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Cardiac Output monitors

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https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#1
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#2
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29127235/cardiac-performance-is-limited-by-oxygen-delivery-to-the-mitochondria-in-the-crystalloid-perfused-working-heart
#3
Sarah Kuzmiak-Glancy, Raul Covian, Armel N Femnou, Brian Glancy, Rafael Jaimes, Anastasia M Wengrowski, Kara Garrott, Stephanie French, Robert S Balaban, Matthew W Kay
The left ventricular (LV) working, crystalloid-perfused heart is used extensively to evaluate basic cardiac function, pathophysiology, and pharmacology. Crystalloid-perfused hearts may be limited by oxygen delivery, as adding oxygen carriers increases myoglobin oxygenation and improves myocardial function. However, whether decreased myoglobin oxygen saturation impacts oxidative phosphorylation (OxPhos) is unresolved since myoglobin has a much lower affinity for oxygen than cytochrome c oxidase (COX). In the present study, a laboratory-based synthesis of an affordable perfluorocarbon (PFC) emulsion was developed to increase perfusate oxygen-carrying capacity without impeding optical absorbance assessments...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29122526/extracorporeal-myocardial-shockwave-therapy-a-precious-blast-for-refractory-angina-patients
#4
Massimo Slavich, Giuseppe Pizzetti, Anna Maria Vella, Claudia Carlucci, Davide Margonato, Roberto Spoladore, Gabriele Fragasso, Alberto Margonato
INTRODUCTION: Refractory Angina Pectoris (RAP) dramatically affects patients' life quality and medical costs. External Shockwave Myocardial Revascularization (ESMR) improves the cardiac blood flow thanks to its pro-angiogenetic action on ischaemic tissues. We hereby describe our experience of ESMR in RAP patients. MATERIALS AND METHODS: This is a retrospective study encompassing all patients referred to OSR for RAP treatment. Efficacy of ESMR was assessed considering the difference between pre and post therapy data in SAQ score and CCS, stress test performance, 24h ECG monitoring, NT-proBNP and echocardiographic measures...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29121915/clinical-monitoring-of-cardiac-output-assessed-by-transoesophageal-echocardiography-in-anaesthetised-dogs-a-comparison-with-the-thermodilution-technique
#5
Matheus M Mantovani, Denise T Fantoni, André M Gimenes, Jacqueline R de Castro, Patrícia B Flor, Keila K Ida, Denise S Schwartz
BACKGROUND: Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65-80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery...
November 9, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29117189/cardiac-cycle-synchronized-electrical-muscle-stimulator-for-lower-limb-training-with-the-potential-to-reduce-the-heart-s-pumping-workload
#6
Ken-Ichiro Sasaki, Hiroo Matsuse, Ryuji Akimoto, Shiro Kamiya, Toshio Moritani, Motoki Sasaki, Yuta Ishizaki, Masanori Ohtsuka, Takaharu Nakayoshi, Takafumi Ueno, Naoto Shiba, Yoshihiro Fukumoto
BACKGROUND: The lower limb muscle may play an important role in decreasing the heart's pumping workload. Aging and inactivity cause atrophy and weakness of the muscle, leading to a loss of the heart-assisting role. An electrical lower limb muscle stimulator can prevent atrophy and weakness more effectively than conventional resistance training; however, it has been reported to increase the heart's pumping workload in some situations. Therefore, more effective tools should be developed...
2017: PloS One
https://www.readbyqxmd.com/read/29113557/correlation-of-lactic-acid-and-base-deficit-values-obtained-from-arterial-and-peripheral-venous-samples-in-a-pediatric-population-during-intraoperative-care
#7
Brianne M Bordes, Hina Walia, Roby Sebastian, David Martin, Dmitry Tumin, Joseph D Tobias
Lactic acid and base deficit (BD) values are frequently monitored in the intensive care unit and operating room setting to evaluate oxygenation, ventilation, cardiac output, and peripheral perfusion. Although generally obtained from an arterial cannula, such access may not always be available. The current study prospectively investigates the correlation of arterial and peripheral venous values of BD and lactic acid. The study cohort included 48 patients. Arterial BD values ranged from -8 to 4 mEq/L and peripheral venous BD values ranged from -8 to 4 mEq/L...
