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"Perioperative hemodynamic monitoring"

Leonard Montenij, Eric de Waal, Michael Frank, Paul van Beest, Ardine de Wit, Cas Kruitwagen, Wolfgang Buhre, Thomas Scheeren
BACKGROUND: Early goal-directed therapy refers to the use of predefined hemodynamic goals to optimize tissue oxygen delivery in critically ill patients. Its application in high-risk abdominal surgery is, however, hindered by safety concerns and practical limitations of perioperative hemodynamic monitoring. Arterial waveform analysis provides an easy, minimally invasive alternative to conventional monitoring techniques, and could be valuable in early goal-directed strategies. We therefore investigate the effects of early goal-directed therapy using arterial waveform analysis on complications, quality of life and healthcare costs after high-risk abdominal surgery...
2014: Trials
Osama A El Sharkawy, Emad K Refaat, Abdel Elmoniem M Ibraheem, Wafiya R Mahdy, Nirmeen A Fayed, Wesam S Mourad, Hanaa S Abd Elhafez, Khaled A Yassen
PURPOSE: Major hepatic resections may result in hemodynamic changes. Aim is to study transesophageal Doppler (TED) monitoring and fluid management in comparison to central venous pressure (CVP) monitoring. A follow-up comparative hospital based study. METHODS: 59 consecutive cirrhotic patients (CHILD A) undergoing major hepatotomy. CVP monitoring only (CVP group), (n=30) and TED (Doppler group), (n=29) with CVP transduced but not available on the monitor. Exclusion criteria include contra-indication for Doppler probe insertion or bleeding tendency...
October 2013: Saudi Journal of Anaesthesia
Matthew E Cove, Michael R Pinsky
Hemodynamic monitoring is the cornerstone of perioperative anesthetic monitoring. In the unconscious patient, hemodynamic monitoring not only provides information relating to cardiac output, volume status and ultimately tissue perfusion, but also indicates depth of anesthesia and adequacy of pain control. In the 21st century the anesthesiologist has an array of devices to choose from. No single device provides a complete assessment of hemodynamic status, and the use of all devices in every situation is neither practical nor appropriate...
December 2012: Best Practice & Research. Clinical Anaesthesiology
Gilles Amr, Jonathan Sobocinski, Mohamad Koussa, Jean-Marc El Arid, Philippe Nicolini, St├ęphan Haulon
Surgical management of extensive thoracoabdominal aortic aneurysms is associated with high rates of mortality and morbidity, including spinal cord ischemia. We report a successful three-stage repair combining open and endovascular surgery in a patient presenting with an ascending, arch, and thoracoabdominal aneurysm. Spinal cord protective measures included a staged approach, preserved antegrade flow to the left subclavian and hypogastric arteries, absence of aortic cross-clamping, and aggressive perioperative hemodynamic monitoring...
June 2013: Journal of Vascular Surgery
Hirotsugu Miyoshi, Shinji Kusunoki, Masashi Kawamoto
An 81-year-old man with cardiac sarcoidosis was scheduled for an open colectomy and partial resection of liver metastasis. He had undergone implantation of a permanent cardiac pacemaker for complete atrioventricular block 5 years before. Preoperative echocardiography revealed severely reduced left ventricular function, with an ejection fraction of 30%. General anesthesia was induced and maintained with remifentanil 0.2 microg x kg(-1) x min(-1), along with a target-controlled infusion of propofol combined with intermittent administrations of low-dose fentanyl...
June 2010: Masui. the Japanese Journal of Anesthesiology
Patrick Schober, Stephan A Loer, Lothar A Schwarte
Invasive cardiac output (CO) monitoring, traditionally performed with transpulmonary thermodilution techniques, is usually reserved for high-risk patients because of the inherent risks of these methods. In contrast, transesophageal Doppler (TED) technology offers a safe, quick, and less invasive method for routine measurements of CO. After esophageal insertion and focusing of the probe, the Doppler beam interrogates the descending aortic blood flow. On the basis of the measured frequency shift between the emitted and received ultrasound frequency, blood flow velocity is determined...
August 2009: Anesthesia and Analgesia
Tatsushi Mutoh, Tatsuya Ishikawa, Kyoko Nishino, Nobuyuki Yasui
Early hemodynamic assessment is of particular importance for adequate cerebral circulation in patients with aneurysmal subarachnoid hemorrhage (SAH), but is often precluded by the invasiveness and complexity of the established cardiac output determination techniques. We examined the utility of an uncalibrated arterial pressure-based cardiac output monitor (FloTrac) for intraoperative and postoperative hemodynamic management after SAH. In 16 SAH patients undergoing surgical clipping, arterial pulse contour cardiac index, and stroke volume variation (SVV) were analyzed via the radial FloTrac system...
