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https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#1
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767416/utility-of-electrical-velocimetry-based-noninvasive-stroke-volume-variation-in-predicting-fluid-responsiveness-under-different-ventilation-modes-in-anaesthetized-dogs
#2
Kazumasu Sasaki, Tatsushi Mutoh, Shuzo Yamamoto, Yasuyuki Taki, Ryuta Kawashima
We evaluated the utility of noninvasive stroke volume variation (SVV) as a functional haemodynamic predictor for fluid responsiveness under different ventilation modes [assist control (A/C), synchronized intermittent mandatory ventilation (SIMV), and continuous positive airway pressure (CPAP)] in 45 anaesthetized dogs, using an electrical velocimetry device. Receiver operating curve analysis confirmed the best predictive value during SVVA /C (12.5% of cut-off value; 75% sensitivity and 86% specificity) followed by SVVSIMV (13...
May 16, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29764550/-predictive-value-of-central-venous-to-arterial-carbon-dioxide-partial-pressure-difference-for-fluid-responsiveness-in-septic-shock-patients-a-prospective-clinical-study
#3
Guangyun Liu, Huibin Huang, Hanyu Qin, Bin Du
OBJECTIVE: To evaluate the accuracy of central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2 ) before and after rapid rehydration test (fluid challenge) in predicting the fluid responsiveness in patients with septic shock. METHODS: A prospective observation was conducted. Forty septic shock patients admitted to medical intensive care unit (ICU) of Peking Union Medical College Hospital from October 2015 to June 2017 were enrolled. All of the patients received fluid challenge in the presence of invasive hemodynamic monitoring...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29756692/the-presence-of-elastic-compression-stockings-reduces-the-fluid-responsiveness-of-patients-in-the-operating-room
#4
Elie Zogheib, Julien Maizel, Nabil Cherradi, Ammar Benammar, Béatrice Labont, Abdel Hchikat, Michael Bernasinski, Faouzi Trojette, Michel Slama, Hervé Dupont
BACKGROUND: To investigate whether elastic compression stockings (ECS) can affect fluid responsiveness parameters before and during passive leg raising (PLR) maneuvers. METHODS: In the operating room (OR), we performed a prospective study including patients referred for cardiac surgery. Blood pressure (BP), ΔPP, heart rate (HR), central venous pressure (CVP), stroke volume (SV) and aortic blood flow (ABF) (by esophageal doppler) were measured according to four conditions: supine position without ECS (baseline 1), lower limbs raised to an angle of 45° (PLR 1), returned to the supine position with ECS (baseline 2), then a second PLR maneuver with ECS was performed (PLR 2)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744245/reliability-of-passive-leg-raising-stroke-volume-variation-and-pulse-pressure-variation-to-predict-fluid-responsiveness-during-weaning-from-mechanical-ventilation-after-cardiac-surgery-a-prospective-observational-study
#5
Christoph Karl Hofer, Martin Geisen, Sonja Hartnack, Omer Dzemali, Michael Thomas Ganter, Andreas Zollinger
Objective: During assisted ventilation and spontaneous breathing, functional haemodynamic parameters, including stroke volume variation (SVV) and pulse pressure variation (PPV), are of limited value to predict fluid responsiveness, and the passive leg raising (PLR) manoeuvre has been advocated as a surrogate method. We aimed to study the predictive value of SVV, PPV and PLR for fluid responsiveness during weaning from mechanical ventilation after cardiac surgery. Methods: Haemodynamic variables and fluid responsiveness were assessed in 34 patients...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29742951/carotid-flow-as-a-surrogate-for-cardiac-output-measurement-in-hemodynamically-stable-participants
#6
Marian Sidor, Lalith Premachandra, Bishoy Hanna, Nanda Nair, Amit Misra
