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J Grensemann, J M Defosse, C Wieland, U W Wild, F Wappler, S G Sakka
Monitoring of cardiac index (CI) by uncalibrated pulse contour (PC) methods has been shown to be inaccurate in critically ill patients. We tested accuracy and trending of a new pulse contour method and a modified Fick method using central venous oxygen saturation. We studied 21 critically ill and mechanically ventilated patients (age 20-86 years) monitored by PC (PulsioFlex®) and transpulmonary thermodilution (TPTD, PiCCO2®) as reference. At baseline, reference and PC-derived CI (CIPC) were recorded and CI obtained by Fick's method (FM, CIFICK)...
July 2016: Anaesthesia and Intensive Care
Huseyin Konur, Gulay Erdogan Kayhan, Huseyin Ilksen Toprak, Nizamettin Bucak, Mustafa Said Aydogan, Saim Yologlu, Mahmut Durmus, Sezai Yılmaz
Fluid management is challenging and still remains controversial in orthotopic liver transplantation (OLT). The pleth variability index (PVI) has been shown to be a reliable predictor of fluid responsiveness of perioperative and critically ill patients; however, it has not been evaluated in OLT. This study was designed to examine whether the PVI can reliably predict fluid responsiveness in OLT and to compare PVI with other hemodynamic indexes that are measured using the PiCCO2 monitoring system. Twenty-five patients were enrolled in this study...
July 2016: Kaohsiung Journal of Medical Sciences
Alexandre Eghiaian, Antony Lanceleur, Anne Laure Le Maho, Arnaud Pouilly, Pierre Meudal de Kerlidy, Pascal Blondel, Stéphanie Suria, Charles Cerf
INTRODUCTION: The PiCCO2 is a commonly used monitor, which education remains theoretical and demonstration based. Simulation allows active learning, which may help achieve a better understanding and handling of this device, hence a safer and more effective use. Because of the lack of availability of dedicated simulators and the uselessness of the demonstration mode of monitors for simulation purpose, simulation remains seldom used. We will describe a novel use of the PiCCO2 for simulation training and its experiment in high-fidelity simulation (HFS)...
April 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Pierre-Grégoire Guinot, Eugénie Bernard, Mélanie Levrard, Hervé Dupont, Emmanuel Lorne
INTRODUCTION: Gradual reduction of the dosage of norepinephrine (NE) in patients with septic shock is usually left to the physician's discretion. No hemodynamic indicator predictive of the possibility of decreasing the NE dosage is currently available at the bedside. The respiratory pulse pressure variation/respiratory stroke volume variation (dynamic arterial elastance (Eadyn)) ratio has been proposed as an indicator of vascular tone. The purpose of this study was to determine whether Eadyn can be used to predict the decrease in arterial pressure when decreasing the NE dosage in resuscitated sepsis patients...
2015: Critical Care: the Official Journal of the Critical Care Forum
Pedro de la Oliva, Juan J Menéndez-Suso, Mabel Iglesias-Bouzas, Elena Álvarez-Rojas, José M González-Gómez, Patricia Roselló, Juan I Sánchez-Díaz, Susana Jaraba
OBJECTIVES: To characterize cardiac preload responsiveness in pediatric patients with cardiovascular dysfunction and dilated cardiomyopathy using global end-diastolic volume index, stroke volume index, cardiac index, and extravascular lung water index. DESIGN: Prospective multicenter observational study. SETTING: Medical/surgical PICUs of seven Spanish University Medical Centers. PATIENTS: Seventy-five pediatric patients (42 male, 33 female), median age 36 months (range, 1-207 mo), were divided into three groups: normal cardiovascular status, cardiovascular dysfunction, and dilated cardiomyopathy...
January 2015: Pediatric Critical Care Medicine
A Feldheiser, O Hunsicker, H Krebbel, K Weimann, L Kaufner, K-D Wernecke, C Spies
BACKGROUND: Evidence for the benefit of an intraoperative use of a goal-directed haemodynamic management has grown. We compared the oesophageal Doppler monitor (ODM, CardioQ-ODM™) with a calibrated pulse contour analysis (PCA, PiCCO2™) with regard to assessment of stroke volume (SV) changes after volume administration within a goal-directed haemodynamic algorithm during non-cardiac surgery. METHODS: The data were obtained prospectively in patients with metastatic ovarian carcinoma undergoing cytoreductive surgery...
