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Dimuthu Vinayagam, Sophie Bowe, Elaine Sheehan, Basky Thilaganathan, Asma Khalil
BACKGROUND: Due to the importance of cardiovascular dysfunction and advances in the development and use of non-invasive cardiac output (CO) monitoring devices, there is a growing interest in their use in the obstetric population. The aim of this study was to compare two commercially available, non-invasive CO monitors in the assessment of heart rate (HR), stroke volume (SV), CO, cardiac index (CI) and total peripheral resistance (TPR) in an obstetric population. METHODS: This was a prospective, comparative study including two groups...
October 6, 2016: Fetal Diagnosis and Therapy
D Vinayagam, O Patey, B Thilaganthan, A Khalil
INTRODUCTION: There is a paucity of data regarding the accuracy, reliability and reproducibility of non-invasive cardiac output monitors in pregnancy. The aim of this study was to compare cardiac output estimations obtained by USCOM® against those obtained by 2-dimensional transthoracic echocardiography (TTE). METHODS: Prospective, observational study in which 114 healthy pregnant and postpartum women had haemodynamic indices obtained by USCOM® and TTE. Accuracy and precision statistics (Bland Altman analysis) are presented as bias, precision, 95% limits of agreement (LOA) and mean percentage difference (MPD)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
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
Thomas Freidl, Nariae Baik, Gerhard Pichler, Bernhard Schwaberger, Barbara Zingerle, Alexander Avian, Berndt Urlesberger
BACKGROUND: Substantial haemodynamic changes occur during the first minutes after birth. Currently, only heart rate (HR) and arterial oxygen saturation are routinely used to monitor haemodynamic transition after birth. OBJECTIVES: The aim of the present study was to continuously assess haemodynamic changes during transition in term infants for the first time by using electrical velocimetry (EV), a new method of non-invasive cardiac output monitoring (NICOM), based on impedance cardiography technology...
August 17, 2016: Neonatology
Po-Yuan Shih, Wen-Ying Lin, Ming-Hui Hung, Ya-Jung Cheng, Kuang-Cheng Chan
BACKGROUND: This study compared the cardiac output (CO) obtained from PiCCO with that obtained from the noninvasive NICOM method. METHODS: Twenty-one cirrhotic patients receiving liver transplantation were enrolled. During the operation, their CO was measured by the PiCCO system via the thermodilution method as the standard and by the NICOM method. Two parameters including cardiac index (CI) and stroke volume index (SVI) were collected simultaneously at three phases during the surgery including the dissection phase (T1), the anhepatic phase (T2), and the reperfusion phase (T3)...
June 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
D Vinayagam, O Patey, B Thilaganathan, A Khalil
OBJECTIVES: There is a paucity of data regarding the reliability of using non-invasive monitors in pregnancy. The aim of this study was to compare hemodynamic measurements obtained by non-invasive methods, against those obtained by 2-dimensional transthoracic echocardiography. METHODS: We recruited a total of 114 healthy pregnant and postpartum women who had cardiac output (CO) estimations obtained by two non-invasive devices as well as 2-D transthoracic echocardiography (TTE)...
March 11, 2016: Ultrasound in Obstetrics & Gynecology
Jeong Jin Min, Jong-Hwan Lee, Kwan Young Hong, Soo Joo Choi
The aim of this prospective study was to evaluate the usefulness of stroke volume variation (SVV) derived from NICOM(®) to predict fluid responsiveness in the prone position. Forty adult patients undergoing spinal surgery in the prone position were included in this study. We measured SVV from NICOM(®) (SVVNICOM) and FloTrac™/Vigileo™ systems (SVVVigileo), and pulse pressure variation (PPV) using automatic (PPVauto) and manual (PPVmanual) calculations at four time points including supine and prone positions, and before and after fluid loading of 6 ml kg(-1) colloid solution...
