Journal of clinical monitoring and computing end of year summary 2018: hemodynamic monitoring and management

Saugel, Bernd; Flick, Moritz; Bendjelid, Karim; Critchley, Lester A. H.; Vistisen, Simon Tilma; Scheeren, Thomas

doi:10.1007/s10877-019-00297-w

Cited by 9 publications

(8 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are also some limitations to the ROC analysis associated with the dispersion of predictor values in the population which is investigated. These limitations are previously described [27] and highlighted in a recent review [28] and should be considered when comparing AUC values from different studies.…”

Section: Discussionmentioning

confidence: 99%

Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery

Hoff

Høiseth

Kirkebøen

et al. 2019

Critical Care Research and Practice

View full text Add to dashboard Cite

Background. Exhaled carbon dioxide (CO2) reflects cardiac output (CO) provided stable ventilation and metabolism. Detecting CO changes may help distinguish hypovolemia or cardiac dysfunction from other causes of haemodynamic instability. We investigated whether CO2 measured as end-tidal concentration (EtCO2) and eliminated volume per breath (VtCO2) reflect sudden changes in cardiac output (CO). Methods. We measured changes in CO, VtCO2, and EtCO2 during right ventricular pacing and passive leg raise in 33 ventilated patients after open heart surgery. CO was measured with oesophageal Doppler. Results. During right ventricular pacing, CO was reduced by 21% (CI 18–24; p<0.001), VtCO2 by 11% (CI 7.9–13; p<0.001), and EtCO2 by 4.9% (CI 3.6–6.1; p<0.001). During passive leg raise, CO increased by 21% (CI 17–24; p<0.001), VtCO2 by 10% (CI 7.8–12; p<0.001), and EtCO2 by 4.2% (CI 3.2–5.1; p<0.001). Changes in VtCO2 were significantly larger than changes in EtCO2 (ventricular pacing: 11% vs. 4.9% (p<0.001); passive leg raise: 10% vs. 4.2% (p<0.001)). Relative changes in CO correlated with changes in VtCO2 (ρ=0.53; p=0.002) and EtCO2 (ρ=0.47; p=0.006) only during reductions in CO. When dichotomising CO changes at 15%, only EtCO2 detected a CO change as judged by area under the receiver operating characteristic curve. Conclusion. VtCO2 and EtCO2 reflected reductions in cardiac output, although correlations were modest. The changes in VtCO2 were larger than the changes in EtCO2, but only EtCO2 detected CO reduction as judged by receiver operating characteristic curves. The predictive ability of EtCO2 in this setting was fair. This trial is registered with NCT02070861.

show abstract

Section: Discussionmentioning

confidence: 99%

Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery

Hoff

Høiseth

Kirkebøen

et al. 2019

Critical Care Research and Practice

View full text Add to dashboard Cite

show abstract

“…Most of the evaluation of hemodynamics is through invasive arterial blood pressure, central venous pressure, pulmonary artery floating catheters, noninvasive cardiac output monitoring. 17,18 It is difficult to meet the clinical requirements for rapid and stable evaluation in clinics. 18 In our study, RUSH process was done within five minutes, we can roughly quantify the blood volume and systolic function by ventricular end-diastolic volume and end-systolic volume, and we can also get some other important information include the amount of pericardial effusion, pleural effusion and abdominal effusion, and venous thrombosis stability.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

A randomized controlled trial of bedside ultrasound RUSH process to improve the quality of anesthesia for elderly emergency surgery patients

