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  • 1
    Online Resource
    Online Resource
    Differences in Hemodynamic Response to Passive Leg Raising Tests during the Day in Healthy Individuals: The Question of Normovolemia
    MDPI AG ; 2023
    In:  Life Vol. 13, No. 7 ( 2023-07-21), p. 1606-
    Details
    In: Life, MDPI AG, Vol. 13, No. 7 ( 2023-07-21), p. 1606-
    Abstract: Background: The passive leg-raising (PLR) test was developed to predict fluid responsiveness and reduce fluid overload. However, the hemodynamic response of healthy individuals to the PLR test and how it changes during the day, between the morning and evening, after individuals have consumed food and fluids, has not been profoundly explored. This study aimed to compare the systemic hemodynamic changes in healthy individuals between morning and evening PLR tests. Methods: In this study, the PLR test was performed twice a day. The first PLR test was performed between 08h00 and 09h00 in the morning, while the second PLR test was performed between 20h00 and 21h00 in the evening. Hemodynamic parameters were measured using an impedance cardiography monitor, and a cutoff value of a 10% increase in stroke volume (SV) during the PLR test was used to differentiate between preload responders and non-responders. Results: We included 50 healthy volunteers in this study. When comparing the morning and evening PLR test results, we found no PLR-induced differences in heart rate (−3 [−8–2] vs. −2 [−8–4] beats/min, p = 0.870), SV (11 [5–22] vs. 12 [4–20] mL, p = 0.853) or cardiac output (0.7 [0.2–1.3] vs. 0.8 [0.1–1.4] L/min, p = 0.639). We also observed no differences in the proportion of preload responders during the PLR test between the morning and evening (64% vs. 66%, p = 0.99). However, there was a moderate agreement between the two PLR tests (morning and evening) (kappa = 0.429, p = 0.012). There was a moderate correlation between the changes in SV between the two PLR tests (rs = 0.50, p 〈 0.001). Conclusion: In young, healthy individuals, we observed no change in the systemic hemodynamic responsiveness to the PLR test between the morning and evening, without restriction of fluid and food intake.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life13071606
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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  • 2
    Online Resource
    Online Resource
    Links between Endothelial Glycocalyx Changes and Microcirculatory Parameters in Septic Patients
    MDPI AG ; 2021
    In:  Life Vol. 11, No. 8 ( 2021-08-05), p. 790-
    Details
    In: Life, MDPI AG, Vol. 11, No. 8 ( 2021-08-05), p. 790-
    Abstract: The glycocalyx is an endothelial surface layer that is essential for maintaining microvascular homeostasis. Impaired integrity of the endothelial glycocalyx may be directly related to the development of microvascular dysfunction. To explore this hypothesis, we conducted a prospective observational study on adult patients diagnosed with sepsis. The study aimed to evaluate the degree of damage to the glycocalyx and to identify correlations between microcirculatory parameters and glycocalyx thickness based on capillary diameter. Sublingual microcirculation was examined using a handheld Cytocam-incident dark field video microscope. A sidestream dark field video microscope attached to a GlycoCheck monitor was used to determine the perfused boundary regions (PBRs) of sublingual blood vessels grouped by diameter (5–9 μm, 10–19 μm, and 20–25 μm). We identified significant damage to the glycocalyx in sublingual blood vessels of all the aforementioned diameters in septic patients compared to healthy age-matched controls. Furthermore, we found that the PBRs of the smallest capillaries (diameter class 5–9µm) correlated moderately and inversely with both total and perfused blood vessel densities. Collectively, our data suggest that there may be a functional relationship between damage to the endothelial glycocalyx of the smallest capillaries and alterations in the microcirculation observed in response to sepsis.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life11080790
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662250-6
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  • 3
    Online Resource
    Online Resource
    Alterations of retinal vessels in patients with sepsis
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Clinical Monitoring and Computing Vol. 34, No. 5 ( 2020-10), p. 937-942
    Details
    In: Journal of Clinical Monitoring and Computing, Springer Science and Business Media LLC, Vol. 34, No. 5 ( 2020-10), p. 937-942
    Type of Medium: Online Resource
    ISSN: 1387-1307 , 1573-2614
    URL: Article
    DOI: 10.1007/s10877-019-00401-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2010139-9
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  • 4
    Online Resource
    Online Resource
    Ethnopharmaceutical knowledge in Samogitia region of Lithuania: where old traditions overlap with modern medicine
    Springer Science and Business Media LLC ; 2018
    In:  Journal of Ethnobiology and Ethnomedicine Vol. 14, No. 1 ( 2018-12)
    Details