December 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29105685/-cardiogenic-shock-from-pharmacological-treatment-to-mechanical-circulatory-support
#8
Ilaria Battistoni, Marco Marini, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Massimo Iacoviello, Renata De Maria, Alessandro Navazio, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a state of critical end-organ hypoperfusion due to reduced cardiac output, despite adequate filling status. The development of multiorgan dysfunction is believed to be the major contributor to the high early mortality. Little evidence exists as to which vasopressor or inotrope should best be used for early treatment; however, customized pharmacological therapy, tailored on hemodynamic monitoring, is essential to achieve normal peripheral perfusion. Moreover, an increasing number of mechanical circulatory support devices are available for hemodynamic support in patients with CS but, at present, data derived from randomized clinical trials on the effectiveness, safety, differential indications for mechanical support devices, and optimal implant timing are limited...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29105684/-cardiogenic-shock-from-early-diagnosis-to-multiparameter-monitoring
#9
Marco Marini, Ilaria Battistoni, Alberto Lavorgna, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Giorgio Caretta, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Andrea Mortara, Daniela Pini, Renata De Maria, Nadia Aspromonte, Andrea Di Lenarda, Michele Massimo Gulizia, Serafina Valente
Cardiogenic shock (CS) is a life-threatening condition that occurs in response to reduced cardiac output, in the presence of adequate intravascular volume, and results in tissue hypoxia. CS can occur as a result of several etiologies but the most common is acute myocardial infarction. Despite the introduction of emergency revascularization for CS complicating acute myocardial infarction, mortality still remains exceptionally high, particularly in patients with refractory CS. The diagnosis of CS is sometimes challenging and it is based on clinical, hemodynamic, and biochemical signs...
October 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#10
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29094424/fetal-sheep-central-hemodynamics-and-cardiac-function-during-ascending-aorta-occlusion
#11
Heikki Huhta, Juulia Junno, Mervi Haapsamo, Tiina Erkinaro, Pasi Ohtonen, Lowell E Davis, A Roger Hohimer, Ganesh Acharya, Juha Rasanen
Fetal aortic isthmus (AoI) allows communication between left (LV) and right (RV) ventricular outputs and represents arterial watershed between the brachiocephalic (brain) and subdiaphragmatic (placenta) circulations. To understand the capability of AoI to maintain the balance between upper and lower body circulations, we performed a complete fetal ascending aorta occlusion in 9 chronically instrumented sheep at near term gestation. We hypothesized that the occlusion would significantly decrease LV output and concomitantly increase RV output in order to maintain adequate systemic cardiac output and perfusion pressure to the fetal brain circulation through retrograde filling of the AoI...
November 2, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#12
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29090260/assessment-of-method-agreement-between-two-minimally-invasive-hemodynamic-measurements-in-septic-shock-patients-on-high-doses-of-vasopressor-drugs-a-preliminary-study
#13
Oana Antal, Mihai Mărginean, Natalia Hagău
BACKGROUND: Minimally invasive hemodynamic monitoring is still controversial among the methods used to assess the hemodynamic profile of the septic shock patient. The aim of this study was to test the level of agreement between two different devices. METHODS: We collected 385 data entries during 12-hour intervals from four critically ill patients with septic shock and high doses of vasoactive therapy using two minimally invasive methods at the same time: Vigileo™ device which uses the pulse contour principle, and EV1000™ monitoring platform which uses the transpulmonary thermodilution principle...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29077613/pressure-waveform-analysis
#14
Mathieu Jozwiak, Xavier Monnet, Jean-Louis Teboul
Monitoring cardiac output is of special interest for detecting early hemodynamic impairment and for guiding its treatment. Among the techniques that are available to monitor cardiac output, pressure waveform analysis estimates cardiac output from the shape of the arterial pressure curve. It is based on the general principle that the amplitude of the systolic part of the arterial curve is proportional to cardiac output and arterial compliance. Such an estimation of cardiac output has the advantage of being continuous and in real time...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29073767/arterial-stiffness-is-associated-with-qtc-interval-prolongation-in-patients-with-heart-failure
