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Pulse contour cardiac output

James Simmons, Corey E Ventetuolo
PURPOSE OF REVIEW: We will briefly review the classification of shock and the hallmark features of each subtype. Available modalities for monitoring shock patients will be discussed, along with evidence supporting the use, common pitfalls, and practical considerations of each method. RECENT FINDINGS: As older, invasive monitoring methods such as the pulmonary artery catheter have fallen out of favor, newer technologies for cardiac output estimation, echocardiography, and noninvasive tests such as passive leg raising have gained popularity...
April 8, 2017: Current Opinion in Critical Care
Niels D Olesen, Henrik Sørensen, Rikard Ambrus, Lars B Svendsen, Anton Lund, Niels H Secher
During abdominal surgery manipulation of internal organs may induce a "mesenteric traction syndrome" (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (ScO2) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD)...
March 14, 2017: Journal of Clinical Monitoring and Computing
Bouchra Lamia, Hyung Kook Kim, Donald A Severyn, Michael R Pinsky
We compared the similarity of cardiac-output (CO) estimates between available bolus thermodilution pulmonary-artery catheters (PAC), arterial pulse-contour analysis (LiDCOplus(™), FloTrac(™) and PiCCOplus(™)), and bioreactance (NICOM(™)). Repetitive simultaneous estimates of CO obtained from the above devices were compared in 21 cardiac-surgery patients during the first 2 h post-surgery. Mean and absolute values for CO across the devices were compared by ANOVA, Bland-Altman, Pearson moment, and linear-regression analyses...
February 10, 2017: Journal of Clinical Monitoring and Computing
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
Nadjib Hammoudi, Guillaume Hékimian, Florent Laveau, Marc Achkar, Richard Isnard, Alain Combes
BACKGROUND: Three-dimensional transoesophageal echocardiography (3D-TOE) is a new noninvasive tool for quantitative assessment of left ventricular (LV) volumes and ejection fraction. AIM: The objective of this pilot study was to evaluate the feasibility and accuracy of 3D-TOE for the estimation of cardiac output (CO), using transpulmonary thermodilution with the Pulse index Contour Continuous Cardiac Output (PiCCO) system as the reference method, in intensive care unit (ICU) patients...
January 2017: Archives of Cardiovascular Diseases
Kuang-Cheng Chan, Chun-Yu Wu, Ming-Hui Hung, Po-Huang Lee, Ya-Jung Cheng
BACKGROUND/PURPOSE: Postoperative acute lung injury (ALI) after liver transplantation is clinically relevant and common. The perioperative thoracic fluid indices changes as well as the association with ALI in liver transplantation have not been thoroughly investigated. METHODS: A total of 52 consecutive adult recipients for elective living donor liver transplantation were enrolled. Each recipient received the same perioperative care plan. Thoracic fluid indices, including the cardiac index, intrathoracic blood volume index (ITBVI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI), were obtained at seven time points (pretransplantation, anhepatic phase, 30 minutes after reperfusion, 2 hours after reperfusion, and postoperative days 1-3) using the pulse contour cardiac output system...
September 22, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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
T G V Cherpanath, B F Geerts, J J Maas, R B P de Wilde, A B Groeneveld, J R Jansen
BACKGROUND: Ventilator-induced dynamic hemodynamic parameters such as stroke volume variation (SVV) and pulse pressure variation (PPV) have been shown to predict fluid responsiveness in contrast to static hemodynamic parameters such as central venous pressure (CVP). We hypothesized that the ventilator-induced central venous pressure variation (CVPV) could predict fluid responsiveness. METHODS: Twenty-two elective cardiac surgery patients were studied post-operatively on the intensive care unit during mechanical ventilation with tidal volumes of 6-8 ml/kg without spontaneous breathing efforts or cardiac arrhythmia...
