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Anton Krige, Martin Bland, Thomas Fanshawe
BACKGROUND: Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are used to predict the need for subsequent fluid loading. This requires a device that can measure CO changes rapidly. The Vigileo™ monitor, using third-generation software, allows continuous CO monitoring. The aim of this study was to compare changes in CO (measured with the Vigileo device) during a PLR manoeuvre to calculate the accuracy for predicting fluid responsiveness...
2016: Journal of Intensive Care
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
Kohshi Hattori, Takuma Maeda, Tetsuhito Masubuchi, Atsushi Yoshikawa, Keigo Ebuchi, Kuniko Morishima, Masataka Kamei, Kenji Yoshitani, Yoshihiko Ohnishi
OBJECTIVES: To determine the accuracy and trending ability of the fourth-generation FloTrac/Vigileo in patients with low cardiac index by comparing FloTrac/Vigileo-derived cardiac index with that measured by 3-dimensional echocardiography. DESIGN: Prospective clinical study. SETTING: Cardiac surgery operating room in a single cardiovascular center. PARTICIPANTS: Twenty-five patients undergoing elective cardiac resynchronization therapy lead implantation...
June 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Cem Aritürk, Meltem Açil, Halim Ulugöl, Zehra Serpil Ustalar Özgen, Eyüp Murat Ökten, Sinan Dağdelen, Eşref Hasan Karabulut, Hüseyin Cem Alhan, Fevzi Toraman
BACKGROUND/AIM: The aim of the current study was to assess the accuracy of cardiac output (CO) measurements obtained by the Nexfin finger cuff method as compared with the FloTrac/Vigileo and echocardiography methods in coronary artery bypass grafting (CABG) patients. MATERIALS AND METHODS: First-time elective CABG patients were prospectively enrolled in this study and divided into three groups according to CO measurement method. CO measurements were performed simultaneously by three different contributors and were collected by the fourth one 24 h postoperative in the intensive care unit (ICU)...
2016: Turkish Journal of Medical Sciences
Xiaobao Zhang, Jiying Feng, Pin Zhu, Hengfei Luan, Yong Wu, Zhibin Zhao
BACKGROUND: Both hypovolemia and hypervolemia are connected with increased morbidity and mortality in the treatment and prognosis of patients. An accurate assessment of volume state allows the optimization of organ perfusion and oxygen supply. Recently, ultrasonography has been used to detect hypovolemia in critically ill patients and perioperative patients. The objective of our study was to assess the correlation between inferior vena cava (IVC) variation obtained with ultrasound and stroke volume variation (SVV) measured by the Vigileo/FloTrac monitor, as fluid responsiveness indicators, in patients undergoing anesthesia for surgery...
July 2016: Journal of Surgical Research
B-F Shih, P-H Huang, H-P Yu, F-C Liu, C-C Lin, P C-H Chung, C-Y Chen, C-J Chang, Y-F Tsai
BACKGROUND: Liver transplant recipients often have violent hemodynamic fluctuation during surgery that may be related to perioperative and postoperative morbidity. Because there are some considerations for the risk of the pulmonary arterial catheter (PAC), the conventional invasive device for cardiac output (CO) measurement, a reliable and minimally invasive alternative is required. We validated the reliability of CO measurements with the use of a minimally invasive FloTrac system with the latest fourth-generation algorithm in liver transplant recipients...
May 2016: Transplantation Proceedings
Matthieu Biais, Laurent Stecken, Aurélie Martin, Stéphanie Roullet, Alice Quinart, François Sztark
Non-invasive respiratory variations in arterial pulse pressure using infrared-plethysmography (PPVCNAP) are able to predict fluid responsiveness in mechanically ventilated patients. However, they cannot be continuously monitored. The present study evaluated a new algorithm allowing continuous measurements of PPVCNAP (PPVCNAPauto) (CNSystem, Graz, Austria). Thirty-five patients undergoing vascular surgery were studied after induction of general anaesthesia. Stroke volume was measured using the Vigileo(TM)/FloTrac(TM)...