November 2014: British Journal of Anaesthesia
A L Vilchez Monge, I Tranche Alvarez-Cagigas, J Perez-Peña, L Olmedilla, C Jimeno, J Sanz, J M Bellón Cano, I Garutti
BACKGROUND: Liver transplantation (LT) implies hemodynamic instability, making invasive monitoring of cardiac output (CO) mandatory. Intermittent thermodilution with pulmonary artery catheter (PAC) remains the clinical gold standard to measure CO. The agreement between PAC and new monitoring methods in LT needs to be further investigated. Our aim is to clarify whether cardiac index (CI) measurements with transpulmonary intermittent thermodilution, and continuous pulmonary thermodilution methods agree sufficiently with those performed intermittently with PAC to be considered interchangeable during LT...
November 2014: Minerva Anestesiologica
Wen-Yun Xu, Na Wang, Hai-Tao Xu, Hong-Bin Yuan, Hai-Jing Sun, Chun-Li Dun, Shuang-Qiong Zhou, Zui Zou, Xue-Yin Shi
OBJECT: Sevoflurane and propofol are both widely used in clinical anesthesia. The aim of this study is to compare the effects of sevoflurane and propofol on right ventricular function and pulmonary circulation in patients receiving esophagectomy. METHODS: Forty adult patients undergoing an elective open-chest thoracotomy for esophagectomy were randomized to receive either propofol (n=20) or sevoflurane (n=20) as the main anesthetic agent. The study was performed in Changzheng Hospital...
2014: International Journal of Clinical and Experimental Pathology
E Kupersztych-Hagege, J-L Teboul, A Artigas, A Talbot, C Sabatier, C Richard, X Monnet
BACKGROUND: Bioreactance estimates cardiac output in a non-invasive way. We evaluated the ability of a bioreactance device (NICOM®) to estimate cardiac index (CI) and to track relative changes induced by volume expansion. METHODS: In 48 critically ill patients, we measured CI estimated by the NICOM® device (CINicom) and by transpulmonary thermodilution (CItd, PiCCO2™ device) before and after a 500 ml saline infusion. Before volume expansion, we performed a passive leg raising (PLR) test and measured the changes it induced in CINicom and in pulse contour analysis-derived CI...
December 2013: British Journal of Anaesthesia
K Bendjelid, G Marx, N Kiefer, T P Simon, M Geisen, A Hoeft, N Siegenthaler, C K Hofer
BACKGROUND: A new calibrated pulse wave analysis method (VolumeView™/EV1000™, Edwards Lifesciences, Irvine, CA, USA) has been developed to continuously monitor cardiac output (CO). The aim of this study was to compare the performance of the VolumeView method, and of the PiCCO2™ pulse contour method (Pulsion Medical Systems, Munich, Germany), with reference transpulmonary thermodilution (TPTD) CO measurements. METHODS: This was a prospective, multicentre observational study performed in the surgical and interdisciplinary intensive care units of four tertiary hospitals...
October 2013: British Journal of Anaesthesia
Andrey I Lenkin, Viktor I Zaharov, Pavel I Lenkin, Alexey A Smetkin, Lars J Bjertnaes, Mikhail Y Kirov
OBJECTIVES: In cardiac surgery, the choice of temperature regimen during cardiopulmonary bypass (CPB) remains a subject of debate. Hypothermia reduces tissue metabolic demands, but may impair the autoregulation of cerebral blood flow and contribute to neurological morbidity. The aim of this study was to evaluate the effect of two different temperature regimens during CPB on the systemic oxygen transport and the cerebral oxygenation during surgical correction of acquired heart diseases...
May 2013: Interactive Cardiovascular and Thoracic Surgery
X Monnet, L Guérin, M Jozwiak, A Bataille, F Julien, C Richard, J-L Teboul
BACKGROUND: In patients receiving an infusion of norepinephrine, the relationship between the amplitude of the oximeter plethysmographic waveform and stroke volume may be variable and quality of the waveform might be reduced, compared with patients not receiving norepinephrine. We assessed the reliability of the pleth variability index (PVI), an automatic measurement of the respiratory variation of the plethysmographic waveform, for predicting fluid responsiveness in patients receiving norepinephrine infusions...
