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Invasive Arterial Blood Pressure Monitoring

Clara Gregori-Pla, Gianluca Cotta, Igor Blanco, Peyman Zirak, Martina Giovannella, Anna Mola, Ana Fortuna, Turgut Durduran, Mercedes Mayos
MOTIVATION: Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA...
2018: PloS One
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
G Frigieri, R A P Andrade, C Dias, D L Spavieri, R Brunelli, D A Cardim, C C Wang, R M M Verzola, S Mascarenhas
OBJECTIVE: We aimed to compare the invasive (iICP) and a non-invasive intracranial pressure (nICP) monitoring methods in patients with traumatic brain injury, based on the similarities of the signals' power spectral densities. MATERIALS AND METHODS: We recorded the intracranial pressure of seven patients with traumatic brain injury admitted to Hospital São João, Portugal, using two different methods: a standard intraparenchymal (iICP) and a new nICP method based on mechanical extensometers...
2018: Acta Neurochirurgica. Supplement
Jonathan M Matthews, Andrea Fanelli, Thomas Heldt
OBJECTIVE: The monitoring of intracranial pressure (ICP) is indicated for diagnosing and guiding therapy in many neurological conditions. Current monitoring methods, however, are highly invasive, limiting their use to the most critically ill patients only. Our goal is to develop and test an embedded device that performs all necessary mathematical operations in real-time for noninvasive ICP (nICP) estimation based on a previously developed model-based approach that uses cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) waveforms...
2018: Acta Neurochirurgica. Supplement
Adam M H Young, Joseph Donnelly, Xiuyun Liu, Mathew R Guilfoyle, Melvin Carew, Manuel Cabeleira, Danilo Cardim, Matthew R Garnett, Helen M Fernandes, Christina Haubrich, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
OBJECTIVE: Computed tomography (CT) of the brain can allow rapid assessment of intracranial pathology after traumatic brain injury (TBI). Frequently in paediatric TBI, CT imaging can fail to display the classical features of severe brain injury with raised intracranial pressure. The objective of this study was to determine early CT brain features that influence intracranial or systemic physiological trends following paediatric TBI. MATERIALS AND METHODS: Thirty-three patients (mean age, 10 years; range, 0...
2018: Acta Neurochirurgica. Supplement
Michael T Froehler, Rohan Chitale, Jordan A Magarik, Matthew R Fusco
PURPOSE: The efficiency of neuroendovascular procedures may partly depend on the time devoted to placement of a radial arterial line (RAL) for intraoperative blood pressure monitoring. An alternative approach is to use a pressure-sensing sheath (PSS) that serves to provide invasive blood pressure monitoring without requiring a separate procedure for placement. We compared the use of a RAL versus PSS and assessed procedure time, anesthetist and patient satisfaction, and cost. METHODS: We performed a single-center, prospective, blockwise, comparative trial of procedure start time using traditional RAL placement versus the EndoPhys PSS for invasive blood pressure monitoring...
February 27, 2018: Journal of Neurointerventional Surgery
Luca Bellini, Irene A Veladiano, Magdalena Schrank, Matteo Candaten, Antonio Mollo
BACKGROUND: Rabbits are particularly sensitive to develop hypotension during sedation or anaesthesia. Values of systolic or mean non-invasive arterial blood pressure below 80 or 60 mmHg respectively are common under anaesthesia despite an ongoing surgery. A reliable method of monitoring arterial blood pressure is extremely important, although invasive technique is not always possible due to the anatomy and dimension of the artery. The aim of this study was to evaluate the agreement between a new oscillometric device for non-invasive arterial blood pressure measurement and the invasive method...
February 27, 2018: BMC Veterinary Research
María Lema Tome, Francisco Andrés De la Gala, Patricia Piñeiro, Luis Olmedilla, Ignacio Garutti
INTRODUCTION: In last few years, emphasis was placed in goal-directed therapy in order to optimize patient's hemodynamic status and improve their prognosis. Parameters based on the interaction between heart and lungs have been questioned in situations like low tidal volume and open chest surgery. The goal of the study was to analyze the changes that one-lung ventilation can produce over stroke volume variation and to assess the possible impact of airway pressures and lung compliance over stroke volume variation...
February 21, 2018: Revista Brasileira de Anestesiologia
François Regoli, Gabriele D'Ambrosio, Maria Luce Caputo, Stefano Svab, Giulio Conte, Tiziano Moccetti, Catherine Klersy, Tiziano Cassina, Stefanos Demertzis, Angelo Auricchio
PURPOSE: Pericardial effusion (PE) may occur during the lead extraction procedure (TLE). Little is known about the incidence, causes, and predictors of this complication. METHODS: From January 2009 to October 2016, TLE was attempted for 297 leads in 212 patients (age 69.3 ± 12.9 years, 169 male, BMI 27.2 ± 9.9 m²/kg, LVEF 43.4 ± 24.6%) for lead dysfunction (62.7%), upgrade (16.0%), infection (14.2%), or other (7.0%) indications. TLE was performed under general anesthesia with continuous invasive arterial blood pressure and transesophageal echocardiography (TEE) monitoring...
