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Basic and Clinical Understanding of Microcirculation

Basic and Clinical Understanding of Microcirculation
Author: Kaneez Fatima Shad
Publisher: BoD – Books on Demand
Total Pages: 168
Release: 2020-07-22
Genre: Medical
ISBN: 1789855519

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Microcirculation is key to providing enough nutrition and oxygen from head to toe. This is possible only through an extensive network of blood vessels spread around the body. Effect of microcirculation abnormalities stretch beyond one’s comprehension. The effects could be felt at any age, from the foetal life to the adulthood. The chapters present in this book describe how these abnormalities could lead to diseases such as atherosclerosis, thrombosis, diabetes, hypertension. Disorders of microcirculation could be related to the structural and/or functional damage to the inner lining of the blood vessels. Early identification of these disorders could benefit many ailments including cardiovascular and cerebrovascular diseases such as heart attack and stroke.


The Cerebral Circulation

The Cerebral Circulation
Author: Marilyn J. Cipolla
Publisher: Biota Publishing
Total Pages: 82
Release: 2016-07-28
Genre: Medical
ISBN: 1615047239

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This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.


Inflammation and the Microcirculation

Inflammation and the Microcirculation
Author: D. Neil Granger
Publisher: Morgan & Claypool Publishers
Total Pages: 99
Release: 2010
Genre: Medical
ISBN: 1615041656

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The microcirculation is highly responsive to, and a vital participant in, the inflammatory response. All segments of the microvasculature (arterioles, capillaries, and venules) exhibit characteristic phenotypic changes during inflammation that appear to be directed toward enhancing the delivery of inflammatory cells to the injured/infected tissue, isolating the region from healthy tissue and the systemic circulation, and setting the stage for tissue repair and regeneration. The best characterized responses of the microcirculation to inflammation include impaired vasomotor function, reduced capillary perfusion, adhesion of leukocytes and platelets, activation of the coagulation cascade, and enhanced thrombosis, increased vascular permeability, and an increase in the rate of proliferation of blood and lymphatic vessels. A variety of cells that normally circulate in blood (leukocytes, platelets) or reside within the vessel wall (endothelial cells, pericytes) or in the perivascular space (mast cells, macrophages) are activated in response to inflammation. The activation products and chemical mediators released from these cells act through different well-characterized signaling pathways to induce the phenotypic changes in microvessel function that accompany inflammation. Drugs that target a specific microvascular response to inflammation, such as leukocyte-endothelial cell adhesion or angiogenesis, have shown promise in both the preclinical and clinical studies of inflammatory disease. Future research efforts in this area will likely identify new avenues for therapeutic intervention in inflammation. Table of Contents: Introduction / Historical Perspectives / Anatomical Considerations / Impaired Vasomotor Responses / Capillary Perfusion / Angiogenesis / Leukocyte-Endothelial Cell Adhesion / Platelet-Vessel Wall Interactions / Coagulation and Thrombosis / Endothelial Barrier Dysfunction / Epilogue / References


Regulation of Tissue Oxygenation, Second Edition

Regulation of Tissue Oxygenation, Second Edition
Author: Roland N. Pittman
Publisher: Biota Publishing
Total Pages: 117
Release: 2016-08-18
Genre: Medical
ISBN: 1615047212

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This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.


Microcirculation

Microcirculation
Author: Ronald F. Tuma
Publisher: Academic Press
Total Pages: 999
Release: 2011-04-28
Genre: Science
ISBN: 0080569935

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This reference is a volume in the Handbook of Physiology, co-published with The American Physiological Society. Growth in knowledge about the microcirculation has been explosive with the field becoming fragmented into numerous subdisciplines and subspecialties. This volume pulls all of the critical information into one volume. Meticulously edited and reviewed. Benefit: Provides investigators a unique tool to explore the significance of their findings in the context of other aspects of the microcirculation. In this way, the updated edition has a direct role in helping to develop new pathways of research and scholarship Highlights the explosive growth in knowledge about the microcirculation including the biology of nitric oxide synthase (NOS), endothelial cell signaling, angiogenesis, cell adhesion molecules, lymphocyte trafficking, ion channels and receptors, and propagated vasomotor responses. Benefit: Microcirculatory biology has become fragmented into numerous sub-disciplines and subspecialties, and these reference reintegrates the information in one volume


Coronary Microvascular Dysfunction

Coronary Microvascular Dysfunction
Author: Filippo Crea
Publisher: Springer Science & Business Media
Total Pages: 263
Release: 2013-08-15
Genre: Medical
ISBN: 8847053676

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In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.


