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Invasive hemodynamic monitoring

John W Kakareka, Anthony Z Faranesh, Randall H Pursley, Adrienne Campbell-Washburn, Daniel A Herzka, Toby Rogers, Josh Kanter, Kanishka Ratnayaka, Robert J Lederman, Thomas J Pohida
Hemodynamic recording during interventional cardiovascular procedures is essential for procedural guidance, monitoring patient status, and collection of diagnostic information. Recent advances have made interventions guided by magnetic resonance imaging (MRI) possible and attractive in certain clinical scenarios. However, in the MRI environment, electromagnetic interference (EMI) can cause severe distortions and artifacts in acquired hemodynamic waveforms. The primary aim of this paper was to develop and validate a system to minimize EMI on electrocardiogram (ECG) and invasive blood pressure (IBP) signals...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Ran Kornowski, Hana Vaknin-Assa, Abid Assali, Gabriel Greenberg, Orna Valtzer, Ifat Lavi
OBJECTIVES: To assess the diagnostic performance of angiography-derived fractional flow reserve (FFRangio) measurements in patients with stable coronary artery disease when used online in the catheterization laboratory during routine coronary angiography. BACKGROUND: FFR, an index of the hemodynamic severity of coronary stenosis, is derived from invasive measurements using a pressure-monitoring guidewire and hyperemic stimulus. While FFR is the gold standard, it remains under-utilized...
March 15, 2018: Journal of Invasive Cardiology
Cole S Bailey, Luke T Wooster, Mary Buswell, Sarvagna Patel, Paul P Pappagianopoulos, Kristian Bakken, Casey White, Melissa Tanguay, Jasmine B Blodgett, Aaron L Baggish, Rajeev Malhotra, Gregory D Lewis
OBJECTIVES: This study sought to characterize the functional and prognostic significance of oxygen uptake (VO2 ) kinetics following peak exercise in individuals with heart failure (HF). BACKGROUND: It is unknown to what extent patterns of VO2 recovery following exercise reflect circulatory response during exercise in HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). METHODS: We investigated patients (30 HFpEF, 20 HFrEF, and 22 control subjects) who underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and a second distinct HF cohort (n = 106) who underwent noninvasive cardiopulmonary exercise testing with assessment of long-term outcomes...
March 1, 2018: JACC. Heart Failure
Fabrizio Poletti, Claudio Coccino, Davide Monolo, Paolo Crespi, Giorgio Ciccioli, Giuseppe Cordio, Giovanni Seveso, Stefano De Servi
PURPOSE: Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care...
March 1, 2018: Journal of Vascular Access
Takashi Juri, Koichi Suehiro, Aya Kimura, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
This study assessed the ability of a continuous non-invasive blood pressure (BP) monitoring system to reduce intra-anesthetic hemodynamic fluctuation compared with intermittent BP cuff measurement. Forty patients undergoing total knee arthroplasty under general anesthesia were enrolled and randomly divided into two groups (Control and CS group). BP management was performed using the same protocol with BP measured by intermittent BP cuff in the Control and that by continuous non-invasive BP monitoring in the CS group...
March 6, 2018: Journal of Clinical Monitoring and Computing
Angela Briganti, Flavia Evangelista, Paola Centonze, Annaliso Rizzo, Francesco Bentivegna, Antonio Crovace, Francesco Staffieri
BACKGROUND: Haemodynamic variations normally occur in anaesthetized animals, in relation to the animal status, administered drugs, sympathetic and parasympathetic tone, fluid therapy and surgical stimulus. The possibility to measure some cardiovascular parameters, such as cardiac output (CO), during anaesthesia would be beneficial for both the anaesthesia management and its outcome. New techniques for the monitoring of CO are aimed at finding methods which are non invasive, accurate and with good trending ability, which can be used in a clinical setting...
March 6, 2018: BMC Veterinary Research
Federico Nalesso, Francesco Garzotto, Ilaria Petrucci, Sara Samoni, Grazia Maria Virzì, Dario Gregori, Mario Meola, Claudio Ronco
INTRODUCTION: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. MATERIALS AND METHODS: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up...
