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Abstrak :
The aim of this book is to enable the reader to comprehend the relation between cardiovascular pathophysiology and vascular hemodynamics and to become familiar with the more recent guidelines. While very complex physical concepts are involved, care has been taken to ensure that the explanations are as straightforward as possible. Complex analyses are presented separately and can be skipped by the reader without impairment of understanding. It is envisaged that the knowledge imparted will prove invaluable in improving the approach to hypertensive patients.

Abstrak :
Questo libro intende presentare, in maniera immediata ed efficace, le complesse nozioni di base dell’emodinamica vascolare e della sua fisiopatologia, sottolineando l’importanza delle proprietà meccaniche delle grandi arterie nella genesi della pressione arteriosa. Con l’ausilio di numerose immagini e con linguaggio accessibile, il lettore è guidato alla scoperta degli elementi che determinano la pressione arteriosa, familiarizzando con i concetti di stiffness arteriosa, velocità dell’onda di polso, pressione centrale, onde riflesse e amplificazione della pressione.

Abstrak :
The book begins with a synopsis of the fundamentals aspects of fluid mechanics to give the reader the essential background to address the proceeding chapters. Then the fundamental elements of vortex dynamics will be discussed, explaining the conditions for their formation and the rules governing their dynamics. The main equations are accompanied by mathematical models. Cardiovascular vortex formation is first analyzed in physiological, healthy conditions in the heart chambers and in the large arterial vessels. The analysis is initially presented with an intuitive appeal grounded on the physical phenomena and a focus on its clinical significance.In the proceeding chapters, the knowledge gained from either clinical or basic science literature will be discussed. The corresponding mathematical elements will finally be presented to ensure the adequate diligence. The proceeding chapters ensue to the analysis of pathological conditions, when the reader may have developed the ability to recognize normal from abnormal vortex formation phenomenon. Pathological vortex formation represents vortices that develop at sites where normally laminar flow should exist, e.g. stenosis and aneurisms. This analysis naturally leads to the interaction of vortices due to the surgical procedures with respect to prediction of changes in vortex formation. The existing techniques, from medical imaging to numerical simulations, to explore vortex flows in the cardiovascular systems will also be described.

Abstrak :
Posisi tubuh semi fowler 30° lateral kanan yang dianggap upaya proteksi mandiri yang memiliki efek positif terhadap hemodinamik pada pasien gagal jantung, namun belum diketahui dampaknya terhadap curah jantung. Penelitian ini bertujuan untuk mengetahui pengaruh posisi semi fowler 30 lateral kanan terhadap curah jantung. Uji klinis crossover pada 20 subjek gagal jantung akut dengan teknik non randomisasi berdasarkan riwayat gagal jantung. Parameter hemodinamik diukur menggunakan alat LiDCO CNAP. Analisa dilakukan untuk menilai efek residual dan efektifitasnya menggunakan SPSS 26 & NCSS. Rentang usia subjek adalah 26-72 tahun. 75% tidak memiliki riwayat gagal jantung. 85% memiliki penurunan fraksi ejeksi ventrikel kiri <40%. Durasi washout 30 menit tidak menimbulkan efek residual dan tidak bermakna secara statistik (p>0.05). Perbedaan rerata stroke volume (p<0.05), variasi stroke volume 20.1±7.6 vs 43.3±19. Rerata curah jantung 4.88 sedangkan semi fowler 4.20, tidak signifikan secara statistik (p>0.05). Semi fowler 30 lateral kanan menurunkan variasi stroke volume dan meningkatkan rerata curah jantung. Dipertimbangkan sebagai strategi optimalisasi beban awal pada pasien gagal jantung preload dependent. ......The right lateral semi fowler 30° body position is considered a self-protective measure that has a positive effect on hemodynamics in heart failure patients, but the impact on cardiac output is not yet known. This study aimed to determine the effect of positioning the right lateral 30 semi fowler on cardiac output. A non randomized Crossover clinical trial on 20 acute heart failure subjects based on history of heart failure. Hemodynamic parameters were measured using the LiDCO CNAP. Statistical analysis was performed to assess the residual effect and assess its effectiveness using SPSS 26 & NCSS software. The age range of subjects is 26-72 years. 75% had no history of heart failure. 85% of subjects had a decrease in left ventricular ejection fraction <40%. The washout duration of 30 minutes caused no residual effect and was not statistically significant (p>0.05). The average stroke volume differs significantly, stroke volume variation in SF30RL was 20.1±7.6 vs 43.3±19 in SF group. The mean cardiac output SF30RL was 4.88 while the semi fowler was 4.20 but not statistically significant (p>0.05). The right lateral 30 semi fowler can increase cardiac output values. Considered as a volume optimization strategy in a preload dependentt patients.