OBJECTIVE: Evaluation of common carotid artery (CCA) blood flow can provide valuable information regarding the hemodynamic status of a patient. Utilizing ultrasound, we aimed to evaluate the correlation between cardiac output and different hemodynamic parameters in the CCA, namely systolic carotid flow (SCF), corrected flow time (CFT), and total carotid flow (TCF). METHODS: We studied a pilot sample of 20 healthy volunteers. Hemodynamic parameters were collected in the right CCA and the heart at rest (baseline), 1-leg compression, 2-leg compression, and passive leg raise...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29716910/noninvasive-blood-pressure-monitoring-and-prediction-of-fluid-responsiveness-to-passive-leg-raising
#7
Joya D Pickett, Elizabeth Bridges, Patricia A Kritek, JoAnne D Whitney
BACKGROUND: Intravenous fluid boluses are administered to patients in shock to improve tissue hypoperfusion. However, fluid boluses result in clinically significant stroke volume increases in only about 50% of patients. Hemodynamic responses to passive leg raising measured with invasive and minimally invasive methods are accurate predictors of fluid responsiveness. However, few studies have used noninvasive blood pressure measurement to evaluate responses to passive leg raising. OBJECTIVE: To determine if passive leg raising-induced increases in pulse pressure or systolic blood pressure can be used to predict clinically significant increases in stroke volume index in healthy volunteers...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29687277/early-goal-directed-therapy-using-a-physiological-holistic-view-the-andromeda-shock-a-randomized-controlled-trial
#8
Glenn Hernández, Alexandre Biasi Cavalcanti, Gustavo Ospina-Tascón, Fernando Godinho Zampieri, Arnaldo Dubin, F Javier Hurtado, Gilberto Friedman, Ricardo Castro, Leyla Alegría, Maurizio Cecconi, Jean-Louis Teboul, Jan Bakker
BACKGROUND: Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate-targeted resuscitation is the gold-standard under current guidelines, although it has several pitfalls including that non-hypoxic sources of lactate might predominate in an unknown proportion of patients. Peripheral perfusion-targeted resuscitation might provide a real-time response to increases in flow that could lead to a more timely decision to stop resuscitation, thus avoiding fluid overload and the risks of over-resuscitation...
April 23, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29679768/comparison-of-proaqt-pulsioflex%C3%A2-and-oesophageal-doppler-for-intraoperative-haemodynamic-monitoring-during-intermediate-risk-abdominal-surgery
#9
Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria
OBJECTIVE: To compare cardiac index (CI) between Proaqt/PulsioFlex® and esophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI. METHODS: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min)...
April 18, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29651944/role-of-point-of-care-ultrasonography-for-management-of-sepsis-and-septic-shock
#10
Gentle Sunder Shrestha, Shrikanth Srinivasan
BACKGROUND: Sepsis and septic shock remain a major cause of morbidity and mortality globally. In recent years, outcome of patients with sepsis and septic shock has gradually improved, in part due to early recognition and timely appropriate management. Bedside physical examination can be of limited value to identify the source of infection and to decide appropriate management. Moreover, the clinical status of these patients can change rapidly, as a part of disease progression or in response to treatment or intervention...
April 12, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/29644558/finger-and-forehead-photoplethysmography-derived-pulse-pressure-variation-and-the-benefits-of-baseline-correction
#11
Shaoxiong Sun, Wouter H Peeters, Rick Bezemer, Xi Long, Igor Paulussen, Ronald M Aarts, Gerrit J Noordergraaf
To non-invasively predict fluid responsiveness, respiration-induced pulse amplitude variation (PAV) in the photoplethysmographic (PPG) signal has been proposed as an alternative to pulse pressure variation (PPV) in the arterial blood pressure (ABP) signal. However, it is still unclear how the performance of the PPG-derived PAV is site-dependent during surgery. The aim of this study is to compare finger- and forehead-PPG derived PAV in their ability to approach the value and trend of ABP-derived PPV. Furthermore, this study investigates four potential confounding factors, (1) baseline variation, (2) PPV, (3) ratio of respiration and heart rate, and (4) perfusion index, which might affect the agreement between PPV and PAV...