January 26, 2018: Blood Purification
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
Silvia Martini, Luigi Corvaglia
Near infrared spectroscopy (NIRS) provides a non-invasive, continuous monitoring of regional tissue oxygenation. NIRS assessment of neonatal splanchnic oxygenation (SrSO2 ) has gained increasing interest over the last decade, as local hypoxia and ischemia underlie the most feared gut complications in neonates. Current literature provides encouraging evidence in support of SrSO2 reliability in detecting mesenteric hemodynamic changes related to various physiological and pathological conditions in-term and preterm infants...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
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
R Blancas, Ó Martínez-González, D Ballesteros, A Núñez, J Luján, D Rodríguez-Serrano, A Hernández, C Martínez-Díaz, C M Parra, B L Matamala, M A Alonso, M Chana
OBJECTIVE: To assess the correlation between left ventricular outflow tract velocity time integral (LVOT VTI) and stroke volume index (SVI) calculated by thermodilution methods in ventilated critically ill patients. DESIGN: A prospective, descriptive, multicenter study was performed. SETTING: Five intensive care units from university hospitals. PATIENTS: Patients older than 17 years needing mechanical ventilation and invasive hemodynamic monitoring were included...
February 7, 2018: Medicina Intensiva
Kevin M Hellman, Caroline S Kuhn, Frank F Tu, Katlyn E Dillane, Nathan A Shlobin, Sangeeta Senapati, Xiaojie Zhou, Wei Li, Pottumarthi V Prasad
BACKGROUND: The lack of non-invasive methods to study dysmenorrhea has resulted in poor understanding of the mechanisms underlying pain, insufficient diagnostic tests, and limited treatment options. To address this knowledge gap, we have developed an MRI-based strategy for continuously monitoring the uterus in relation to participants' spontaneous pain perception. OBJECTIVE: The study objective was to evaluate whether MRI can detect real-time changes in myometrial activity during cramping episodes in women with dysmenorrhea, with a hand-held squeeze bulb for pain reporting...
January 31, 2018: American Journal of Obstetrics and Gynecology
Pradeep Padmanabhan, Chikelue Oragwu, Bibhuti Das, John A Myers, Ashok Raj
Pain crisis in children with sickle cell disease (SCD) is typically managed with intravenous fluids and parenteral opioids in the pediatric emergency department. Electrical cardiometry (EC) can be utilized to measure cardiac output (CO) and cardiac index (CI) non-invasively. Near-infrared spectroscopy (NIRS) measuring cerebral (rCO₂) and splanchnic regional (rSO₂) mixed venous oxygenation non-invasively has been utilized for monitoring children with SCD. We studied the value and correlation of NIRS and EC in monitoring hemodynamic status in children with SCD during pain crisis...
January 29, 2018: Children
Raphaël Giraud, Paul S Abraham, Pauline Brindel, Nils Siegenthaler, Karim Bendjelid
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. Cardiac output (CO) and dynamic parameters [stroke volume variation (SVV) and pulse pressure variation (PPV)] measured by transpulmonary thermodilution and pulse contour analysis (PiCCO™) as well as classical hemodynamic parameters were recorded at baseline and after FC...
January 29, 2018: Journal of Clinical Monitoring and Computing
Mayra Lizeth Nava-Martínez, Enriqueta Macias-Miranda, Karla Guadalupe Lozada-Rosete, Juan José Dosta-Herrera
BACKGROUND: Conjoined twins are among the most rare and challenging congenital malformations. The incidence varies from 1:30 000 to 1:200 000 live births. Pygopagus twins account for about 10 to 18% of all conjoined twins. CLINICAL CASE: We report the case of male conjoined pygopagus twins. They shared medullary canal, anal canal and sacrococcygeal region, without any degree of cross circulation. At the moment of the surgery, twin 1 had congenital heart disease without medical treatment...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
Rebecca Re, Ileana Pirovano, Davide Contini, Lorenzo Spinelli, Alessandro Torricelli
Measurement of muscle oxidative metabolism is of interest for monitoring the training status in athletes and the rehabilitation process in patients. Time domain near infrared spectroscopy (TD NIRS) is an optical technique that allows the non-invasive measurement of the hemodynamic parameters in muscular tissue: concentrations of oxy- and deoxy-hemoglobin, total hemoglobin content, and tissue oxygen saturation. In this paper, we present a novel TD NIRS medical device for muscle oxidative metabolism. A custom-printed 3D probe, able to host optical elements for signal acquisition from muscle, was develop for TD NIRS in vivo measurements...
January 17, 2018: Sensors
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
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
Eduardo Tobar, Mario A Abedrapo, Jaime A Godoy, Jose L Llanos, Mauricio J Díaz, Rodrigo Azolas, Gunther R Bocic, Jaime A Escobar, Rodrigo A Cornejo, Carlos M Romero
BACKGROUND: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. METHODS: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery...
December 26, 2017: Revista Brasileira de Anestesiologia
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