July 2009: Journal of Neurosurgical Anesthesiology
C Hainer, M Bernhard, K Scheuren, H Rauch, M A Weigand
In light of the growing proportion of illness in the general population, the complexity of modern surgery requires precise perioperative hemodynamic monitoring. Echocardiography has emerged over the past 15 years as an especially valuable diagnostic instrument for intensive medicine. No other monitoring technique provides in such a short time, with so little invasiveness, so much additional anatomic information for determining the cause of acute hemodynamic instability. There is of course the possibility of proceeding transthoracally at first, with poor imaging quality but noninvasively, or transesophageally...
October 2006: Der Anaesthesist
V A Lishchuk, D Sh Gazizova, G V Lobacheva, R S Ovchinnikov, E S Nikitin, L V Sazykina, K O Seregin, N O Sokol'skaia, L A Bokeriia
No abstract text is available yet for this article.
May 2006: Anesteziologiia i Reanimatologiia
M Imai, Y Hayashi, R Ono, C Shibata, T Mashimo
Anesthesia for a 49-year-old man with cardiac sarcoidosis is reported. Preoperative cardiac examination showed left ventricular dysfunction (ejection fraction = 27%) and myocardial conduction defects. In addition, his previous history included atrial fibrillation and cerebral infarction. Transesophageal echocardiography showed thrombus in the left appendage. Anesthesia was induced with fentanyl and diazepam and maintained with fentanyl and isoflurane. Perioperative hemodynamic monitoring included direct arterial pressure, central venous and pulmonary artery pressure and continuous cardiac output...
January 2001: Masui. the Japanese Journal of Anesthesiology
T Ezri, B Kunichezki, M Sternfeld, P Szmuk, D Soroker, A Eliraz
During 1987-1991, 78 coronary patients were admitted to the intensive care unit (ICU) for noncardiac surgery. 40 were under invasive hemodynamic monitoring and treatment before operation (group A) and 38 were only admitted to the ICU postoperatively, since ICU beds were not available before surgery (group B). The overall incidence of the perioperative complications, ischemic heart, myocardial infarction and cardiac arrhythmias was significantly higher in group B than in group A (p < 0.01). 5% of group A and 11% of group B died in the ICU postoperatively...
July 1994: Harefuah
H L Feikes, A J Roberts
The importance of accurate perioperative hemodynamic monitoring in cardiac surgery has been emphasized in recent years. We describe a technique for the intraoperative insertion of a flow-directed pulmonary artery catheter. This method is done under direct vision and avoids many of the complications associated with percutaneous insertion techniques.
June 1982: Chest
L Goldman
When internists are consulted to assess risks and to aid in the perioperative management of surgical patients, they often can rely on substantial clinical data to guide the consultation. Perioperative cardiac risk can be estimated based on the severity of underlying heart failure, the occurrence of a recent myocardial infarction or various arrhythmias, the presence of aortic stenosis, the patient's age, the type of planned surgery (including whether it is an emergency or elective procedure), and the patient's general medical condition...
April 1983: Annals of Internal Medicine
D K Quek, L Y Pung
Cardiac complications comprise as much as 50% of perioperative vascular surgical morbidity and mortality. Using the Goldman multifactorial index for evaluating cardiac risk pre-operatively, 53 consecutive patients who underwent abdominal aortic aneurysm surgery were prospectively studied. Forty patients (75.5%) were also evaluated with echocardiography for assessment of left ventricular function. There were 14 (23.7%) peri-operative events, of which nine (17.0%) were acute myocardial infarctions--two of whom died (3...
September 1990: Medical Journal of Malaysia
S P Pietak, S J Teasdale
Hemodynamic monitoring and care of the patient at high risk for anesthesia require a careful and systematic approach. During preoperative evaluation the patient at increased risk must be identified and correctable problems must be solved. The patient's current medications must be reviewed because they may influence the choice of anesthetic approach and may alter the physiologic response to the stresses commonly associated with anesthesia. In addition to conventional clinical and electrocardiographic monitoring, perioperative hemodynamic monitoring may be desirable for patients at special risk, who are likely to have significant associated medical problems or to undergo complicated surgical procedures...
October 6, 1979: Canadian Medical Association Journal
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