March 10, 2016: Journal of Clinical Monitoring and Computing
Peter C Hou, Michael R Filbin, Anthony Napoli, Joseph Feldman, Peter S Pang, Jeffrey Sankoff, Bruce M Lo, Howard Dickey-White, Robert H Birkhahn, Nathan I Shapiro
OBJECTIVE: Fluid responsiveness is proposed as a physiology-based method to titrate fluid therapy based on preload dependence. The objectives of this study were to determine if a fluid responsiveness protocol would decrease progression of organ dysfunction, and a fluid responsiveness protocol would facilitate a more aggressive resuscitation. METHODS: Prospective, 10-center, randomized interventional trial. INCLUSION CRITERIA: suspected sepsis and lactate 2...
August 2016: Shock
Jie Zhang, Lester A H Critchley, Daniel C W Lee, Kim S Khaw, Shara W Y Lee
To compare the performance of a bioreactance cardiac output (CO) monitor (NICOM) and transcutaneous Doppler (USCOM) during head up tilting (HUT). Healthy young adult subjects, age 22 ± 1 years, 7 male and 7 female, were tilted over 3-5 s from supine to 70° HUT, 30° HUT and back to supine. Positions were held for 3 min. Simultaneous readings of NICOM and USCOM were performed 30 s into each new position. Mean blood pressure (MBP), heart rate (HR), CO and stroke volume (SV), and thoracic fluid content (TFC) were recorded...
October 2016: Journal of Clinical Monitoring and Computing
Daniel Stott, Mareike Bolten, Mona Salman, Daniela Paraschiv, Katherine Clark, Nikos A Kametas
INTRODUCTION: Fetal growth restriction (FGR) is associated with poor perinatal outcomes. Screening and prevention tools for FGR, such as uterine artery Doppler imaging and aspirin, underperform in high-risk groups, compared with general antenatal populations. There is a paucity of sensitive screening tests for the early prediction of FGR in high-risk pregnancies. MATERIALS AND METHODS: This was a prospective observational study based in a dedicated antenatal hypertension clinic at a tertiary UK hospital...
March 2016: Acta Obstetricia et Gynecologica Scandinavica
Antonio Saad, Mahbubur Rahman, Nicole Ribeiro Marques, Joe Funston, Luis Pacheco, William Whitehead, George Kramer, Aristides Koutrouvelis
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Li Huang, Lester A H Critchley, Jie Zhang
BACKGROUND: Minimally invasive continuous cardiac output measurements are recommended for use during anesthesia to guide fluid therapy, but such measurements must trend changes reliably. The NICOM Cheetah, a BioReactance monitor, is being recommended for intraoperative use. To validate its use, Doppler methods, suprasternal USCOM and esophageal CardioQ, were used in tandem to provide reliable estimates of changing trends in cardiac output. Preliminary comparisons showed that upper abdominal surgical interventions caused shifts in the calibration of the NICOM...
October 2015: Anesthesia and Analgesia
Sak Lee, Seung Hyun Lee, Byung-Chul Chang, Jae-Kwang Shim
PURPOSE: We compared the efficacy of postoperative hemodynamic goal-directed therapy (GDT) using a pulmonary artery catheter (PAC) and bioreactance-based noninvasive cardiac output monitoring (NICOM) in patients with atrial fibrillation undergoing valvular heart surgery. MATERIALS AND METHODS: Fifty eight patients were randomized into two groups of GDT with common goals to maintain a mean arterial pressure of 60-80 mm Hg and cardiac index ≥2 L/min/m²: the PAC group (n=29), based on pulmonary capillary wedge pressure, and the NICOM group (n=29), based on changes in stroke volume index after passive leg raising...
July 2015: Yonsei Medical Journal
J-H Lee, H-J No, I-K Song, H-S Kim, C-S Kim, J-T Kim
BACKGROUND: This study evaluated the ability of a non-invasive cardiac output monitoring device (NICOM) to predict fluid responsiveness in paediatric patients undergoing cardiac surgery. METHODS: Children aged <5 yr undergoing congenital heart surgery were included. Once the sternum had been closed after repair of the congenital heart defect, 10 ml kg(-1) colloid solution was administered for volume expansion. Transoesophageal echocardiography (TOE) was performed to measure stroke volume (SV) and respiratory variation in aortic blood flow peak velocity (ΔV(peak)) before and after volume expansion...