November 2016: Acta Anaesthesiologica Scandinavica
Yi-Lun Chiang, Pei-Chi Chen, Chin-Cheng Lee, Su-Kiat Chua
BACKGROUND: Pheochromocytoma is an endocrine tumor that causes hypertension, facial pallor, and headache. Pheochromocytoma patients rarely present with acute heart failure or cardiogenic shock. METHOD: We discuss the case of a female patient with Takotsubo-pattern cardiomyopathy who presented with acute heart failure caused by pheochromocytoma. RESULT: Treatment was adjusted based on the data of the pulse contour cardiac output system. After intensive hydration and medication for heart failure, the condition of the patient stabilized...
September 2016: Medicine (Baltimore)
José M Alonso-Iñigo, Francisco J Escribá, José I Carrasco, María J Fas, Pilar Argente, José M Galvis, José E Llopis
BACKGROUND: Pressure recording analytical method (PRAM) is a novel, arterial pulse contour method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have shown contradictory results. The aim of the study was to compare the MostCare(®) -PRAM vs the Fick method of cardiac output estimation (reference method). METHODS: This is a single-center, prospective observational study in 52 pediatric patients who underwent diagnostic right and left heart catheterization...
November 2016: Paediatric Anaesthesia
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Michael Fritzenwanger, Bjoern Kabisch, Hans-Reiner Figulla, Christian Jung
BACKGROUND: Heart failure is known to be a major public health problem. Fluid redistribution contributes to acute heart failure; therefore, knowledge of hemodynamic parameters could be important for optimizing outcomes. The pulse contour cardiac output monitor PiCCO uses the single thermal indicator technique and pulse contour analysis to calculate hemodynamic parameters of preload, afterload, cardiac output, systemic vascular resistance and extravascular lung water. OBJECTIVES: We primarily aimed to describe values and parameters seen in acute heart failure patients admitted to the intensive care unit (ICU) and secondly to investigate associations between hemodynamic measurements and survival data...
December 2016: Wiener Klinische Wochenschrift
Michael Dahl, Chris Hayes, Bodil Steen Rasmussen, Anders Larsson, Niels H Secher
BACKGROUND: Whether during spontaneous breathing arterial pressure variations (APV) can detect a volume deficit is not established. We hypothesized that amplification of intra-thoracic pressure oscillations by breathing through resistors would enhance APV to allow identification of a reduced cardiac output (CO). This study tested that hypothesis in healthy volunteers exposed to central hypovolemia by head-up tilt. METHODS: Thirteen healthy volunteers were exposed to central hypovolemia by 45° head-up tilt while breathing through a facemask with 7...
August 11, 2016: BMC Anesthesiology
Akila Rajakumar, Shiwalika Gupta, Selvakumar Malleeswaran, Joy Varghese, Ilankumaran Kaliamoorthy, Mohamed Rela
BACKGROUND AND AIMS: The perioperative management of patients presenting for simultaneous liver and kidney transplantation (SLKT) is a complex process. We analysed SLKTs performed in our institution to identify preoperative, intraoperative and post-operative challenges encountered in the management. METHODS: We retrospectively studied the case records of 12 patients who underwent SLKT between 2009 and 2014 and analysed details of pre-operative evaluation and optimisation, intraoperative anaesthetic management and the implications of use of perioperative continuous renal replacement therapy (CRRT) and the post-operative course of these patients...
July 2016: Indian Journal of Anaesthesia
Marc-Olivier Fischer, Momar Diouf, Robert B P de Wilde, Hervé Dupont, Jean-Luc Hanouz, Emmanuel Lorne
Cardiac output measurement with pulse contour analysis is a continuous, mini-invasive, operator-independent, widely used, and cost-effective technique, which could be helpful to assess changes in cardiac output. The 4-quadrant plot and the polar plot have been described to compare the changes between 2 measurements performed under different conditions, and the direction of change by using different methods of measurements. However, the 4-quadrant plot and the polar plot present a number of limitations, with a risk of misinterpretation in routine clinical practice...