June 16, 2016: Journal of Clinical Monitoring and Computing
Masaaki Asamoto, Ryo Orii, Mikiya Otsuji, Masahiko Bougaki, Yousuke Imai, Yoshitsugu Yamada
Knowing a patient's cardiac output (CO) could contribute to a safe, optimized hemodynamic control during surgery. Precise CO measurements can serve as a guide for resuscitation therapy, catecholamine use, differential diagnosis, and intervention during a hemodynamic crisis. Despite its invasiveness and intermittent nature, the thermodilution technique via a pulmonary artery catheter (PAC) remains the clinical gold standard for CO measurements. LiDCOrapid™ (LiDCO, London, UK) and FloTrac/Vigileo™ (Edwards Lifesciences, Irvine, CA) are less invasive continuous CO monitors that use arterial waveform analysis...
June 14, 2016: Journal of Clinical Monitoring and Computing
Pedro Marques, Miguel Nobre Menezes, Gustavo Lima da Silva, Ana Bernardes, Andreia Magalhães, Nuno Cortez-Dias, Luís Carpinteiro, João de Sousa, Fausto J Pinto
INTRODUCTION AND AIM: Multi-site pacing is emerging as a new method for improving response to cardiac resynchronization therapy (CRT), but has been little studied, especially in patients with atrial fibrillation. We aimed to assess the effects of triple-site (Tri-V) vs. biventricular (Bi-V) pacing on hemodynamics and QRS duration. METHODS: This was a prospective observational study of patients with permanent atrial fibrillation and ejection fraction <40% undergoing CRT implantation (n=40)...
June 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
T D Phan, R Kluger, C Wan
There is lack of data about the agreement of minimally invasive cardiac output monitors, which make it impossible to determine if they are interchangeable or differ objectively in tracking physiological trends. We studied three commonly used devices: the oesophageal Doppler and two arterial pressure-based devices, the Vigileo FloTrac™ and LiDCOrapid™. The aim of this study was to compare the agreement of these three monitors in adult patients undergoing elective non-cardiac surgery. Measurements were taken at baseline and after predefined clinical interventions of fluid, metaraminol or ephedrine bolus...
May 2016: Anaesthesia and Intensive Care
Hidemasa Takahashi, Dai Shida, Kyoko Tagawa, Takeo Suzuki
BACKGROUND: Mesenteric traction syndrome (MTS) develops in the early phase of laparotomy, which is triggered by pulling of the mesentery. We attempted to analyze the circulatory dynamics of MTS by using the FloTrac sensor. METHODS: Prospective randomized control study, the MTS trial, was conducted with or without prophylactic administration of flurbiprofen axetil in order to control MTS development in 57 elective open colorectal surgeries. None of the Flurbipurofen group patients (n = 23) develop MTS and were allocated to the non-MTS group...
May 2016: Journal of Clinical Anesthesia
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
Lisa Sangkum, Geoffrey L Liu, Ling Yu, Hong Yan, Alan D Kaye, Henry Liu
Although cardiac output (CO) by pulmonary artery catheterization (PAC) has been an important guideline in clinical management for more than four decades, some studies have questioned the clinical efficacy of CO in certain patient populations. Further, the use of CO by PAC has been linked to numerous complications including dysrhythmia, infection, rupture of pulmonary artery, injury to adjacent arteries, embolization, pulmonary infarction, cardiac valvular damage, pericardial effusion, and intracardiac catheter knotting...
June 2016: Journal of Anesthesia
Matthew Lee, Laurence Weinberg, Brett Pearce, Nicholas Scurrah, David A Story, Param Pillai, Peter R McCall, Larry P McNicol, Philip J Peyton
To study agreement in cardiac index (CI), systemic vascular resistance index (Systemic VRI) and stroke volume variation (SV variation) between the FloTrac/Vigileo at radial and femoral arterial cannulation sites, and pulmonary artery catheter (PAC) thermodilution, in patients undergoing orthotopic liver transplantation. A prospective observational study of 25 adult patients with liver failure. Radial and femoral arteries were cannulated with standardised FloTrac/Vigileo arterial transducer kits and a PAC was inserted...
