Interrater reliability of cardiac output measurements by transcutaneous Doppler ultrasound: implications for noninvasive hemodynamic monitoring in the ED

Nguyen, H. Bryant; Losey, Theodore; Rasmussen, Janet; Oliver, R.; Guptill, Mindi; Wittlake, William A.; Corbett, Stephen W.

doi:10.1016/j.ajem.2006.05.012

Cited by 38 publications

(27 citation statements)

References 40 publications

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“…The systolic function can be evaluated by ejection fraction. This procedure may be an alternative to traditional invasive hemodynamic monitoring [18].…”

Section: Echocardiographymentioning

confidence: 99%

Fluid Assessment and Management in the Emergency Department

Somma¹,

Gori²,

Grandi³

et al. 2010

Contributions to Nephrology

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Evaluation of hydration state or water homeostasis is an important component in the assessment and treatment of critically ill patients in the emergency department (ED). The main purpose of ED physicians is to immediately distinguish between normal hydrated, dehydrated and hyperhydrated states. Fluid depletion may result from renal losses and extrarenal losses (from the GI tract, respiratory system, skin, fever, sepsis, third space accumulations). Total body fluid increase can result from heart failure, kidney disease, liver disease, malignant lymphoedema or thyroid disease. In patients with fluid overload due to acute heart failure, diuretics should be given when there is evidence of systemic volume overload, in a dose up-titrated according to renal function, systolic blood pressure, and history of chronic diuretic use. The bioelectrical impedance vector analysis (BIVA) is a noninvasive technique to estimate body mass and water composition by bioelectrical impedance measurements, resistance and reactance. In patients with hyperhydration state due to heart failure, some authors showed that reactance is strongly related to BNP values and the NYHA functional classes. Other authors found a correlation between impedance and central venous pressure in critically ill patients. We have been analyzing the hydration state at admission to the ED, 24, 72 h after admission and at discharge, and found a significant and indirectly proportional correlation between BIVA hydration and the Caval index at the time of presentation to the ED and 24 and 72 h after hospital admission. Moreover, at admission we found an inverse relationship between BIVA hydration and reduced urine output that became directly proportional at 72 h. This confirms the good response to diuretic therapy with the shift of fluids from interstitial spaces.

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“…The systolic function can be evaluated by ejection fraction. This procedure may be an alternative to traditional invasive hemodynamic monitoring [18].…”

Section: Echocardiographymentioning

confidence: 99%

Fluid Assessment and Management in the Emergency Department

Somma¹,

Gori²,

Grandi³

et al. 2010

Contributions to Nephrology

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“…In parallel, measurement of cardiac output, venous pressure and bioelectric impedance vector analysis may also help ensure continued and targeted diuretic therapy while preventing unwanted iatrogenic complications [22]. Accurate estimation of cardiac output can now be easily achieved by means of arterial pressure monitoring combined with pulse contour analysis or by Doppler ultrasound [23][24][25]. Knowledge of cardiac output allows physicians to develop a physiologically safer and more logical approach to the simultaneous treatment of AHF and acute decompensated heart failure and AKI.…”

Section: Cardiorenal Syndrome Type 1 (Acute Cardiorenal Syndrome)mentioning

confidence: 99%

Cardiorenal Syndromes: An Executive Summary from the Consensus Conference of the Acute Dialysis Quality Initiative (ADQI)

Ronco

McCullough

Anker

et al. 2010

Contributions to Nephrology

128

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The cardiorenal syndrome (CRS) is a disorder of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The general definition has been expanded into five subtypes reflecting the primacy of organ dysfunction and the time-frame of the syndrome: CRS type 1 = acute worsening of heart function leading to kidney injury and/or dysfunction; CRS type 2 = chronic abnormalities in heart function leading to kidney injury or dysfunction; CRS type 3 = acute worsening of kidney function leading to heart injury and/or dysfunction; CRS type 4 = chronic kidney disease leading to heart injury, disease and/or dysfunction, and CRS type 5 = systemic conditions leading to simultaneous injury and/or dysfunction of heart and kidney. Different pathophysiological mechanisms are involved in the combined dysfunction of heart and kidney in these five types of the syndrome.

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“…Good correlation between two experienced users of the USCOM has been demonstrated in a small neonatal study by Todd et al (n=12, r=0.93, p<0.0001), and in an adult study by Nguyen et al 15 24. Neither study assessed agreement between new and experienced users.…”

Section: Discussionmentioning

confidence: 83%