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Invasive Arterial Blood Pressure Monitoring

Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
Jeffrey S Lillie, Alexander S Liberson, David A Borkholder
Hypertension is a significant worldwide health issue. Continuous blood pressure monitoring is important for early detection of hypertension, and for improving treatment efficacy and compliance. Pulse wave velocity (PWV) has the potential to allow for a continuous blood pressure monitoring device; however published studies demonstrate significant variability in this correlation. In a recently presented physics-based mathematical model of PWV, flow velocity is additive to the classic pressure wave as estimated by arterial material properties, suggesting flow velocity correction may be important for cuff-less non-invasive blood pressure measures...
October 11, 2016: Cardiovascular Engineering and Technology
Audun E Rimehaug, Eirik Skogvoll, Petter Aadahl, Oddveig Lyng, Dag O Nordhaug, Lasse Løvstakken, Idar Kirkeby-Garstad
Cardiac power, the product of aortic flow and blood pressure, appears to be a fundamental cardiovascular parameter. The simplified version named cardiac power output (CPO), calculated as the product of cardiac output (CO) in L/min and mean arterial pressure (MAP) in mmHg divided by 451, has shown great ability to predict outcome in a broad spectrum of cardiac disease. Beat-by-beat evaluation of cardiac power (PWR) therefore appears to be a possibly valuable addition when monitoring circulatory unstable patients, providing parameters of overall cardiovascular function...
October 2016: Physiological Reports
Rosie Earle, Himat Vaghadia, Enda Shanahan, Raymond Tang, Andrew Sawka
We report the novel application of photoplethysmographic technology with the Nexfin HD monitor for real-time measurement of blood pressure (BP) in a patient with tetraamelia. The patient was a 58-year-old man with tetraamelia secondary to thalidomide exposure in utero, who presented for surgical excision of a maxillary schwannoma. Because difficulty of cuff use on rudimentary limbs and failure to gain invasive arterial access due to abnormalities of limb vasculature, this population is known to pose some unique challenges for BP measurement...
November 2016: Journal of Clinical Anesthesia
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
D Vinayagam, S Bampoe, B Thilaganathan, A Khalil
BACKGROUND: Intraoperative haemodynamic monitoring is carried out in high-risk surgical patients, often using invasive methods, including pulmonary artery catheterisation. Early goal-directed therapy in high-risk surgical patients reduces tissue hypoxia, organ failure and improves outcomes. Significant maternal morbidity arises as a result of perioperative haemorrhage. At present, heart rate and brachial blood pressure are used as proxy markers to aid in fluid resuscitation, however, we know that these exhibit minimal change during early stages of shock, and are poor indicators of the adequacy of therapeutic intervention...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Safwat Aly, Mohamed El-Dib, Mohamed Mohamed, Hany Aly
Background Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO2) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO2 monitoring using reduced-temperature probes (41°C). Objective The objective of this study was to assess reliability and safety of tcPCO2 monitoring at reduced-temperature probe in VLBW infants. Design and Methods A prospective study was conducted on VLBW infants...
September 27, 2016: American Journal of Perinatology
Jun-Long Gao, Yu-Lan Li, Xiu-Mei Wang, Qian-Long Zhao, Hai-Jun Zhang, Fang-Fang Han, Xia-Xia Li, Dong-Hang Zhang
BACKGROUND: Evidence suggests that electroacupuncture (EA) protects against arrhythmia and myocardial injury induced by myocardial ischaemia-reperfusion. However, to our knowledge, it remains unknown whether EA could alleviate bupivacaine-induced cardiotoxicity. Therefore, we aimed to explore the effect of EA pretreatment on bupivacaine-induced cardiac arrest and outcomes of cardiopulmonary resuscitation (CPR) in rats. METHODS: 24 adult male Sprague-Dawley rats were randomly divided into two groups: EA (n=12), and minimal acupuncture (MA) (n=12)...
September 23, 2016: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
T Yu Rebrova, T M Ripp, S A Afanas'ev, V F Mordovin, E F Muslimova
AIM: to investigate time course of changes in the adrenoreactivity (AR) of erythrocyte membranes (EM) after radiofrequency ablation of the synaptic nerves of the renal arteries (RA) in patients with resistant hypertension (RH) and to assess whether this indicator can be used for the early evaluation of the efficiency of an invasive intervention into the RA. SUBJECTS AND METHODS: 24 patients with RH, who received full-dose antihypertensive therapy with at least three drugs, including a diuretic, were examined...
2016: Terapevticheskiĭ Arkhiv
Mingwu Gao, William C Rose, Barry Fetics, David A Kass, Chen-Huan Chen, Ramakrishna Mukkamala
Generalized transfer functions (GTFs) are available to compute the more relevant central blood pressure (BP) waveform from a more easily measured radial BP waveform. However, GTFs are population averages and therefore may not adapt to variations in pulse pressure (PP) amplification (ratio of radial to central PP). A simple adaptive transfer function (ATF) was developed. First, the transfer function is defined in terms of the wave travel time and reflection coefficient parameters of an arterial model. Then, the parameters are estimated from the radial BP waveform by exploiting the observation that central BP waveforms exhibit exponential diastolic decays...
2016: Scientific Reports
Sabri Soussi, Benjamin Deniau, Axelle Ferry, Charlotte Levé, Mourad Benyamina, Véronique Maurel, Maïté Chaussard, Brigitte Le Cam, Alice Blet, Maurice Mimoun, Jêrome Lambert, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand
BACKGROUND: Impact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients. METHODS: Retrospective, single-center cohort study was conducted in a university hospital. Forty critically ill burn patients with total body surface area (TBSA) burn-injured >20 % with invasive blood pressure and cardiac output monitoring (transpulmonary thermodilution technique) within 8 h from trauma were included...