    In: Journal of Ethnobiology and Ethnomedicine, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2018-12)
    Type of Medium: Online Resource
    ISSN: 1746-4269
    URL: Article
    DOI: 10.1186/s13002-018-0268-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2202544-3
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Ethnomedicinal Uses of Honeybee Products in Lithuania: The First Analysis of Archival Sources
    Hindawi Limited ; 2016
    In:  Evidence-Based Complementary and Alternative Medicine Vol. 2016 ( 2016), p. 1-7
    Details
    In: Evidence-Based Complementary and Alternative Medicine, Hindawi Limited, Vol. 2016 ( 2016), p. 1-7
    Abstract: Lithuania has old ethnomedicine traditions, consisting of many recipes with herbal, animal, and mineral original ingredients. All these findings were mostly collected in Lithuanian language, often in local community’s dialects, and stored only in archives. We analyzed archival sources about honeybee and its products used for medicinal purposes dated from 1886 till 1992 in different parts of Lithuania. We systematized and presented the most important information about bees and their products: indication for usage, ingredients used in the recipe, their preparation techniques, and application for therapeutic purposes. Researchers in Lithuania are now looking for new evidence based indications and preparation and standardization methods of bee products. Archival sources are a foundation for studies in Lithuania. The results can be integrated into scientifically approved folk medicine practices into today’s healthcare.
    Type of Medium: Online Resource
    ISSN: 1741-427X , 1741-4288
    URL: Article
    DOI: 10.1155/2016/9272635
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2016
    detail.hit.zdb_id: 2148302-4
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  • 6
    Online Resource
    Online Resource
    Conjunctival microcirculatory blood flow is altered but not abolished in brain dead patients: a prospective observational study
    Springer Science and Business Media LLC ; 2016
    In:  BMC Neurology Vol. 16, No. 1 ( 2016-12)
    Details
    In: BMC Neurology, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2016-12)
    Type of Medium: Online Resource
    ISSN: 1471-2377
    URL: Article
    DOI: 10.1186/s12883-016-0618-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2041347-6
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  • 7
    Online Resource
    Online Resource
    International Study on Microcirculatory Shock Occurrence in Acutely Ill Patients*
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Critical Care Medicine Vol. 43, No. 1 ( 2015-01), p. 48-56
    Details
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 1 ( 2015-01), p. 48-56
    Type of Medium: Online Resource
    ISSN: 0090-3493
    URL: Article
    DOI: 10.1097/CCM.0000000000000553
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2034247-0
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  • 8
    Online Resource
    Online Resource
    Time Evolution of Sublingual Microcirculatory Changes in Recreational Marathon Runners
    Hindawi Limited ; 2017
    In:  BioMed Research International Vol. 2017 ( 2017), p. 1-7
    Details
    In: BioMed Research International, Hindawi Limited, Vol. 2017 ( 2017), p. 1-7
    Abstract: We aimed to evaluate changes in sublingual microcirculation induced by a marathon race. Thirteen healthy male controls and 13 male marathon runners volunteered for the study. We performed sublingual microcirculation, using a Cytocam-IDF device (Braedius Medical, Huizen, Netherlands), and systemic hemodynamic measurements four times: 24 hours prior to their participation in the Kaunas Marathon (distance: 41.2 km), directly after finishing the marathon, 24 hours after the marathon, and one week after the marathon. The marathon runners exhibited a higher functional capillary density (FCD) and total vascular density of small vessels at the first visit compared with the controls. Overall, we did not find any changes in sublingual microcirculation of the marathon runners at any of the other visits. However, in a subgroup of marathon runners with a decreased FCD compared to the subgroup with increased FCD, the subgroup with decreased FCD had shorter running time ( 190.37 ± 30.2 versus 221.80 ± 23.4  min, p = 0.045 ), ingested less fluids ( 907 ± 615 versus 1950 ± 488  mL, p = 0.007 ) during the race, and lost much more weight ( - 2.4 ± 1.3 versus - 1.0 ± 0.8  kg, p = 0.041 ). Recreational marathon running is not associated with an alteration of sublingual microcirculation. However, faster running and dehydration may be crucial for further impairing microcirculation.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    URL: Article
    DOI: 10.1155/2017/7120785
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2017
    detail.hit.zdb_id: 2698540-8
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  • 9
    Online Resource
    Online Resource
    Ocular microvascular changes in patients with sepsis: a prospective observational study
    Springer Science and Business Media LLC ; 2020
    In:  Annals of Intensive Care Vol. 10, No. 1 ( 2020-12)