Liu¹,

Chen²,

Yao³

et al. 2022

Pak J Med Sci

View full text Add to dashboard Cite

Objectives: The rapid ultrasound in shock examination (RUSH process) is an assessment of patient’s heart function, volume status, and vasculature, which can help anesthesiologist understand the patient’s physical condition. In this study, the RUSH process was applied to elderly emergency surgery patients to evaluate whether it is beneficial to maintain the patient’s vital signs stable during the operation. Methods: In this randomized controlled clinical study one hundred elderly patients who needed general anesthesia and emergency surgery from January 2021 to July 2021 were randomly divided into RUSH group (Group-A, n=52) and control group (Group-B, n=48). The main result include the area under the intraoperative blood pressure curve (AUC), liquid input, urine output, lactic acid levels, number of vasoactive drugs used. Results: There were no significant differences in patients’ basic information, preoperative blood pressure, intraoperative blood loss, intraoperative fluid input, intraoperative blood transfusion, and urine output. Intraoperative systolic blood pressure less than 90mmHg AUC of Group-A is less than Group-B(P<0.05), diastolic blood pressure less than 60mmHg AUC of Group-A is less than Group-B(P<0.05). After the operation, the blood gas analysis lactic acid level in Group-A was lower than that in Group-B(P<0.05). Group-A used more vasoactive drugs than Group-B(P<0.05). Conclusion: The bedside ultrasound RUSH process is of great significance for anesthesiologist to understand the preoperative physical condition of elderly emergency surgery patients, and is beneficial to maintain the stability of intraoperative vital signs. doi: https://doi.org/10.12669/pjms.38.6.5104 How to cite this:Liu D, Chen K, Yao Y, Sun J. A randomized controlled trial of bedside ultrasound RUSH process to improve the quality of anesthesia for elderly emergency surgery patients. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5104 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

Section: Introductionmentioning

confidence: 99%

“…The basic task of intensive care unit (ICU) is to ensure stable hemodynamic of patients, improve oxygen delivery of tissues and organs, and further improve oxygen metabolism of tissues and even cells. 4 At present, in the early stage of fluid resuscitation, central venous oxygen saturation (ScvO2), lactate clearance rate (LCR), Pcv-aCO2 and other hemodynamic parameters have been widely used in clinical treatment. However, all the parameters have limitations, because after normalization of macro hemodynamic parameters and antibiotics treatment, microcirculation damage still affects capillary permeability and leukocyte endothelial interaction, and is considered to be an important factor of organ damage.…”

Section: Introductionmentioning

confidence: 99%

The Prediction of Surgery Outcomes in Abdominal Tumor Patients with Sepsis by Pcv-aCO2/Ca-cvO2

Yang¹,

Han²,

Liu³

et al. 2022

TCRM

View full text Add to dashboard Cite

Background To determine whether Pcv-aCO2/Ca-cvO2 combined with Pcv-aCO2 could predict the outcomes in patients complicated with abdominal infection and sepsis after abdominal tumor operation. Methods Total 92 patients admitted to our hospital from January 2017 to December 2020 who underwent abdominal tumor operation were enrolled. Blood gas analysis of artery and central vein, various laboratory indexes, SOFA score, hemodynamic parameters at different time points and treatment outcome were recorded. Results ROC curve analysis showed that hemodynamic parameter alone could not predict ICU treatment outcome and mortality of patients, but 72-hour SOFA score could predict treatment outcome of patients (AUC = 0.930, 95% CI: 0.803–1.000, p = 0.019). The significant hemodynamic parameter for evaluating treatment outcome and prognosis of patients was Pcv-aCO2 + Ratio of T3. Kaplan–Meier univariate survival curve and Log-rank suggested that patients who had higher combined predictive parameter of T3 Ratio + T3 Pcv-aCO2 still had ischemia and hypoxia of tissues and organs after standard fluid resuscitation, and treatment outcome was not good. In subgroup analysis, patients with higher Ratio had higher lactate, higher T72 SOFA score, and poor treatment outcome. Conclusion The combination of Ratio and Pcv-aCO2 could evaluate clinical treatment outcome of patients complicated with abdominal infection and sepsis after abdominal tumor operation.

show abstract

Journal of clinical monitoring and computing end of year summary 2018: hemodynamic monitoring and management

Cited by 9 publications

References 58 publications

Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery

Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery

A randomized controlled trial of bedside ultrasound RUSH process to improve the quality of anesthesia for elderly emergency surgery patients

The Prediction of Surgery Outcomes in Abdominal Tumor Patients with Sepsis by Pcv-aCO2/Ca-cvO2

Contact Info

Product

Resources

About