Microcirculation

Microcirculation
Author: Maria Dorobantu
Publisher: Springer Nature
Total Pages: 298
Release: 2019-11-04
Genre: Medical
ISBN: 303028199X

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This comprehensive reference book of coronary microcirculation broadly covers theoretical aspects, clinical cases and therapeutic considerations from an innovative perspective. Topics covered include: ischemic heart disease, silent cerebral damage, heart failure, left ventricular hypertrophy arrhythmias, and cerebral and renal microcirculation. Microcirculation: From Bench to Bedside underlines the clinical importance of addressing coronary microcirculation with relevant clinical examples that are often encountered by practitioners. It therefore provides a critical resource on microcirculation for both specialist and non-specialist practitioners.


The Endothelium

The Endothelium
Author: Michel Félétou
Publisher: Morgan & Claypool Publishers
Total Pages: 309
Release: 2011
Genre: Science
ISBN: 1615041230

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The endothelium, a monolayer of endothelial cells, constitutes the inner cellular lining of the blood vessels (arteries, veins and capillaries) and the lymphatic system, and therefore is in direct contact with the blood/lymph and the circulating cells. The endothelium is a major player in the control of blood fluidity, platelet aggregation and vascular tone, a major actor in the regulation of immunology, inflammation and angiogenesis, and an important metabolizing and an endocrine organ. Endothelial cells controls vascular tone, and thereby blood flow, by synthesizing and releasing relaxing and contracting factors such as nitric oxide, metabolites of arachidonic acid via the cyclooxygenases, lipoxygenases and cytochrome P450 pathways, various peptides (endothelin, urotensin, CNP, adrenomedullin, etc.), adenosine, purines, reactive oxygen species and so on. Additionally, endothelial ectoenzymes are required steps in the generation of vasoactive hormones such as angiotensin II. An endothelial dysfunction linked to an imbalance in the synthesis and/or the release of these various endothelial factors may explain the initiation of cardiovascular pathologies (from hypertension to atherosclerosis) or their development and perpetuation. Table of Contents: Introduction / Multiple Functions of the Endothelial Cells / Calcium Signaling in Vascular Cells and Cell-to-Cell Communications / Endothelium-Dependent Regulation of Vascular Tone / Conclusion / References


Regulation of Coronary Blood Flow

Regulation of Coronary Blood Flow
Author: Michitoshi Inoue
Publisher: Springer Science & Business Media
Total Pages: 330
Release: 2013-11-09
Genre: Medical
ISBN: 4431683674

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Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.


Core Topics in Neuroanaesthesia and Neurointensive Care

Core Topics in Neuroanaesthesia and Neurointensive Care
Author: Basil F. Matta
Publisher: Cambridge University Press
Total Pages:
Release: 2011-10-13
Genre: Medical
ISBN: 1139499858

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Core Topics in Neuroanesthesia and Neurointensive Care is an authoritative and practical clinical text that offers clear diagnostic and management guidance for a wide range of neuroanesthesia and neurocritical care problems. With coverage of every aspect of the discipline by outstanding world experts, this should be the first book to which practitioners turn for easily accessible and definitive advice. Initial sections cover relevant anatomy, physiology and pharmacology, intraoperative and critical care monitoring and neuroimaging. These are followed by detailed sections covering all aspects of neuroanesthesia and neurointensive care in both adult and pediatric patients. The final chapter discusses ethical and legal issues. Each chapter delivers a state-of-the art review of clinical practice, including outcome data when available. Enhanced throughout with numerous clinical photographs and line drawings, this practical and accessible text is key reading for trainee and consultant anesthetists and critical care specialists.