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Sjaak Pouwels, Bianca Lascaris, Simon W Nienhuijs, Arthur R Bouwman, Marc P Buise
BACKGROUND: Compared to healthy individuals, obese have significantly higher systolic and diastolic blood pressure, mean arterial pressure, heart rate, and cardiac output. The aim of this study was to evaluate cardiovascular hemodynamic changes before and 3 months after bariatric surgery. METHODS: Patients scheduled for bariatric surgery between the 29th of September 2016 and 24th of March 2016 were included and compared with 24 healthy individuals. Hemodynamic measurements were performed preoperatively and 3 months after surgery, using the Nexfin® non-invasive continuous hemodynamic monitoring device (Edwards Lifesciences/BMEYE B...
January 30, 2017: Obesity Surgery
Richard M Nowak, Brian P Reed, Salvatore DiSomma, Prabath Nanayakkara, Michele Moyer, Scott Millis, Phillip Levy
BACKGROUND: There is little known about the baseline hemodynamic (HD) profiles (beyond pulse/blood pressure) of patients presenting to the Emergency department (ED) with acute heart failure (AHF). Assessing these baseline parameters could help differentiate underlying HD phenotypes which could be used to develop specific phenotypic specific approaches to patient care. METHODS: Patients with suspected AHF were enrolled in the PREMIUM (Prognostic Hemodynamic Profiling in the Acutely Ill Emergency Department Patient) multinational registry and continuous HD monitoring was initiated on ED presentation using noninvasive finger cuff technology (Nexfin, BMEYE, Edwards Lifesciences, Irvine, California)...
December 8, 2016: American Journal of Emergency Medicine
Pär I Johansson, Christian R Mortensen, Tatiana Nielsen, Carsten Tollund, Jakob Stensballe, Carsten P Hansen, Hans J Frederiksen, Sisse R Ostrowski
BACKGROUND: Capillary leakage, secondary to endothelial breakdown, is common in patients undergoing major surgical procedures with extensive tissue injury and this is associated with increased morbidity and mortality. Prostacyclin has been ascribed cytoprotective properties together with its vasodilatory and antiplatelet effects. The present pilot study investigated the safety and endothelial protective effects of low-dose prostacyclin infusion. PATIENTS AND METHODS: A randomized placebo-controlled pilot study evaluating the effect of prostacyclin (iloprost) infusion (1...
December 6, 2016: European Journal of Gastroenterology & Hepatology
Maurits R Hollander, Maarten A H van Leeuwen, Dirk J van der Heijden, Vincent M N Keizer, Peter M van de Ven, Sander J J IJsselmuiden, Nicolas M Van Mieghem, Giovanni Amoroso, Marco J P F Ritt, Paul Knaapen, Niels van Royen
AIMS: This study aims primarily to assess the extent of the collateral circulation of the hand in a combined population of healthy individuals and patients who underwent transradial catheterisation, using both the Nexfin system and laser Doppler perfusion imaging. METHODS AND RESULTS: In total, 85 adults were included in the study (18 healthy volunteers; 67 patients who underwent transradial catheterisation). The perfusion of the thumb was assessed prior to and during complete radial artery compression using laser Doppler perfusion imaging (LDPI) and the Nexfin system...
February 20, 2017: EuroIntervention
Rosie Earle, Himat Vaghadia, Enda Shanahan, Raymond Tang, Andrew Sawka
We report the novel application of photoplethysmographic technology with the Nexfin HD monitor for real-time measurement of blood pressure (BP) in a patient with tetraamelia. The patient was a 58-year-old man with tetraamelia secondary to thalidomide exposure in utero, who presented for surgical excision of a maxillary schwannoma. Because difficulty of cuff use on rudimentary limbs and failure to gain invasive arterial access due to abnormalities of limb vasculature, this population is known to pose some unique challenges for BP measurement...
November 2016: Journal of Clinical Anesthesia
P Schraverus, M M Kuijpers, J Coumou, C A Boly, C Boer, S van Kralingen
Morbidly obese patients are at increased risk of intra-operative haemodynamic instability, which may necessitate intensive monitoring. Non-invasive monitoring is increasingly used to measure cardiac output; however, it is unknown whether the weight-based algorithm utilised in these devices is applicable to patients with morbid obesity. We compared the level of agreement and trending ability of non-invasive cardiac output measurements (Nexfin(®) ) with the gold-standard thermodilution technique in 30 morbidly obese patients undergoing laparoscopic surgery...