Abstrak :
This book offers a mathematical update of the state of the art of the research in the field of mathematical and numerical models of the circulatory system. It is structured into different chapters, written by outstanding experts in the field. Many fundamental issues are considered, such as : the mathematical representation of vascular geometries extracted from medical images, modelling blood rheology and the complex multilayer structure of the vascular tissue, and its possible pathologies, the mechanical and chemical interaction between blood and vascular walls, and the different scales coupling local and systemic dynamics. All of these topics introduce challenging mathematical and numerical problems, demanding for advanced analysis and efficient simulation techniques, and pay constant attention to applications of relevant clinical interest.

Abstrak :
Pendahuluan: Laparoskopi memiliki risiko intraoperatif dan pascaoperasi, termasuk instabilitas hemodinamik dan nyeri pascaoperasi. Anestesi umum sering digunakan untuk operasi ini, namun teknik ini tidak menekan peningkatan resistensi vaskular sistemik selama laparoskopi sehingga fluktuasi hemodinamik tetap terjadi. Sayatan dinding abdomen dan regangan peritoneum selama operasi juga menyebabkan nyeri somatis dan viseral yang dirasakan pascaoperasi. Penambahan blok TAP pada operasi laparoskopi belum memuaskan disamping memerlukan instrumen tambahan serta bergantung pada kemampuan operator. Anestesi spinal dapat menguntungkan karena dapat menetralkan peningkatan SVR dan menghambat nyeri selama operasi, namun penggunaannya dikaitkan dengan mobilisasi yang tertunda. Penelitian ini bertujuan untuk mengetahui apakah kombinasi anestesi umum dan anestesi spinal lebih baik dalam menjaga perubahan hemodinamik intraoperatif, nyeri pascaoperasi, dan waktu pulih dibandingkan anestesi umum dan blok TAP. Metode: Penelitian ini merupakan uji klinis acak tersamar tunggal pada 40 pasien yang dibagi menjadi 2 kelompok. Kelompok S (spinal) dilakukan anestesi spinal menggunakan bupivacaine 10 mg + morfin 50 mcg intratekal disusul anestesi umum. Kelompok T (blok TAP) dilakukan anestesi anestesi umum disusul blok TAP dengan bupivacaine 0.25% 20 ml pada kedua sisi abdomen. Perubahan tekanan darah dan nadi, NRS pascaoperasi 3 jam dan 6 jam, waktu untuk mencapai Bromage 0, serta kejadian nyeri bahu dan mual muntah pascaoperasi dicatat. Hasil: Pada kelompok S terdapat perubahan tekanan darah sistolik yang signifikan dibandingkan dengan kelompok T setelah 15 menit insuflasi (-9,35(±19,69) vs 7,65(±16,34), p<0,05). Tidak ada perbedaan nyeri pascaoperasi dan waktu pulih pada kedua kelompok. Kesimpulan: Kombinasi anestesi umum dan anestesi spinal lebih baik dalam menurunkan tekanan darah sistolik, namun tidak berbeda dalam nyeri pascaoperasi, dan waktu pulih dibandingkan kombinasi anestesi umum dan blok TAP. ......Introduction: Laparoscopy is associated with intraoperative and postoperative risks, including hemodynamic instability and postoperative pain. Although general anesthesia is often used for this procedure, hemodynamic fluctuations still occur because this technique does not suppress the increase in systemic vascular resistance during laparoscopy. Incisions in the abdominal wall and stretching of the peritoneum during surgery can also cause somatic and visceral pain after surgery. Adding TAP block to laparoscopic surgery is not satisfactory, apart from requiring additional instruments and depending on the operator’s abilities. Spinal anesthesia may be beneficial as it can counteract the increase in SVR and suppress pain during surgery, but its use is associated with delayed mobilization. The purpose of this study is to determine whether the combination of general and spinal anesthesia is superior in maintaining intraoperative hemodynamic changes, postoperative pain, and recovery time compared to general anesthesia and TAP blockade. Methods: This study is a single-blind, randomized clinical trial with 41 patients divided into two groups. Group S (spinal) received spinal anesthesia with 10 mg bupivacaine + 50 μg morphine administered intrathecally, followed by general anesthesia. Group T (TAP block) received general anesthesia followed by TAP block with 20 ml of 0.25% bupivacaine on each side of the abdomen. Intraoperative blood pressure and heart rate changes, NRS at 3 and 6 hours postoperatively, time to reach bromage 0, and occurrence of postoperative shoulder pain and nausea and vomiting were recorded. Results: In group S there was a significant change in systolic blood pressure compared to group T after 15 minutes of insufflation (-9,35(±19,69) vs 7,65(±16,34), p<0,05). There was no difference in postoperative pain and recovery time in the two groups. Conclusion: The combination of general anesthesia and spinal anesthesia is better in reducing systolic blood pressure, but does not differ in postoperative pain and recovery time compared to the combination of general anesthesia and TAP block.