Compromised perfusion indicates the inability of the cardiovascular system to sustain the normal distribution of blood flow within the entire body and can be defined as a reduction of perfusion pressure leading to the exclusion of single capillaries or groups of capillaries. Occurring in patients subjected to shock, trauma, extensive surgery and organ transplantation, it reduces the surface area available for exchange of nutrients and metabolites with the consequence of tissue hypoxia and accumulation of waste products. To counteract compromised perfusion hypertonic/hyperoncotic saline/dextran solutions are used efficiently. This book presents an overview of the most recent findings from studies investigating compromised perfusion. The selected contributions discuss the mechanistic effects and side effects of small volume resuscitation, as well as specific effects of dextran in the field of organ conservation and post-ischemic leukocyte/endothelium interaction. Furthermore, specific aspects of the biology and pathophysiology of microvascular endothelium are considered. Providing a critical review of recent advances, this volume serves as an excellent source of information for all those interested in both clinical and experimental microcirculation research.

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

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.

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.

For the first time, this invaluable book shows how cardiac perfusion and pumping can be quantified and correlated. Self-contained and unified in presentation, the explanations in the compendium are detailed enough to capture the reader's curiosity and complete enough to provide the background material to explore further into the subject.Mathematically rigorous and clinically oriented, the book is a major resource for biomedical engineers, cardiologists, cardiac surgeons and clinicians. For students, it is an ideal textbook for senior-level courses in cardiovascular engineering.

Bone quality is one of the most important factors in the successful osseointegration of dental implants. However, the concepts of bone quality and compromised bone have never been well defined in the field of implant dentistry. To provide a clear definition of these terms, the contributors to this volume have compiled data from almost two decades of experimental and case studies, resulting in a comprehensive review of the current knowledge regarding the placement of implants in compromised bone. The book also presents specific considerations for placing implants in different types of compromised bone, such as aged, underdeveloped, and irradiated bone. A useful work of reference for implant students, practicing implant clinicians, and implant-oriented researchers.

This textbook provides an up-to-date summary of the scientific basis, assessment for and provision of anaesthesia throughout pregnancy and labour. It is divided into nine sections including physiology, assessment, complications and systemic disease.