February 16, 2016: Journal of Clinical Monitoring and Computing
Takuma Maeda, Ryo Sakurai, Katsura Nakagawa, Kuniko Morishima, Masayuki Maekawa, Kyoko Furumoto, Toshihiko Kono, Atsushi Egawa, Yosuke Kubota, Shinya Kato, Hideo Okamura, Kenji Yoshitani, Yoshihiko Ohnishi
OBJECTIVES: First, to examine the perioperative association between increased cardiac index (CI) measured using three-dimensional echocardiography (CI3D), two-dimensional echocardiography (CI2D), and FloTrac/Vigileo (CIFT) (Edwards Lifesciences, Irvine, CA) after cardiac resynchronization therapy (CRT) and decreased brain natriuretic peptide (BNP) 6 months after CRT. Second, to evaluate the accuracy and tracking ability of CI2D and CIFT. DESIGN: A prospective clinical study...
June 2016: Journal of Cardiothoracic and Vascular Anesthesia
J C Lewejohann, H Braasch, M Hansen, C Zimmermann, E Muhl, T Keck
BACKGROUND: Appropriate fluid resuscitation is a fundamental aspect for the hemodynamic management of septic shock patients and should ideally be achieved before vasopressors and positive inotropic substances are administered. The development of hemodynamic monitoring has revealed that in some cases patients had been improperly treated with high-dose catecholamines for initially insufficient fluid resuscitation. The aim of this study was to show that in some cases it is possible to actively reduce catecholamines by a volume challenge adapted according to the individual patient needs...
September 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Lihua Wang, Yi Xu, Weiwen Zhang, Wei Lu, Meiqin Chen, Jian Luo
AIM: The aim of this study was to investigate the clinical significance of minimally invasive hemodynamic monitoring in the early catheter-based intervention for acute massive pulmonary embolism (PE). METHODS: A total of 40 cases with acute massive PE were randomized into experimental and control group with 20 cases in each group. In the experimental group, the hemodynamics was monitored via Vigileo/FloTrac system, while echocardiography was used in the control group...
2015: International Journal of Clinical and Experimental Medicine
Ji-Hyun Chin, Wook-Jong Kim, Jeong-Hyun Choi, Yun A Han, Seon-Ok Kim, Woo-Jong Choi
BACKGROUND: The FloTrac/Vigileo™ system does not thoroughly reflect variable arterial tones, due to a lack of external calibration. The ability of this system to measure stroke volume and track its changes after fluid administration has not been fully evaluated in patients with the high systemic vascular resistance that can develop during laparoscopic surgery. METHODS: In 42 patients undergoing laparoscopic prostatectomy, the stroke volume derived by the third-generation FloTrac/Vigileo™ system (SV-Vigileo), the stroke volume measured using transesophageal echocardiography (SV-TEE) as a reference method, and total systemic vascular resistance were evaluated before and after 500 ml fluid administration during pneumoperitoneum combined with the Trendelenburg position...
2015: PloS One
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takayuki Kunisawa, Hiroshi Iwasaki
PURPOSE: The aim of this study was to investigate fluid loading-induced changes in left ventricular end-diastolic volume (LVEDV) and stroke volume variability (SVV) in patients with end-stage renal disease (ESRD) using real-time three-dimensional transesophageal echocardiography and the Vigileo-FloTrac system. PATIENTS AND METHODS: After obtaining ethics committee approval and informed consent, 28 patients undergoing peripheral vascular procedures were studied. Fourteen patients with ESRD on hemodialysis (HD) were assigned to the HD group and 14 patients without ESRD were assigned to the control group...
2015: Therapeutics and Clinical Risk Management
Leonard J Montenij, Johannes P Sonneveld, Arno P Nierich, Wolfgang F Buhre, Eric E De Waal
OBJECTIVES: Uncalibrated arterial waveform analysis provides minimally invasive and continuous measurement of cardiac output (CO). This technique could be of great value in patients with impaired left ventricular function, but the validity in these patients is not well established. The aim of this study was to investigate the accuracy, precision, and trending ability of uncalibrated arterial waveform analysis of cardiac output in patients with impaired left ventricular function. DESIGN: Prospective, observational, method-comparison study...
January 2016: Journal of Cardiothoracic and Vascular Anesthesia
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