December 2016: Anaesthesia
Jonatan Myrup Staalsø, Kim Zillo Rokamp, Niels D Olesen, Lars Lonn, Niels H Secher, Niels V Olsen, Teit Mantoni, Ulf Helgstrand, Henning B Nielsen
BACKGROUND: Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS: One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C)...
December 2016: Anesthesia and Analgesia
Richard M Nowak, Brian P Reed, Prabath Nanayakkara, Salvatore DiSomma, Michele L Moyer, Scott Millis, Phillip Levy
OBJECTIVES: To derive distinct clusters of septic emergency department (ED) patients based on their presenting noninvasive hemodynamic (HD) measurements and to determine if any clinical parameters could identify these groups. METHODS: Prospective, observational, convenience study of individuals with confirmed systemic infection. Presenting, pretreatment noninvasive HD parameters were compiled using Nexfin (Bmeye/Edwards LifeSciences) from 127 cases. Based on normalized parameters, k-means clustering was performed to identify a set of variables providing the greatest level of intercluster discrimination and intracluster cohesion...
December 2016: American Journal of Emergency Medicine
J F Heusdens, S Lof, C W A Pennekamp, J C Specken-Welleweerd, G J de Borst, W A van Klei, L van Wolfswinkel, R V Immink
BACKGROUND: Patients undergoing carotid endarterectomy require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. In this study we tested whether non-invasive beat-to-beat Nexfin finger BP (BPfin) can replace invasive beat-to-beat radial artery BP (BPrad) in this setting. METHODS: In 25 consecutive patients (median age 71 yr) scheduled for carotid endarterectomy and receiving general anaesthesia, BPfin and BPrad were monitored simultaneously and ipsilaterally during the 30-min period surrounding carotid artery cross-clamping...
September 2016: British Journal of Anaesthesia
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
Anne-Sophie G T Bronzwaer, Jasper Verbree, Wim J Stok, Mark A van Buchem, Mat J A P Daemen, Matthias J P van Osch, Johannes J van Lieshout
In healthy subjects, variation in cardiovascular responses to sympathetic stimulation evoked by submaximal lower body negative pressure (LBNP) is considerable. This study addressed the question whether inter-subject variation in cardiovascular responses coincides with consistent and reproducible responses in an individual subject. In 10 healthy subjects (5 female, median age 22 years), continuous hemodynamic parameters (finger plethysmography; Nexfin, Edwards Lifesciences), and time-domain baroreflex sensitivity (BRS) were quantified during three consecutive 5-min runs of LBNP at -50 mmHg...
2016: Frontiers in Physiology
Michele Panzarino, Angela Gravina, Veronica Carosi, Patrizio Crobeddu, Alessia Tiroli, Roberto Lombardi, Stefano D'Ottavio, Alberto Galante, Jacopo M Legramante
BACKGROUND: Aging is characterized by a physiological reduction in physical activity, which is inversely correlated with survival. AIMS: Aim of the present study is to evaluate the cardiovascular, central hemodynamic and autonomic responses to a single bout of adapted physical exercise in octogenarian subjects. METHODS: We studied cardiovascular, hemodynamic and autonomic responses to adapted physical activity in 33 subjects by a noninvasive methodology (Nexfin(®), Edwards Lifesciences Corporation)...
June 20, 2016: Aging Clinical and Experimental Research
R B P de Wilde, F de Wit, B F Geerts, A L van Vliet, L P H J Aarts, J Vuyk, J R C Jansen
We compared the accuracy and precision of the non-invasive Nexfin(®) device for determining systolic, diastolic, mean arterial pressure and pulse pressure variation, with arterial blood pressure values measured from a radial artery catheter in 19 patients following upper abdominal surgery. Measurements were taken at baseline and following fluid loading. Pooled data results of the arterial blood pressures showed no difference between the two measurement modalities. Bland-Altman analysis of pulse pressure variation showed significant differences between values obtained from the radial artery catheter and Nexfin finger cuff technology (mean (SD) 1...