June 2016: Medicine (Baltimore)
Ruud F Spee, Victor M Niemeijer, Thijs Schoots, Pieter F Wijn, Pieter A Doevendans, Hareld M Kemps
Oxygen uptake (V̇o2) kinetics are prolonged in patients with chronic heart failure (CHF). This may be caused by impaired oxygen delivery or skeletal muscle derangements. We investigated whether impaired cardiac output (Q̇) kinetics limit skeletal muscle oxygen delivery relative to the metabolic demands at submaximal exercise in CHF patients by evaluating the relation between Q̇ kinetics and skeletal muscle deoxygenation. Forty-three CHF patients, NYHA II-III, performed a constant-load exercise test at 80% of the ventilatory aerobic threshold (VAT) to assess V̇o2 kinetics (τV̇o2)...
July 1, 2016: Journal of Applied Physiology
J Y Wagner, M Langemann, G Schön, S Kluge, D A Reuter, B Saugel
The T-Line(®) system (Tensys(®) Medical Inc., San Diego, CA, USA) non-invasively estimates cardiac output (CO) using autocalibrating pulse contour analysis of the radial artery applanation tonometry-derived arterial waveform. We compared T-Line CO measurements (TL-CO) with invasively obtained CO measurements using transpulmonary thermodilution (TDCO) and calibrated pulse contour analysis (PC-CO) in patients after major gastrointestinal surgery. We compared 1) TL-CO versus TD-CO and 2) TL-CO versus PC-CO in 27 patients treated in the intensive care unit (ICU) after major gastrointestinal surgery...
May 2016: Anaesthesia and Intensive Care
N A Garofalo, F J Teixeira-Neto, J C Rodrigues, S A Cerejo, A J A Aguiar, D R Becerra-Velásquez
BACKGROUND: Transpulmonary thermodilution (TPTDCO ) and calibrated pulse contour analysis (PCACO ) are alternatives to pulmonary artery thermodilution cardiac output (PATDCO ) measurement. HYPOTHESIS: Ten mL of ice-cold thermal indicator (TI10 ) would improve the agreement and trending ability between TPTDCO and PATDCO compared to 5 mL of indicator (TI5 ) (Phase-1). The agreement and TA between PCACO and PATDCO would be poor during changes in systemic vascular resistance (SVR) (Phase-2)...
July 2016: Journal of Veterinary Internal Medicine
Sabino Scolletta, Federico Franchi, Stefano Romagnoli, Rossella Carlà, Abele Donati, Lea P Fabbri, Francesco Forfori, José M Alonso-Iñigo, Silvia Laviola, Valerio Mangani, Giulia Maj, Giampaolo Martinelli, Lucia Mirabella, Andrea Morelli, Paolo Persona, Didier Payen
OBJECTIVES: Echocardiography and pulse contour methods allow, respectively, noninvasive and less invasive cardiac output estimation. The aim of the present study was to compare Doppler echocardiography with the pulse contour method MostCare for cardiac output estimation in a large and nonselected critically ill population. DESIGN: A prospective multicenter observational comparison study. SETTING: The study was conducted in 15 European medicosurgical ICUs...
July 2016: Critical Care Medicine
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
W X Yang, G H Guo, G L Shen, W Lin, X Y Zhao, Q Qi, H G Qian, W Z Xie, Z X Wang
OBJECTIVE: To investigate the effect of the application of pulse contour cardiac output (PiCCO) monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty. METHODS: The clinical data of 41 patients injured in Kunshan dash explosion hospitalized in the First Affiliated Hospital of Soochow University, the 100th Hospital of the People's Liberation Army, and Suzhou Municipal Hospital were retrospectively analyzed. The patients were divided into traditional monitoring group (T, n=22) and PiCCO monitoring group (P, n=19) according to the monitoring technic during delayed resuscitation...
March 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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