    Details
    In: Annals of Intensive Care, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-12)
    Abstract: The aim of the study was to detect differences in the conjunctival microcirculation between septic patients and healthy subjects and to evaluate the course of conjunctival and retinal microvasculature in survivors and non-survivors over a 24-h period of time. Methods This single-center prospective observational study was performed in mixed ICU in a tertiary teaching hospital. We included patients with sepsis or septic shock within the first 24 h after ICU admission. Conjunctival imaging, using an IDF video microscope, and retinal imaging, using portable digital fundus camera, as well as systemic hemodynamic measurements, were performed at three time points: at baseline, 6 h and 24 h. Baseline conjunctival microcirculatory parameters were compared with healthy controls. Results A total of 48 patients were included in the final assessment and analysis. Median APACHE II and SOFA scores were 16[12–21] and 10[7–12] , respectively. Forty-four (92%) patients were in septic shock, 48 (100%) required mechanical ventilation. 19 (40%) patients were discharged alive from the intensive care unit. We found significant reductions in all microcirculatory parameters in the conjunctiva when comparing septic and healthy subjects. In addition, we observed a significant lower microvascular flow index (MFI) of small conjunctival vessels during all three time points in non-survivors compared with survivors. However, retinal arteriolar vessels were not different between survivors and non-survivors. Conclusions Conjunctival microvascular blood flow was altered in septic patients. In the 24-h observation period conjunctival small vessels had a significantly higher MFI, but no difference in retinal arteriolar diameter in survivors in comparison with non-survivors. Trial registration NCT04214743, https://www.clinicaltrials.gov . Date of registration: 31 December 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04214743
    Type of Medium: Online Resource
    ISSN: 2110-5820
    URL: Article
    DOI: 10.1186/s13613-020-00655-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2617094-2
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  • 10
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    Online Resource
    Effects of remote ischemic conditioning on microcirculatory alterations in patients with sepsis: a single-arm clinical trial
    Springer Science and Business Media LLC ; 2021
    In:  Annals of Intensive Care Vol. 11, No. 1 ( 2021-12)
    Details
    In: Annals of Intensive Care, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-12)
    Abstract: Remote ischemic conditioning (RIC) is a promising technique that may protect organs and tissues from the effects of additional ischemic episodes. However, the therapeutic efficacy of RIC in humans with sepsis remains unknown. We hypothesized that RIC might improve sublingual microcirculation in patients with sepsis. Methods This prospective single-arm trial was performed in a mixed ICU at a tertiary teaching hospital. We included patients with sepsis or septic shock within 24 h of ICU admission. The RIC procedure comprised 3 cycles of brachial cuff inflation to 200 mmHg for 5 min followed by deflation to 0 mmHg for another 5 min. The procedure took 30 min. RIC was performed at the time of study inclusion and repeated after 12 and 24 h. Sublingual microcirculatory measurements were obtained before and after each RIC procedure using a Cytocam ® -incident dark-field (IDF) device (Braedius Medical, Huizen, The Netherlands). The microcirculatory data were compared with a historical control. Data are reported as the medians along with the 25th and 75th percentiles. Results Twenty-six septic patients with a median age of 65 (57–81) years were enrolled in this study. The median Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at admission were 20 (13–23) and 10 (9–12), respectively. All patients were receiving vasopressors. After the 1st RIC procedure, the microvascular flow index (MFI) and the proportion of perfused vessels (PPV) among small vessels were significantly higher than before the procedure, with pre- and post-treatment values of 2.17 (1.81–2.69) and 2.59 (2.21–2.83), respectively, for MFI ( p  = 0.003) and 87.9 (82.4–93.8) and 92.5 (87.9–96.1) %, respectively, for PPV ( p  = 0.026). This result was confirmed by comparison with a historical control group. We found no change in microcirculatory flow or density parameters during repeated RIC after 12 h and 24 h. Conclusion In patients with sepsis, the first remote ischemic conditioning procedure improved microcirculatory flow, whereas later procedures did not affect sublingual microcirculation. Trial registration NCT04644926, http://www.clinicaltrials.gov . Date of registration: 25 November 2020. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04644926 .
    Type of Medium: Online Resource
    ISSN: 2110-5820
    URL: Article
    DOI: 10.1186/s13613-021-00848-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2617094-2
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