July 2016: Anaesthesia
Felix Balzer, Marit Habicher, Michael Sander, Julian Sterr, Stephanie Scholz, Aarne Feldheiser, Michael Müller, Carsten Perka, Sascha Treskatsch
OBJECTIVE: Continuous invasive arterial blood pressure (IBP) monitoring remains the gold standard for BP measurement, but traditional oscillometric non-invasive intermittent pressure (NIBP) measurement is used in most low-to-moderate risk procedures. This study compared non-invasive continuous arterial BP measurement using a Nexfin® monitor with NIBP and IBP monitors. METHODS: This was a single-centre, prospective, pilot study in patients scheduled for elective orthopaedic surgery...
August 2016: Journal of International Medical Research
Patrick Schramm, Irene Tzanova, Tilman Gööck, Frank Hagen, Irene Schmidtmann, Kristin Engelhard, Gunther Pestel
BACKGROUND: Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. Transesophageal echocardiography (TEE) to measure cardiac output (CO)/cardiac index (CI) and stroke volume (SV), and invasive arterial blood pressure measurements for systolic (ABPsys), diastolic (ABPdiast) and mean arterial pressure (MAP) are established monitoring technologies for these kind of procedures. A noninvasive device for continuous monitoring of blood pressure and CO based on a modified Penaz technique (volume-clamp method) was introduced recently...
March 18, 2016: Journal of Neurosurgical Anesthesiology
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...
2016: Journal of Anesthesia
Christian Tronstad, Ivar N Omenås, Leiv A Rosseland
Measurement artifacts are common in hemodynamic recordings such as cardiac output and blood pressure. Manual artifact removal is cumbersome for large datasets, and automatic processing using algorithms may reduce workload and provide more reproducible outcomes. This paper presents an artifact removal algorithm which is more aggressive compared to a previously described method. The algorithm was evaluated on cardiac output (CO) and mean arterial pressure (MAP) recordings from 23 subjects measured by two different devices (LiDCO and Nexfin), and compared to the previously described method as a reference...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Antonia Blanié, Mickael Soued, Dan Benhamou, Jean Xavier Mazoit, Jacques Duranteau
BACKGROUND: In this prospective observational study, we compared changes in cardiac index (CI) during fluid challenge using photoplethysmography (PPG; Nexfin™) (CIPPG) versus esophageal Doppler (ED) (CIED) in major noncardiac surgery patients. METHODS: Measurements were obtained when the attending anesthesiologist decided to perform a fluid challenge. Correlations with linear regression, Bland-Altman analysis, and analysis of covariance were performed. Trending ability was studied using 2 different methods: a 4-quadrant plot and a polar plot...
February 2016: Anesthesia and Analgesia
Stefania Sacchi, Alessandro Paoletti Perini, Paola Attanà, Gino Grifoni, Marco Chiostri, Giuseppe Ricciardi, Paolo Pieragnoli, Luigi Padeletti
BACKGROUND: SonR sensor signal correlates well with myocardial contractility expressed in terms of left ventricular (LV) dP/dt max. The aim of our study was to evaluate the changes in myocardial contractility during isometric effort in heart failure patients undergoing cardiac resynchronization therapy (CRT) with right atrial SonR sensor. METHODS: Thirty-one patients (19 men, 65 ± 7 years, LV ejection fraction [LVEF] 28% ± 5%, in sinus rhythm) were implanted with a CRT-defibrillator (CRT-D) device equipped with SonR sensor, which was programmed in VVI mode at 40 beats/min...
March 2016: Pacing and Clinical Electrophysiology: PACE
S B Nicia, T A van Veelen, J Stens, M M W Koopman, C Boer
We investigated which haemodynamic parameters derived from Nexfin non-invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole-blood donors. Mean arterial pressure, cardiac index, systemic vascular resistance index and pulse pressure variation were recorded during controlled breathing, and a Valsalva manoeuvre was performed before and after blood donation. Blood donation resulted in a reduction in cardiac index (from 3...
February 2016: Anaesthesia
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