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Jasmine Tay, Lin Foo, Giulia Masini, Phillip R Bennett, Carmel M McEniery, Ian B Wilkinson, Christoph C Lees
BACKGROUND: Preeclampsia and fetal growth restriction are considered to be placentally mediated disorders. The clinical manifestations are widely held to relate to gestation age at onset with early- and late-onset preeclampsia considered to be phenotypically distinct. Recent studies have reported conflicting findings in relation to cardiovascular function, and in particular cardiac output, in preeclampsia and fetal growth restriction. OBJECTIVE: We conducted this study to examine the possible relation between cardiac output and peripheral vascular resistance in preeclampsia and fetal growth restriction...
May 2018: American Journal of Obstetrics and Gynecology
Miriam Kuhn, Andreas Hornung, Heidi Ulmer, Christian Schlensak, Michael Hofbeck, Gesa Wiegand
There are many complex cardiac malformations that are characterized by a functionally univentricular physiology. Staged surgical repair according to the Fontan principle separates the systemic and pulmonary circulations by connecting the systemic venous return to the pulmonary arteries. However, long-term follow-up studies demonstrate a gradual deterioration of cardiac function, particularly from the second or third decade. Noninvasive evaluation of the cardiac function is, therefore, important in the follow-up of these patients...
April 2018: Pediatric Cardiology
F L Foo, A Collins, C M McEniery, P R Bennett, I B Wilkinson, C C Lees
STUDY QUESTION: Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? SUMMARY ANSWER: Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. WHAT IS KNOWN ALREADY: Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link...
May 1, 2017: Human Reproduction
J Tay, L Foo, C McEniery, I Wilkinson, C Lees
INTRODUCTION: This pilot study aims to compare cardiac output (CO) and total peripheral resistance (TPR) in pregnancies with fetal growth restriction (FGR) with healthy normal third trimester of pregnancies. Most studies previously done on cardiac parameters in pregnancy focused mainly on pre-eclampsia (PE) and FGR with PE, but not in normotensive FGR women. METHODS: Eight pregnancies with FGR (AC < 10th percentile with raised umbilical PI) in the third trimester (27-35 weeks gestation) compared with 42 uncomplicated ongoing pregnancies within similar gestation bands...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Lin Foo, Jerome Cornette, Jasmine Tay, Christoph Lees
INTRODUCTION: There are multiple modalities used to measure cardiac output in pregnancy. The accepted gold standard is cardiac catheterisation, then measurement via direct Fick method or thermo-dilution. These methods are invasive and not feasible for assessment of healthy pregnant women. There are several non-invasive devices widely used to measure cardiac output including Innocor, an inert gas re-breathing technique which has been validated against thermodilution [1-3] and direct Fick methods [4,5] for measurement of pulmonary blood flow and thus, cardiac output...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Amanda M Perak, Alexander R Opotowsky, Brian K Walsh, Jesse J Esch, James A DiNardo, Barry D Kussman, Diego Porras, Jonathan Rhodes
OBJECTIVE: To assess the feasibility and accuracy of inert gas rebreathing (IGR) pulmonary blood flow (Qp) estimation in mechanically ventilated pediatric patients, potentially providing real-time noninvasive estimates of cardiac output. STUDY DESIGN: In mechanically ventilated patients in the pediatric catheterization laboratory, we compared IGR Qp with Qp estimates based upon the Fick equation using measured oxygen consumption (VO2) (FickTrue); for context, we compared FickTrue with a standard clinical short-cut, replacing measured with assumed VO2 in the Fick equation (FickLaFarge, FickLundell, FickSeckeler)...
October 2016: Journal of Pediatrics
Jonathan Grønbæk, Henrik Wegener Hallas, Lambang Arianto, Knud Pedersen, Arne Thomsen, Bo Lund Chawes, Hans Bisgaard
BACKGROUND: Multiple breath washout (MBW) is an informative but time-consuming test. This study evaluates the uncertainty of a time-saving predictor algorithm in adolescents. METHODS: Adolescents were recruited from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC2000) birth cohort. MBW trials were performed at 13 y of age with Innocor model Inn00400 using sulfur hexafluoride (SF6) as tracer gas. Measurements were analyzed using a mixed model focusing on two prediction points doubling (t5%) and quadrupling (t10%) the standard end point (t2...