February 2013: British Journal of Anaesthesia
Xavier Monnet, Aurélien Bataille, Eric Magalhaes, Jérôme Barrois, Marine Le Corre, Clément Gosset, Laurent Guerin, Christian Richard, Jean-Louis Teboul
PURPOSE: In stable ventilatory and metabolic conditions, changes in end-tidal carbon dioxide (EtCO(2)) might reflect changes in cardiac index (CI). We tested whether EtCO(2) detects changes in CI induced by volume expansion and whether changes in EtCO(2) during passive leg raising (PLR) predict fluid responsiveness. We compared EtCO(2) and arterial pulse pressure for this purpose. METHODS: We included 65 patients [Simplified Acute Physiology Score (SAPS) II = 57 ± 19, 37 males, under mechanical ventilation without spontaneous breathing, 15 % with chronic obstructive pulmonary disease, baseline CI = 2...
January 2013: Intensive Care Medicine
Nicholas Kiefer, Christoph K Hofer, Gernot Marx, Martin Geisen, Raphaël Giraud, Nils Siegenthaler, Andreas Hoeft, Karim Bendjelid, Steffen Rex
INTRODUCTION: Transpulmonary thermodilution is used to measure cardiac output (CO), global end-diastolic volume (GEDV) and extravascular lung water (EVLW). A system has been introduced (VolumeView/EV1000™ system, Edwards Lifesciences, Irvine CA, USA) that employs a novel algorithm for the mathematical analysis of the thermodilution curve. Our aim was to evaluate the agreement of this method with the established PiCCO™ method (Pulsion Medical Systems SE, Munich, Germany, clinicaltrials...
2012: Critical Care: the Official Journal of the Critical Care Forum
Filipe Pissarra, Antonio Oliveira, Paulo Marcelino
A pilot study aimed to introduce intraoperative monitoring of liver surgery using transoesophageal echocardiography (TEE) is described. A set of TEE measurements was established as a protocol, consisting of left atrial (LA) dimension at the aortic valve plane; mitral velocity flow integral, calculation of stroke volume and cardiac output (CO); mitral annular plane systolic excursion; finally, right atrial area. A total of 165 measurements (on 21 patients) were performed, 31 occurring during hypotension. The conclusions reached were during acute blood loss LA dimension changed earlier than CVP, and, in one patient, a dynamic left ventricular (LV) obstruction was observed; in 3 patients a transient LV systolic dysfunction was documented...
2012: Cardiology Research and Practice
Nicolas Dufour, Marianne Delville, Jean-Louis Teboul, Laurent Camous, Aude Favier du Noyer, Christian Richard, Xavier Monnet
PURPOSE: To assess whether continuous veno-venous hemofiltration (CVVH) with high blood pump flow alters the measurements of cardiac index (CI), global end-diastolic volume indexed (GEDVI), and extravascular lung water indexed (EVLWI) performed by transpulmonary thermodilution. METHODS: Sixty-nine patients were included if they were monitored by a PiCCO2 device and received CVVH through a femoral (n = 62) or an internal jugular (n = 7) dialysis catheter. The blood pump flow was set at 250 mL/min (n = 31) or 350 mL/min (n = 38) and the filtration flow at 6,000 mL/h...
July 2012: Intensive Care Medicine
Xavier Monnet, Romain Persichini, Mariem Ktari, Mathieu Jozwiak, Christian Richard, Jean-Louis Teboul
INTRODUCTION: We wanted to determine the number of cold bolus injections that are necessary for achieving an acceptable level of precision for measuring cardiac index (CI), indexed global end-diastolic volume (GEDVi) and indexed extravascular lung water (EVLWi) by transpulmonary thermodilution. METHODS: We included 91 hemodynamically stable patients (age 59 (25% to 75% interquartile range: 39 to 79) years, simplified acute physiologic score (SAPS)II 59 (53 to 65), 56% under norepinephrine) who were monitored by a PiCCO2 device...
2011: Critical Care: the Official Journal of the Critical Care Forum
E Weninger, B Nyga, M Sachs, C Heide, K Mörstedt, N Riegler, S Feller, M Stoschek, K Peter
UNLABELLED: Extracorporeal shock-wave lithotripsy (ESWL) is the method of choice for the treatment of solitary stones in the kidney or ureter. Early lithotripters required prolonged immobility of the patient and caused considerable pain, necessitating general or epidural anaesthesia during the procedure. Modern lithotripters are quicker, but still require analgesia. Intravenous opioids are currently the drugs in favour. The opioids most commonly used are fentanyl and its shorter-acting analogue, alfentanil...
April 1996: Der Anaesthesist
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