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Non-invasive cardiac monitoring

Jörn Grensemann
Routine use of cardiac output (CO) monitoring became available with the introduction of the pulmonary artery catheter into clinical practice. Since then, several systems have been developed that allow for a less-invasive CO monitoring. The so-called "non-calibrated pulse contour systems" (PCS) estimate CO based on pulse contour analysis of the arterial waveform, as determined by means of an arterial catheter without additional calibration. The transformation of the arterial waveform signal as a pressure measurement to a CO as a volume per time parameter requires a concise knowledge of the dynamic characteristics of the arterial vasculature...
2018: Frontiers in Medicine
Karthik Vishwanath, Rajan Gurjar, David Wolf, Suzannah Riccardi, Michael Duggan, David King
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation...
February 1, 2018: Biomedical Optics Express
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
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
Rayan Saab, Pradeep Bhambhvani, Ami E Iskandrian, Fadi G Hage
Cardiac sarcoidosis has long been an evasive diagnosis with a spectrum of clinical presentations that extend from asymptomatic to ventricular arrhythmias and sudden cardiac death. The diagnosis has traditionally relied on histology which suffers from the low sensitivity of endomyocardial biopsy due to the patchy nature of the disease in addition to its invasive nature. Due to significant advancements in imaging, it is now possible to accurately identify cardiac sarcoidosis using non-invasive imaging modalities even without histological confirmation...
February 8, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Philip J Peyton, Monique Kozub
Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO 2 elimination (VCO 2 ) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO 2 and end-tidal CO 2 concentration with each breath...
February 8, 2018: Journal of Clinical Monitoring and Computing
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
Prasan Kumar Sahoo, Hiren Kumar Thakkar, Wen-Yen Lin, Po-Cheng Chang, Ming-Yih Lee
Cardiovascular disease (CVD) is a major public concern and socioeconomic problem across the globe. The popular high-end cardiac health monitoring systems such as magnetic resonance imaging (MRI), computerized tomography scan (CT scan), and echocardiography (Echo) are highly expensive and do not support long-term continuous monitoring of patients without disrupting their activities of daily living (ADL). In this paper, the continuous and non-invasive cardiac health monitoring using unobtrusive sensors is explored aiming to provide a feasible and low-cost alternative to foresee possible cardiac anomalies in an early stage...
January 28, 2018: Sensors
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
Marie Janaillac, Thierry P Beausoleil, Keith J Barrington, Marie-Josée Raboisson, Oliver Karam, Mathieu Dehaes, Anie Lapointe
Haemodynamic assessment during the transitional period in preterm infants is challenging. We aimed to describe the relationships between cerebral regional tissue oxygen saturation (CrSO2), perfusion index (PI), echocardiographic, and clinical parameters in extremely preterm infants in their first 72 h of life. Twenty newborns born at < 28 weeks of gestation were continuously monitored with CrSO2 and preductal PI. Cardiac output was measured at H6, H24, H48, and H72. The median gestational age and birth weight were 25...
January 27, 2018: European Journal of Pediatrics
Rachel Lord, David MacLeod, Keith George, David Oxborough, Rob Shave, Mike Stembridge
An acute non-invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate (HR), whereas blood volume extraction reduces preload without HR changes. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (4 female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end-extraction following the controlled removal of 25% of total blood volume (1062 ± 342 ml)...
January 18, 2018: Experimental Physiology
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
Baptiste Fohlen, Quentin Tavernier, Thi-Mum Huynh, Cédric Caradeuc, Delphine Le Corre, Gildas Bertho, Bernard Cholley, Nicolas Pallet
Many stressors that are encountered upon kidney injury are likely to trigger endoplasmic reticulum (ER) stress, subsequently activating transcriptional, translational and metabolic reprogramming. Monitoring early cellular adaptive responses engaged after hemodynamic impairment yields may represent a clinically relevant approach. However, a non-invasive method for detecting the ER stress response has not been developed. We combined a metabolomic approach with genetic marker analyses using urine from individuals undergoing scheduled cardiac surgery under cardiopulmonary bypass to investigate the feasibility and significance of monitoring the ER stress response in the kidney...
December 20, 2017: EBioMedicine
Rafael Morales-Soriano, Neus Esteve-Pérez, Juan José Segura-Sampedro, Pedro Cascales-Campos, Pedro Barrios
INTRODUCTION: Radical Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), has been proposed as the current standard of treatment for metastatic peritoneal disease by several tumors. Despite its widely utilization, there seems to be a great variability in their organization, clinical practice, and safety among centers. AIM OF THE STUDY: To obtain updated information on clinical practice in different perioperative areas of the CRS-HIPEC...
February 2018: European Journal of Surgical Oncology
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
Anton S Becker, Andreas Boss, Markus Klarhoefer, Tim Finkenstaedt, Moritz C Wurnig, Cristina Rossi
The quantitative and non-invasive monitoring of cerebrospinal fluid (CSF) dynamics and composition may have high clinical relevance in the management of CSF disorders. In this study, we propose the use of the Intravoxel Incoherent Motion (IVIM) MRI for obtaining simultaneous measurements of CSF self-diffusion and fluid circulation. The rationale for this study was that turbulent fluid and mesoscopic fluid fluctuations can be modeled in a first approximation as a fast diffusion process. In this case, we expect that the fast fluid circulation and slower molecular diffusion dynamics can be quantified, assuming a bi-exponential attenuation pattern of the diffusion-weighted signal in MRI...
December 8, 2017: NeuroImage
Ana Rodríguez Sánchez de la Blanca, M Sánchez Luna, N González Pacheco, M Arriaga Redondo, N Navarro Patiño
Closure of a patent ductus arteriosus (PDA) in preterm infants modifies cardiac output and induces adaptive changes in the hemodynamic situation. The present study aims to analyze those changes, through a non-invasive cardiac output monitor based on blood electrical velocimetry, in preterm babies. A prospective observational study of preterm infants with a gestational age of less than 28 weeks, and a hemodynamic significant PDA, requires intravenous ibuprofen or surgical closure. All patients were monitored with electrical velocimetry before treatment and through the following 72 h...
February 2018: European Journal of Pediatrics
P Sutha, V E Jayanthi
Birth defect-related demise is mainly due to congenital heart defects. In the earlier stage of pregnancy, fetus problem can be identified by finding information about the fetus to avoid stillbirths. The gold standard used to monitor the health status of the fetus is by Cardiotachography(CTG), cannot be used for long durations and continuous monitoring. There is a need for continuous and long duration monitoring of fetal ECG signals to study the progressive health status of the fetus using portable devices. The non-invasive method of electrocardiogram recording is one of the best method used to diagnose fetal cardiac problem rather than the invasive methods...
December 8, 2017: Journal of Medical Systems
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
January 2018: Der Anaesthesist
Prashant Rao, Jack B Keenan, Taufiek K Rajab, Alice Ferng, Samuel Kim, Zain Khalpey
We describe the intraoperative non-invasive use of an infrared (IR) camera to monitor Del Nido cardioplegia delivery in patients undergoing cardiac surgery. Thermal pictures were taken pre- and post-cardioplegia and at timed points after arrest, and compared to readings from a transseptal temperature probe. There was good concordance between the transseptal probe and the IR camera temperature readings. This non-invasive technique, which assesses cardioplegic distribution, may help to determine when additional doses of Del Nido cardioplegia are required during periods of cardioplegic arrest...
December 2017: Journal of Cardiac Surgery
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