February 23, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
Logan K France, Meghan S Vermillion, Caroline M Garrett
Blood pressure is a critical parameter for evaluating cardiovascular health, assessing effects of drugs and procedures, monitoring physiologic status during anesthesia, and making clinical decisions. The placement of an arterial catheter is the most direct and accurate method for measuring blood pressure; however, this approach is invasive and of limited use during brief sedated examinations. The objective of this study was to determine which method of indirect blood pressure monitoring was most accurate compared with measurement by direct arterial catheterization...
January 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Veera K van Wijnen, Dik Ten Hove, Reinold O B Gans, Wybe Nieuwland, Arie M van Roon, Jan C Ter Maaten, Mark P M Harms
INTRODUCTION: Orthostasis is a frequent trigger for (pre)syncope but some forms of orthostatic (pre)syncope have a worse prognosis than others. Routine assessment of orthostatic BP in the ED can detect classic orthostatic hypotension, but often misses these other forms of orthostatic (pre)syncope. This study aimed to determine the frequency of abnormal orthostatic BP recovery patterns in patients with (pre)syncope by using continuous non-invasive BP monitoring. METHODS: We performed a prospective cohort study in suspected patients with (pre)syncope in the ED of a tertiary care teaching hospital between January and August 2014...
January 24, 2018: Emergency Medicine Journal: EMJ
Rachel Lord, David MacLeod, Keith George, David Oxborough, Rob Shave, Mike Stembridge
An acute non-invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate (HR), whereas blood volume extraction reduces preload without HR changes. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (4 female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end-extraction following the controlled removal of 25% of total blood volume (1062 ± 342 ml)...
January 18, 2018: Experimental Physiology
Michele Diana, Eric Noll, Andras Legnèr, Seong-Ho Kong, Yu-Yin Liu, Luigi Schiraldi, Francesco Marchegiani, Jordan Bano, Bernard Geny, Anne-Laure Charles, Bernard Dallemagne, Véronique Lindner, Didier Mutter, Pierre Diemunsch, Jacques Marescaux
BACKGROUND: Standard insufflators compensate for intra-abdominal pressure variations with pressure spikes. Our aim was to evaluate the impact of a stable, low-pressure pneumoperitoneum induced by a valve-less insufflator, on working space, hemodynamics, inflammation, and peritoneal physiology, in a model of laparoscopic sigmoid resection. MATERIALS AND METHODS: Twelve pigs (47 ± 3.3 kg) were equipped for invasive hemodynamic monitoring and randomly assigned to Standard (n = 6) vs...
January 12, 2018: Surgical Endoscopy
P Zrimšek, J Sredenšek, M Vengušt, A Seliškar
To examine agreement in anaesthetised dogs between invasive blood pressure measurements and measurements obtained with an oscillometric blood pressure monitor. MATERIALS AND METHODS: Paired invasive and oscillometric measurements were taken in 24 dogs every 5 minutes during anaesthesia (9 to 37 measurements per dog). Agreement between measurement methods was explored using Bland-Altman plots. To determine the accuracy of the oscillometric measurements, the results were compared with the guidelines recommended by the American College of Veterinary Internal Medicine and the Association for the Advancement of Medical Instrumentation...
January 10, 2018: Journal of Small Animal Practice
Karim Lakhal, Vincent Robert-Edan
No abstract text is available yet for this article.
December 2017: Journal of Thoracic Disease
A Ruesch, M A Smith, G Wollstein, I A Sigal, S Nelson, J M Kainerstorfer
The mechanism that maintains a stable blood flow in the brain despite changes in cerebral perfusion pressure (CPP), and therefore guaranties a constant supply of oxygen and nutrients to the neurons, is known as cerebral autoregulation (CA). In a certain range of CPP, blood flow is mediated by a vasomotor adjustment in vascular resistance through dilation of blood vessels. CA is known to be impaired in diseases like traumatic brain injury, Parkinson's disease, stroke, hydrocephalus and others. If CA is impaired, blood flow and pressure changes are coupled and the oxygen supply might be unstable...
February 2017: Proceedings of SPIE
Laura Hornby, Sonny Dhanani, Sam D Shemie
OBJECTIVES: There has been a growth in publications focusing on the phenomena of autoresuscitation in recent years. In 2010, we systematically reviewed the medical literature with the primary objective of summarizing the evidence on the timing of autoresuscitation. Healthcare professionals have continued to voice concerns regarding the potential for autoresuscitation. With this in mind, the objective of this brief report is to update the results of our original review of autoresuscitation...
December 26, 2017: Critical Care Medicine
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
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