Montorfano ◽  
Emanuele Lo Menzo ◽  
Samuel Szomstein ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Renal Sinus ◽  
Renal Sinus Fat

Blood pressure lability is associated with subcortical atrophy in early Parkinson's disease

2020 ◽  
Vol 38 (10) ◽  
pp. 2043-2049
Author(s):  
Sang-Won Yoo ◽  
Eunkyeong Yun ◽  
Mirim Bang ◽  
Uicheul Yoon ◽  
Ji-Yeon Yoo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Parkinson’S Disease ◽  
Blood Pressure Lability

Bariatric Surgery Controls Blood Pressure

JAMA ◽  
2018 ◽  
Vol 319 (4) ◽  
pp. 333
Author(s):  
Anita Slomski
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery
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