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Pearse, Rupert M; Ikram, Kashif; Barry, John J.

doi:10.1186/cc2852

Cited by 104 publications

(19 citation statements)

References 62 publications

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“…The LiDCOplus system (LiDCO Ltd, Cambridge, UK) is also well validated [ 57 ]. In 2005 Pearse and colleagues [ 38 ] conducted a RCT of post-operative GDT in high-risk general surgical patients using colloid and dopexamine to achieve a 2 or conventional management DO 2 I of 600 ml/minute/m using the LiDCOplus to measure CO.…”

Section: How To Perform Goal Directed Therapy In High-risk Surgical Pmentioning

confidence: 99%

Clinical review: Goal-directed therapy in high risk surgical patients

2009

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A small group of patients account for the majority of peri-operative morbidity and mortality. These 'high-risk' patients have a poor outcome due to their inability to meet the oxygen transport demands imposed on them by the nature of the surgical response during the peri-operative period. It has been shown that by targeting specific haemodynamic and oxygen transport goals at any point during the peri-operative period, the outcomes of these patients can be improved. This goal directed therapy includes the use of fluid loading and inotropes, in order to optimize the preload, contractility and afterload of the heart whilst maintaining an adequate coronary perfusion pressure. Despite the benefits seen, it remains a challenge to implement this management due to difficulties in identifying these patients, scepticism and lack of critical care resources.

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Section: How To Perform Goal Directed Therapy In High-risk Surgical Pmentioning

confidence: 99%

Clinical review: Goal-directed therapy in high risk surgical patients

2009

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“…Additional methods of CO monitoring were also evaluated and suggested a lower rate of utilization. These methods included the ED,[5] NICO,[20] PiCCO,[1] LiDCO,[21] and combination of bioimpedance and bioreactance technologies. [22] The biggest disadvantages of bioimpedance devices are their sensitivity to motion and arrhythmogenic response to the use of electrocautery.…”

Section: Discussionmentioning

confidence: 99%

The utilization spectrum of cardiac output monitoring devices among anesthesiology programs across Veterans Health Administration in the United States

et al. 2019

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Background: Electronic monitoring of physiologic variables has gained widespread support over the past decade for critical patients in the intensive care setting. Specifically, anesthesiologists have increased the emphasis and practice of hemodynamic control through monitoring cardiac output (CO). However, these physicians are presented with several options in terms of how they wish to study the trend of this physiologic parameter. Materials and Methods: A survey was distributed to 250 general and subspecialty-trained anesthesiologists. A series of questions were presented in terms of preference of patient monitoring methods requiring yes or no answers. Anesthesiologists were asked about subspecialty training, years since residency graduation, and preferences toward specific hemodynamic monitoring tools. Nonparametric statistical analysis and Chi-squared tests were used to analyze both normal and nonnormally distributed data. Results: CO monitoring devices were implemented by 106 out of 133 anesthesiologists, with 98 of these physicians utilizing CO monitoring for fluid and vasopressors response. Of the physicians implementing a monitoring device, 48 out of 107 physicians preferred pulmonary artery catheter, while pulse contour analysis was preferred by 17 anesthesiologists. An echocardiography unit was available to the department for 90 anesthesiologists, and 77 anesthesiologists were trained to use this technology for monitoring cardiac function. Conclusion: Many anesthesiologists have placed emphasis on the importance of CO monitoring within the intensive care setting. However, physicians are still faced with multiple options in terms of how they wish to specifically monitor this hemodynamic variable. Factors that influence such decisions include the time of physician's residency training along with patient and clinical case characteristics.

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“…Methods based on pulse-wave analysis have become increasingly accepted and gradually introduced into clinical practice 5-10. Commercially available devices include the PiCCOsystem (PiCCO™, Pulsion Medical Systems) and the LiDCO-system (LiDCO™, LiDCO Ltd.), which both require invasive calibration by either transpulmonary thermodilution or lithium dilution after a certain time to compensate for interindividual differences in vascular compliance 19. The FloTrac/Vigileo™ system offers the possibility of uncalibrated, continuous CO measurements on the basis of arterial waveform analysis combined with simple usability.…”

Section: Discussionmentioning

confidence: 99%

“…The results of these techniques with respect to reproducibility and accuracy are not uniform 11-13,19. Whether they can guide therapy better than routine measurement of blood pressure remains to be determined.…”

Section: Discussionmentioning

confidence: 99%

Comparison of quality of life, satisfaction with surgery and shoulder-arm morbidity in breast cancer survivors submitted to breast-conserving therapy or mastectomy followed by immediate breast reconstruction

Torres

Cardoso

et al. 2010

Clinics

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OBJECTIVES:This study was designed to compare the prevalence of shoulder-arm morbidity, patient satisfaction with surgery and the quality of life of women submitted to breast-conserving therapy or modified radical mastectomy and immediate breast reconstruction.METHODS:This study was a cross-sectional study of women who underwent breast-conserving therapy (n = 44) or modified radical mastectomy and immediate breast reconstruction (n = 26). Quality of life was evaluated with the SF-36 Health Survey Questionnaire.RESULTS:No differences were found in the prevalence of lymphedema. The movements that were most commonly affected by these procedures were abduction, flexion and external rotation. When the two groups were compared, however, we only found a statistically significant difference for the prevalence of restricted internal rotation, which occurred in 32% of women in the breast-conserving therapy group and 12% of those in the modified radical mastectomy and immediate breast reconstruction group (OR: 7.23; p = 0.03 following adjustment for potential confounding factors). No difference in quality of life or satisfaction with surgery was found between the two groups.CONCLUSIONS:These data suggest that the type of surgery did not affect the occurrence of lymphedema. Breast-conserving therapy, however, increased the risk of shoulder movement limitation. No differences were found between the two surgical techniques with respect to quality of life or satisfaction with surgery.

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Abstract: The LiDCO™plus system is a minimally/non-invasive technique of continuous cardiac output measurement. In common with all cardiac output monitors this technology has both strengths and weaknesses. This review discusses the technological basis of the device and its clinical application.

Cited by 104 publications

References 62 publications

Clinical review: Goal-directed therapy in high risk surgical patients

Clinical review: Goal-directed therapy in high risk surgical patients

The utilization spectrum of cardiac output monitoring devices among anesthesiology programs across Veterans Health Administration in the United States

Comparison of quality of life, satisfaction with surgery and shoulder-arm morbidity in breast cancer survivors submitted to breast-conserving therapy or mastectomy followed by immediate breast reconstruction

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