Our findings demonstrate that oxygen extraction rate is the major factor in the difference between S(v)O(2) and S(cv)O(2). Under certain circumstances S(cv)O(2) differed substantially from S(v)O(2). Therefore in selected patients both parameters should be monitored to exclude general or focal hypoperfusion.
Introduction Adequate fluid loading is the first step of hemodynamic optimization in cardiac patients undergoing surgery. Neither a clinical approach alone nor conventional parameters like central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) are thought to be sufficient for recognizing fluid deficiency or overload. The aim of this study was to evaluate the suitability of CVP, PCWP, global enddiastolic volume index (GEDVI), pulse pressure variation (PPV), and stroke volume variation (SVV) for predicting changes in the cardiac index (CI) and stroke volume index (SVI) after sternotomy.
Introduction Cardiac output (CO) monitoring is indicated only in selected patients. In cardiac surgical patients, perioperative haemodynamic management is often guided by CO measurement by pulmonary artery catheterisation (CO PAC ). Alternative strategies of CO determination have become increasingly accepted in clinical practice because the benefit of guiding therapy by data derived from the PAC remains to be proven and less invasive alternatives are available. Recently, a device offering uncalibrated CO measurement by arterial waveform analysis (CO Wave ) was introduced. As far as this approach is concerned, however, the validity of the CO measurements obtained is utterly unclear. Therefore, the aim of this study was to compare the bias and the limits of agreement (LOAs) (two standard deviations) of CO Wave at four specified time points prior, during, and after coronary artery bypass graft (CABG) surgery with a simultaneous measurement of the gold standard CO PAC and aortic transpulmonary thermodilution CO (CO Transpulm ).
Introduction Monitoring of the cardiac output by continuous arterial pulse contour (CO PiCCOpulse ) analysis is a clinically validated procedure proved to be an alternative to the pulmonary artery catheter thermodilution cardiac output (CO PACtherm ) in cardiac surgical patients. There is ongoing debate, however, of whether the CO PiCCOpulse is accurate after profound hemodynamic changes. The aim of this study was therefore to compare the CO PiCCOpulse after cardiopulmonary bypass (CPB) with a simultaneous measurement of the CO PACtherm .
Introduction Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery.
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