July 2016: Pediatric Research
David Hannon, Judy M Bradley, Ian Bradbury, Nicholas Bell, J Stuart Elborn, Katherine O'Neill
BACKGROUND: Lung clearance index (LCI) derived from sulfur hexafluoride (SF6) multiple breath washout (MBW) is a sensitive measure of lung disease in people with cystic fibrosis (CF). However, it can be time-consuming, limiting its use clinically. AIM: To compare the repeatability, sensitivity and test duration of LCI derived from washout to 1/30th (LCI1/30), 1/20th (LCI1/20) and 1/10th (LCI1/10) to 'standard' LCI derived from washout to 1/40th initial concentration (LCI1/40)...
2014: BMJ Open Respiratory Research
Alex Horsley, Kenneth Macleod, Ruchi Gupta, Nick Goddard, Nicholas Bell
BACKGROUND: The Innocor device contains a highly sensitive photoacoustic gas analyser that has been used to perform multiple breath washout (MBW) measurements using very low concentrations of the tracer gas SF6. Use in smaller subjects has been restricted by the requirement for a gas analyser response time of <100 ms, in order to ensure accurate estimation of lung volumes at rapid ventilation rates. METHODS: A series of previously reported and novel enhancements were made to the gas analyser to produce a clinically practical system with a reduced response time...
2014: PloS One
C Siebenmann, P Rasmussen, H Sørensen, M Zaar, M Hvidtfeldt, A Pichon, N H Secher, C Lundby
Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%)...
February 2015: Scandinavian Journal of Medicine & Science in Sports
Djordje G Jakovljevic, David Nunan, Gay Donovan, Lynette D Hodges, Gavin R H Sandercock, David A Brodie
The purpose of this study was to assess the agreement and consistency between gas exchange variables measured by two online metabolic systems during an incremental exercise test. After obtaining local ethics approval and informed consent, 15 healthy subjects performed an incremental exercise test to volitional fatigue using the Bruce protocol. The Innocor (Innovision, Denmark) and CardiO2 (Medical Graphics, USA) systems were placed in series, with the Innocor mouthpiece attached to the pneumotach of the CardiO2...
2008: Journal of Sports Science & Medicine
Rochus Pokan, Helmuth Ocenasek, Rainer Hochgatterer, Martin Miehl, Karin Vonbank, Serge P Von Duvillard, Barry Franklin, Sabine Würth, Ivo Volf, Manfred Wonisch, Peter Hofmann
PURPOSE: This study aimed to evaluate cardiorespiratory and hemodynamic responses during 24 h of continuous cycle ergometry in ultraendurance athletes. METHODS: Eight males (mean ± SD; age = 39 ± 8 yr, height = 179 ± 7 cm, body weight [Wt] = 77.1 ± 6.0 kg) were monitored during 24 h at a constant workload,∼25% below the first lactate turn point at 162 ± 23 W. Measurements included Wt, HR, oxygen consumption (V˙O2), cardiac output (Q), and stroke volume (SV) determined by a noninvasive rebreathing technique (Innocor; Innovision, Odense, Denmark)...
February 2014: Medicine and Science in Sports and Exercise
Shreya S Sheth, Dawn M Maxey, Alice E Drain, Jeffrey A Feinstein
Outpatient measurements of oxygen consumption (VO2) and cardiac output (CO) are valuable in the management of pediatric cardiac disease. Current methods are inaccurate and cumbersome or require invasive procedures. New devices to measure these variables in adults have not been rigorously tested for children. The Innocor system uses a photoacoustic analyzer to measure gas content for noninvasive measurement of VO2 and CO. This study sought to validate Innocor-derived VO2 measurements in children and adults by comparing them against the gold standard Douglas bag method...
April 2013: Pediatric Cardiology
Jessica E Pittman, Robin C Johnson, Paul W Jones, Stephanie D Davis
OBJECTIVE: The multiple breath wash-out technique (MBW) that measures lung clearance index (LCI) and functional residual capacity (FRC) may be more sensitive than spirometry for identification of early obstructive airways disease. The open MBW setup using mass spectrometry referenced in previous publications is not readily available in the U.S. Our objective was to assess validity and sensitivity of a commercially available device that uses a closed (rebreathing) setup with photoacoustic spectroscopy for MBW testing...