April 11, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29621027/cardiac-output-monitoring-how-to-choose-the-optimal-method-for-the-individual-patient
#12
Bernd Saugel, Jean-Louis Vincent
PURPOSE OF REVIEW: To review the different methods available for the assessment of cardiac output (CO) and describe their specific indications in intensive care and perioperative medicine. RECENT FINDINGS: In critically ill patients, persistent circulatory shock after initial resuscitation is an indication for the assessment of CO to monitor the response to fluids and vasoactive agents. In patients with circulatory shock associated with right ventricular dysfunction, pulmonary artery hypertension, or acute respiratory distress syndrome, invasive CO monitoring using indicator dilution methods is indicated...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29593185/effectiveness-of-using-non-invasive-continuous-arterial-pressure-monitoring-with-clearsight-in-hemodynamic-monitoring-during-living-renal-transplantation-in-a-recipient-a-case-report
#13
Nami Kakuta, Yasuo M Tsutsumi, Chiaki Murakami, Yoko Sakai, Takuro Oyama, Asuka Kasai, Katsuyoshi Kume, Katsuya Tanaka
We investigated the effectiveness of the ClearSight system for hemodynamic management during kidney transplantation for a recipient. The recipient was to receive a kidney transplant from his mother under general anesthesia. We used continuous noninvasive finger-cuff-based monitoring of blood pressure, provided by the ClearSight system, and stroke volume variation to predict fluid responsiveness. We used of a balanced anesthetic technique and stringent monitoring standards to ensure a successful outcome for the patient...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29574777/doppler-renal-resistance-index-for-the-prediction-of-response-to-passive-leg-raising-following-cardiac-surgery
#14
William Beaubien-Souligny, Gabriel Huard, Josée Bouchard, Yoan Lamarche, André Denault, Martin Albert
PURPOSE: Doppler-based renal resistance index (RI) can be measured at the bedside of critically ill patients. This study was designed to assess if the RI predicted an increase in cardiac output (CO) following passive leg-raising (PLR) in patients admitted to the intensive care unit after cardiac surgery. METHODS: During this single center prospective study, Doppler assessment of RI and measurements of CO using the thermodilution method were performed, after surgery, in the intensive care unit before and after PLR...
March 25, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29533353/cardiac-index-changes-with-fluid-bolus-therapy-in-children-with-sepsis-an-observational-study
#15
Elliot Long, Franz E Babl, Ed Oakley, Bennett Sheridan, Trevor Duke
OBJECTIVES: Fluid bolus therapy is the initial recommended treatment for acute circulatory failure in sepsis, yet it is unknown whether this has the intended effect of increasing cardiac index. We aimed to describe the effect of fluid bolus therapy on cardiac index in children with sepsis. DESIGN: A prospective observational cohort study. SETTING: The Emergency Department of The Royal Children's Hospital, Melbourne, VIC, Australia. PATIENTS: A convenience sample of children meeting international consensus criteria for sepsis with acute circulatory failure...
March 10, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29520998/does-respiratory-variation-of-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-spontaneously-ventilating-children-with-sepsis
#16
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29519280/-variability-of-peripheral-arterial-peak-velocity-predicts-fluid-responsiveness-in-patients-with-septic-shock
#17
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29506842/evaluation-of-the-fluid-responsiveness-in-patients-with-septic-shock-by-ultrasound-plus-the-passive-leg-raising-test
#18
Jingyi Wu, Zhen Wang, Tao Wang, Tao Yu, Jing Yuan, Qingling Zhang, Weihua Lu, Xia Zhang
BACKGROUND: Prompt, accurate, and noninvasive prediction of fluid responsiveness is still lacking in intensive care unit. This study is to investigate the value of the Doppler ultrasound evaluation of variation in brachial artery peak velocity (VVpeakbrach ) and passive leg raising (PLR)-induced changes in the brachial artery peak velocity (ΔVpeakPLR ) in predicting the fluid responsiveness in mechanically ventilated patients with severe sepsis or septic shock. METHODS: A prospective study was conducted involving 62 patients...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29488025/positive-end-expiratory-pressure-induced-increase-in-external-jugular-venous-pressure-does-not-predict-fluid-responsiveness-in-laparoscopic-prostatectomy
#19
Min Hur, Seokha Yoo, Jung-Yoon Choi, Sun-Kyung Park, Dhong Eun Jung, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: Dynamic change in central venous pressure (CVP) was associated with fluid responsiveness. External jugular venous pressure (EJVP) may reliably estimate CVP and have the advantages of being less invasive. We investigated whether increase in EJVP induced by positive end-expiratory pressure (PEEP) could be a reliable predictor of fluid responsiveness in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). METHODS: Fifty patients who underwent RALP with steep Trendelenburg position were enrolled...
February 27, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29477233/-behaviour-of-stroke-volume-variation-in-hemodynamic-stable-patients-during-thoracic-surgery-with-one-lung-ventilation-periods
#20
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...
May 2018: Revista Brasileira de Anestesiologia
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