July 2015: British Journal of Anaesthesia
Hongjie Tong, Caibao Hu, Xuejing Hao, Guolong Cai, Qun Rao, Molei Yan, Jin Chen, Jing Yan
OBJECTIVE: To investigate the value of bioreactance-based passive leg raising (PLR) test predicting fluid responsiveness of elderly patients with sepsis. METHODS: This prospective and self-controlled clinical study included 31 elderly patients with sepsis in the Department of Intensive Care Medicine of Zhejiang Hospital. Hemodynamic parameters including cardiac output (CO), stroke volume variation (SVV) were continuously recorded by bioreactance-based device (noninvasive cardiac output monitoring, NICOM) before and after PLR and volume expansion (VE) test...
February 2015: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Asma Khalil
OBJECTIVES: Corin, an atrial natriuretic peptide-converting enzyme, has been found to promote trophoblast invasion and spiral artery remodeling. Reduced maternal plasma atrial natriuretic peptide (ANP) levels and elevated corin levels have been reported in pregnancies complicated by PE. The aim of this study was to investigate longitudinal changes in maternal plasma levels of corin and midregional proatrial natriuretic peptide (MR-PANP) in pregnancies that develop preeclampsia (PE) and gestational hypertension (GH)...
January 2015: Pregnancy Hypertension
Asma Khalil
OBJECTIVES: Maternal cardiac adaptation to pregnancy is important in maintaining normal uteroplacental perfusion. These changes could potentially explain the different clinical phenotypes associated with impaired placentation and could potentially be used to guide therapy. The aim of this study was to investigate the changes in the maternal systemic circulation in normotensive pregnancies and those complicated by pre-eclampsia (PE). METHODS: This was a prospective case-control study in singleton pregnancies recruited after 20 weeks' gestation, some of whom developed PE and some of whom remained normotensive...
January 2015: Pregnancy Hypertension
Hongbin Gu, Jinfen Liu, Chi Wu
OBJECTIVE: To compare the different outcomes of dexmedetomidine (Dex) vs. propofol combined with sevoflurane in children's laparoscopic surgery by noninvasive continuous cardiac output monitoring (NICOM). METHODS: Twenty-eight ASA class I-II children scheduled for elective laparoscopic surgery under general anesthesia of intravenous and inhalation were randomly divided into two groups by computing random numbers' generation. Group D (Dex + sevoflurane + remifentanil) received an infusion of Dex 1 μg/kg bolus for induction over minutes, and then a maintenance dose of Dex 0...
2014: International Journal of Clinical and Experimental Medicine
Clément Dubost, Adrien Bouglé, Calliope Hallynck, Matthieu Le Dorze, Philippe Roulleau, Catherine Baujard, Dan Benhamou
BACKGROUND AND AIMS: Cardiac output (CO) monitoring and goal-directed therapy during major abdominal surgery is currently used to decrease postoperative complications. However, few monitors are currently available for pediatric patients. Nicom(®) is a noninvasive CO monitoring technique based on the bioreactance principle (analysis of frequency variations of a delivered oscillating current traversing the thoracic cavity). Nicom(®) may be a useful monitor for pediatric patients. SUBJECTS AND METHODS: Pediatric patients undergoing major abdominal surgery under general anesthesia with cardiac monitoring by transesophageal Doppler (TED) were included...
January 2015: Indian Journal of Critical Care Medicine
Michael A Jones, Raj Khiani, Paul Foley, David Webster, Norman Qureshi, Kelvin C K Wong, Kim Rajappan, Yaver Bashir, Timothy R Betts
BACKGROUND: Quadripolar left ventricular pacing leads permit a variety of pacing configurations from different sites within a coronary vein. There may be advantages to selecting a specific pacing vector. This study examines whether the range of cardiac outputs obtained at cardiac resynchronization therapy (CRT) implantation is greater between different poles within a vein, or greater between two different veins. METHODS AND RESULTS: The cardiac index (CI, L/min/m(2) ) was measured during CRT implantation using a noninvasive cardiac output monitor (NICOM™, Cheetah Medical Inc...
February 2015: Pacing and Clinical Electrophysiology: PACE
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