December 2012: Pediatric Pulmonology
Gesa Wiegand, Wolfhard Binder, Heidi Ulmer, Renate Kaulitz, Joachim Riethmueller, Michael Hofbeck
In the majority of patients, secundum atrial septal defects (ASDs) are treated interventionally or surgically, before the onset of clinical symptoms, between 3 and 6 years of age. Because right-ventricular dimensions usually normalize after ASD closure, it has been assumed that cardiac function and exercise performance also normalize at long-term follow-up. The aim of our study was to determine cardiac index (CI) at rest and during exercise at medium-term follow-up of children who had undergone surgical or interventional closure of ASD because no such reports have been published thus far...
October 2012: Pediatric Cardiology
Dirk Prochnau, Thomas Forberg, Helmut Kühnert, Matthias Heinke, Hans R Figulla, Ralf Surber
AIMS: It is not clear whether cardiac resynchronization therapy (CRT) should only be optimized at rest or whether it is necessary to perform CRT optimization during exercise. Our study aims to answer this question by using an inert gas rebreathing method (Innocor®). METHODS AND RESULTS: Twenty-seven patients with congestive heart failure and implanted CRT devices were included in the study. The aetiology of the heart failure was ischaemic in nine (33%) patients...
February 2012: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
S Hostettler, J Brechbühl, L Leuthold, G Mueller, S K Illi, C M Spengler
STUDY DESIGN: The study is conducted on the basis of comparative-repeated measures. OBJECTIVES: The objective of this study is to assess the reliability of non-invasive cardiac output (CO) measurements in individuals with tetraplegia (TP) at rest and during exercise using Innocor, and to test the hypothesis that CO measurements are less reliable in TP than in able-bodied (AB) individuals. SETTING: Ambulatory volunteers, Switzerland. METHODS: Nine male motor-complete TP (C5-C7) and nine pair-matched AB performed repeated CO measurements at rest and during submaximal arm-crank and wheelchair exercises in four different test sessions...
May 2011: Spinal Cord
Jakob Hauser, Ina Michel-Behnke, Katarina Zervan, Christiane Pees
The contribution of atrial contraction to cardiac output (CO) has been the subject of extensive research but has yet to be quantified adequately in children and adolescents. Patients with third-degree atrioventricular (AV) block treated with pacemakers (PMs) are ideal candidates to assess the atrial contribution to CO by repeated measurements in single-chamber pacing mode (VVIR) and dual-chamber pacing mode (DDD/VDD). Hemodynamic measurements in children are often complicated by technical restrictions, but more recently a noninvasive method involving inert gas rebreathing has become available, which is an excellent tool for this age group...
January 2011: American Journal of Cardiology
Gesa Wiegand, Gunter Kerst, Winfried Baden, Michael Hofbeck
Standard methods for determination of cardiac output (CO) are either invasive or technically demanding. Measurement of CO by the inert gas-rebreathing (IGR) method, applied successfully in adults, uses a low-concentration mixture of an inert and a blood-soluble gas, respectively. This study tested the feasibility of this method for determining CO during exercise for pediatric patients with complete congenital atrioventricular block (CCAVB) stimulated with a VVI pacemaker. In this study, 5 CCAVB patients (age 9...
November 2010: Pediatric Cardiology
Joachim Saur, Frederik Trinkmann, Christina Doesch, Armin Scherhag, Joachim Brade, Stefan O Schoenberg, Martin Borggrefe, Jens J Kaden, Theano Papavassiliu
Cardiac output (CO) is an important parameter for diagnosis and therapy of heart diseases, but it is still difficult to determine. Innocor, a novel noninvasive inert gas rebreathing (IGR) system, has shown promising results. However, the impact of pulmonary diseases on IGR remains unclear. The aim of the study therefore was to assess the accuracy and reliability of IGR in patients with distinct chronic lung disease. A total of 96 patients were enrolled, including 48 consecutive patients with variant lung diseases (group A) and 48 pair-matched pulmonary healthy patients (group B)...
October 2010: Lung
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