December 2016: Annals of Intensive Care
Rie Sasaki-Nakashima, Tabito Kino, Lin Chen, Hiroshi Doi, Shintaro Minegishi, Kaito Abe, Teruyasu Sugano, Masataka Taguri, Tomoaki Ishigami
BACKGROUND: Recently, new non-invasive vascular indexes named arterial velocity pulse index (AVI) and arterial pressure volume index (API), which is evaluated by a multifunctional blood pressure monitoring device, were developed using cuff oscillometric technologies and suprasystolic cuff oscillometric wave measurement. However, although a few studies including a computational model have been performed, data on subjects with cardiovascular diseases in actual outpatient clinics remain scant...
August 31, 2016: Journal of Cardiology
E Mancini, C Perazzini, L Gesualdo, F Aucella, A Limido, F Scolari, S Savoldi, M Tramonti, L Corazza, M Atti, S Severi, P Bolasco, A Santoro
BACKGROUND: Intradialytic hypotension (IDH) has a dramatic impact on the main outcomes of dialysis patients. Early warning of hemodynamic worsening during dialysis would enable preventive measures to be taken. Blood oxygen saturation (SO2) is used for hemodynamic monitoring in the critical care setting and may provide useful information about IDH onset. AIM: To evaluate whether short- and medium-term variations in the SO2 signal (ST-SO2var, MT-SO2var,) during dialysis are a predictor of IDH...
August 29, 2016: Journal of Nephrology
Bernardo Bollen Pinto, Glen Atlas, Bart F Geerts, Karim Bendjelid
The oesophageal Doppler (OD) is a minimally invasive haemodynamic monitor used in the surgical theatre and the ICU. Using the OD, goal-directed therapy (GDT) has been shown to reduce perioperative complications in high-risk surgical patients. However, most GDT protocols currently in use are limited to stroke volume optimisation. In the present manuscript, we examine the conceptual models behind new OD-based measurements. These would provide the clinician with a comprehensive view of haemodynamic pathophysiology; including pre-load, contractility, and afterload...
August 27, 2016: Journal of Clinical Monitoring and Computing
J F Heusdens, S Lof, C W A Pennekamp, J C Specken-Welleweerd, G J de Borst, W A van Klei, L van Wolfswinkel, R V Immink
BACKGROUND: Patients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive beat-to-beat radial artery BP (BPrad) in this setting. METHODS: In 25 consecutive patients (median age 71 yr) scheduled for carotid endarterectomy and receiving general anaesthesia, BPfin and BPrad were monitored simultaneously and ipsilaterally during the 30-min period surrounding carotid artery cross-clamping...
September 2016: British Journal of Anaesthesia
Zhe-Zhe Peng, Ma-Zhong Zhang, Ying Sun, Jie Bai, Hong-Bin Gu, Pei-Pei Liu, Min Li, Mei-Hua Cai
OBJECTIVE: Anesthetic management for patients undergoing surgical repair of aortic coarctation (CoA) should include constant blood pressure monitoring of the right upper extremity and a lower extremity. The delayed or absent pulse in the lower limbs often leads to unsuccessful arterial cannulation in infants and the oscillometric technique used for blood pressure measurement. The aim of this study was to evaluate the agreement between the oscillometric method and intra-arterial technique for blood pressure monitoring in the lower limbs of infants undergoing CoA...
November 2016: Paediatric Anaesthesia
Aymen N Naguib, Peter D Winch, Roby Sebastian, Daniel Gomez, Luisa Guzman, Julie Rice, Dmitry Tumin, Mark Galantowicz, Joseph D Tobias
BACKGROUND: Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). OBJECTIVES: The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2)...
August 15, 2016: Journal of Intensive Care Medicine
Jonathan Lipps, Andrew Goldberg, Samuel DeMaria, Yury Khelemsky, Adam Levine, Vedat Yildiz, Bryan Mahoney
With pulseless electrical activity (PEA) emerging as one of the leading cardiac arrest arrhythmias, the rapid response and accurate diagnosis of PEA is essential to improve survival rates. Although the use of invasive blood pressure monitoring to more quickly detect changes in blood pressure is widespread, evidence for its use is largely anecdotal and placement is not without risk. This is a prospective, multi-center, randomized controlled trial involving 58 senior anesthesiology residents undergoing a simulation of intraoperative PEA using high-fidelity simulation...
August 13, 2016: Journal of Clinical Monitoring and Computing
S Rimoldi, F H Messerli, D Cerny, S Laurent, C Seiler
OBJECTIVE: Heart rate (HR) lowering by betablockade was shown to be beneficial after myocardial infarction. In contrast heart rate lowering with ivabradine was found to confer no benefits in two prospective randomized trials in patients with coronary artery disease (CAD). We hypothesised that this inefficacy could be in part related to ivabradine's effect on central (aortic) pressure. Aim of this study was to assess the HR lowering effect of ivabradine on invasively measured central blood pressure...
September 2016: Journal of Hypertension
P Boutouyrie, F Elmula, P Rebora, A Talvik, S Salerno, E Miszkowska-Nagorna, X Liuc, T Comotti, A Larstorp, M Rostrup, E Qwierblewska, M Valsecchi, S E Kjeldsen, M Viigimaa, K Narkiewicz, G Parati, S Laurent
OBJECTIVE: In the BEAUTY study we investigated whether utilizing non-invasive monitoring of hemodynamic parameters by thoracic impedance plethysmography (IHM) combined with a drug selection algorithm (DSA) compared to conventional drug selection may improve uncontrolled hypertension in European Hypertension Excellence Centres. Although the results of the BEAUTY study on ABPM were neutral (J Hypertens 2015), we investigated whether IHM-DSA could favourably influence central BP and arterial stiffness...
September 2016: Journal of Hypertension
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