#15
Salah Al-Zaiti, Samir Saba, Rodolfo Pike, Jennifer Williams, Fadi Khraim
BACKGROUND: A prolonged corrected QT (QTc) interval is a known risk factor for adverse cardiac events. Understanding the determinants and physiologic correlates of QTc is necessary for selecting proper strategies to reduce the risk of adverse events in high-risk patients. We sought to evaluate the role of arterial stiffness in heart failure as a determinant of QTc prolongation. METHOD: This was an observational study that recruited ambulatory heart failure patients (New York Heart Association Classes I-II) from an outpatient heart failure clinic...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/29064159/influence-of-catecholamines-at-different-dosages-on-the-function-of-the-lidco-sensor-in-isoflurane-anesthetized-horses
#16
Klaus Hopster, Tamas D Ambrisko, Sabine B R Kästner
OBJECTIVE: To compare the lithium dilution method for cardiac output (LiDCO) and bolus-thermo-dilution (BTD) measurements before and during infusion of dobutamine, dopamine, phenylephrine, or noradrenaline at 2 different doses in anesthetized horses and to examine the correlation between sensor voltages (saline-blood exposed) and possible measurement errors. DESIGN: Prospective experimental study. SETTING: University teaching hospital. ANIMALS: Nine Warmblood horses...
November 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29062560/use-of-a-minimally-invasive-cardiac-output-monitor-to-optimise-haemodynamics-in-a-patient-with-mitral-valve-disease-undergoing-cerebrovascular-surgery
#17
Ali M Al-Mashani, Niranjan D Waje, Neeraj Salhotra, Samaresh Das, Neelam Suri, Rashid A Al-Sheheimi, Nilay Chatterjee
Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29061119/computer-controlled-closed-loop-drug-infusion-system-for-automated-hemodynamic-resuscitation-in-endotoxin-induced-shock
#18
Kazunori Uemura, Toru Kawada, Can Zheng, Meihua Li, Masaru Sugimachi
BACKGROUND: Hemodynamic resuscitation in septic shock requires aggressive fluid replacement and appropriate use of vasopressors to optimize arterial pressure (AP) and cardiac output (CO). Because responses to these drugs vary between patients and within patient over time, strict monitoring of patient condition and repetitive adjustment of drug dose are required. This task is time and labor consuming, and is associated with poor adherence to resuscitation guidelines. To overcome this issue, we developed a computer-controlled closed-loop drug infusion system for automated hemodynamic resuscitation in septic shock, and evaluated the performance of the system in a canine model of endotoxin shock...
October 23, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29060676/gamma-variate-modeling-of-indicator-dilution-curves-in-electrical-impedance-tomography
#19
Benjamin Hentze, Thomas Muders, Henning Luepschen, Steffen Leonhardt, Christian Putensen, Marian Walter
Electrical impedance tomography (EIT) is a non-invasive imaging technique, that can be used to monitor regional lung ventilation (V̇) in intensive care units (ICU) at bedside. This work introduces a method to extract regional lung perfusion (Q̇) from EIT image streams in order to quantify regional gas exchange in the lungs. EIT data from a single porcine animal trial, recorded during injection of a contrast agent (NaCl 10%) into a central venous catheter (CVC), are used for evaluation. Using semi-negative matrix factorization (Semi-NMF) a set of source signals is extracted from the data...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059883/monitoring-of-cardiac-output-and-lung-ventilation-by-electrical-impedance-tomography-in-a-porcine-model-of-acute-lung-injury
#20
Nadine Hochhausen, Henriette Dohmeier, Rolf Rossaint, Michael Czaplik
Adequate medical treatment of the Acute Respiratory Distress Syndrome is still challenging since patient-individual aspects have to be taken into account. Lung protective ventilation and hemodynamic stability have always been two of the most crucial aims of intensive care therapy. For both aspects, a continuous - preferably non-invasive - monitoring is desirable that is available at the bedside. Unfortunately, there is no technique clinically established yet, that provides both measurement of cardiac stroke volume and ventilation dynamics in real-time...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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