Monitoring cardiac function in intensive care

Heartsmart® Software Computer Program for Performing Haemodynamic Studies at Bedside During Resuscitative Fluid Therapy: Vasopressors and Inotropes

“…Even more so if the results stay within the normal or abnormal bandwidths. Similar results in other prospective and retrospective clinical trials since 1995 where CCDM -HeartSmart has been compared with PACTD would indicate that HeartSmart's performance is comparable with PACTD [28][29][30][31][32][33][34][35][36][37][38][39] , HeartSmart-CCDM appears to be an important technological advance in bedside haemodynamic monitoring. However, the issue of the nurses and physcians knowledge and skill in performing haemodynamic measurements using PACTD remains a major issue some high a century later 40,41 .…”

“…Hence the need for a simple haemodynamic system that is not so operator dependant, simple and easy to use, and far less costly that can be used on any group of patients routinely, would be of great benefit. But of special importance and usefulness haemodynamic monitoring is the ability to be able to reasonably assess the haemodynamic status of those patients who are suffering from shock by way of sepsis based on SIRS, where aggressive interventional therapy is being administered to the patient by the medical staff [28][29][30] . CCDM HeartSmart has to be validated against existing technologies and in particular against the perceived 'standard' the pulmonary artery catheter thermodilution method PACTD.…”

“…However, the cardiovascular physiology and physics underpinning the empirical physiological formulae need to be vigorously tested not only against established haemodynamic technologies but its performance in the most serious of clinical situations. Amongst all the controversy of the benefits of haemodynamic monitoring and its usefulness, there is little doubt that haemodynamic monitoring plays a useful role in the fluid management either for the critically ill or those patients undergoing major surgical or medical procedures [23][24][25][26][27][28] . In the face of such a controversial subject of any haemodynamic monitoring to assist in assessing cardio-dynamics in the management of fluids, or by optimising blood flow using goal directed therapy, with the all the differential outcomes, the necessity for a system such as HeartSmart-CCDM is a key technology to simply resolve many of the issues of the value of haemodynamic monitoring.…”

Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

“…com L a determinación del gasto cardiaco (GC) es una herramienta útil para guiar la terapia de pacientes en estado de choque, cuando es incorporado a algoritmos de tratamiento específico [1][2][3] , permitiendo una aproximación más racional y personalizada a la reanimación con fluidos y catecolaminas [4][5][6] . Los signos clínicos para reconocer una entrega de oxígeno (DO 2 ) inadecuada son inespecíficos y la capacidad para estimar un GC reducido en niños sólo con examen físico es muy limitada 7 .…”

Variabilidade na determinação do ponto externo de referência para a medida de pressão venosa central em crianças

“…12 Normal mean right atrial pressure levels range from 0 and 6 mmHg (mean of 3 mmHg) in children, but these levels change considerably according to breathing patterns. When CVP is measured using the water column method, the values obtained in centimeters of water (cmH 2 O), are assessed by using the ratio of 1 mmHg to 1.36 cmH 2 O as a conversion parameter. 4 The accurate measurement of CVP basically depends on three factors: placement of the patient in a neutral supine position, proper insertion and permeability of the central venous catheter tip, and selection of an external reference point (ERP) to determine the equivalence with atmospheric pressure (zero level).…”