Noninvasive Measurement of Cardiac Output in Hemodialysis Patients by Task Force Monitor: A Comparison with the Transonic System

Kitzler, Thomas M.; Sergeyeva, Olga; Morris, Alice T.; Skrabal, F.; Kotanko, Peter; Levin, Nathan W.

doi:10.1097/mat.0b013e31812e6a90

Cited by 22 publications

(18 citation statements)

References 25 publications

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“…Among noninvasive techniques, thoracic bioimpedance cardiography (ICG) is an attractive operator-independent and cost-effective method. ICG was developed by the National Aeronautics and Space Administration in the 1960s to monitor cardiac output in astronauts (13), and this approach has been used in critically ill patients (14,15) and in patients with heart failure (16). The ICG signal is obtained from thoracic impedance detected at beat-to-beat intervals; changes in thorax impedance during the cardiac cycle allow for the calculation of stroke volume, cardiac output, and indicators of cardiac contractility (17).…”

Section: Introductionmentioning

confidence: 99%

Impaired hemodynamic response to meal intake in insulin-resistant subjects: an impedance cardiography approach

Kreutzenberg¹,

Fadini²,

Boscari³

et al. 2011

The American Journal of Clinical Nutrition

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Background: In the postprandial state, insulin regulates metabolic and cardiovascular responses. In insulin resistance, the insulin action is impaired at both levels. However, postprandial hemodynamic responses are poorly characterized in this setting. Objective: We investigated fasting and postprandial cardiac and vascular hemodynamic responses in subjects with and without insulin resistance. Design: Sixty-six atherosclerosis-free, healthy volunteers were studied in a fasted state and 180 min after ingestion of a mixed meal. The insulin sensitivity index was determined by using a minimal model analysis; hemodynamic response was monitored by using continuous impedance cardiography that allowed a reliable beat-to-beat noninvasive evaluation of stroke volume, cardiac contractility, and several derived variables. Results: Subjects were divided into insulin-resistant (IR; n = 33) and insulin-sensitive (IS; n = 33) groups. After fasting, IR subjects had significantly higher values of systolic and diastolic blood pressures and the systemic vascular resistance index (SVRI) than did IS subjects. In the postprandial state, acute vasodilatation was comparable and synchronous (at 30 min) in IR and IS subjects (P = 0.209), but subsequent vascular tone recovery (30-180 min) was significantly impaired in IR subjects (P = 0.018), even after adjustment for age and sex (P = 0.031). Hemodynamic dysregulation was directly correlated with metabolic disturbances in the postprandial state. In basal and postprandial states, hemodynamic variables related to cardiac function were not significantly different in IR and IS subjects. Conclusions: IR subjects had a worse fasting vascular performance than did IS subjects. In the postprandial phase, insulin resistance was associated with a shorter duration of vasodilatation in the absence of an altered cardiac performance. Peripheral hemodynamic alterations in fasting and postprandial states may have a negative effect on cardiovascular performance in IR patients.Am J Clin Nutr 2011;93:926-33.

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Section: Introductionmentioning

confidence: 99%

Impaired hemodynamic response to meal intake in insulin-resistant subjects: an impedance cardiography approach

Kreutzenberg¹,

Fadini²,

Boscari³

et al. 2011

The American Journal of Clinical Nutrition

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“…However, our study was not planned as a validation study; rather, we aimed to demonstrate the applicability of ICG-derived hemodynamic measurements in cirrhotic patients. The TFM and other commercially available devices equipped with ICG to define hemodynamic status were already utilized in previous researches where ICG results were confirmed and validated in comparison with invasive and noninvasive methods (4,6,7,(12)(13)(14)(15)17). Therefore, we did not need to involve any invasive or noninvasive comparative hemodynamic assessment tool.…”

Section: Discussionmentioning

confidence: 99%

“…From this point of view, TFM, which has already obtained FDA 510(k) (K014063) clearance, is a novel noninvasive hemodynamic monitoring tool utilizing an improved estimate of thoracic volume (considering the influence of the patient's body weight on the thorax shape, a mathematical model based on a "modified" Kubicek and Sramek designs is applied) and new shortband electrodes to generate a good homogeneous thoracic field (6). Previous reports have proven the applicability of TFM in various clinical conditions, including hemodynamic monitoring in heart transplant candidates in comparison with both thermodilution and another commercially available ICG device (6) and in hemodialysis patients (17), and its utility for optimization of cardiac resynchronization therapy (18) and for evaluation of exercise physiology (19,20) and vasovagal syncope (21). However, there are only a few reports (with very small sample sizes) involving ICG as a noninvasive measure of hemodynamics in cirrhosis patients (4,8).…”

Section: Discussionmentioning

confidence: 99%

Utilization of impedance cardiography in noninvasive assessment of hemodynamic status in cirrhotic patients

Süleymanlar

Aktaş²,

Başarıcı³

2010

Turk J Gastroenterol

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“…Both ScvO 2 and Hgb are indispensable for eU-BBF computation, and the advent of the Crit-Line Monitor has made routine, noninvasive and quasi-continuous measurements of these 2 parameters during HD a reality. Future detailed physiological studies including hemodynamic monitoring [30] and AVF flow measurement are required to better understand the maturation dynamics and the associated hemodynamic adaptation. Efforts should be made to characterize the expected trajectories of ScvO 2 and eUBBF during adequate AVF maturation and cardiac adaptation.…”

Section: Discussionmentioning

confidence: 99%

Tracking Arteriovenous Fistula Maturation: A Novel Approach

et al. 2018

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Background: The time between the creation of an arteriovenous fistula (AVF) and its successful use is significantly longer in hemodialysis (HD) patients in the United States compared to those in other countries, and there is an urgent need to reduce the residence time of central-venous catheters (CVC). Methods: Successful AVF creation and maturation results in typical hemodynamic changes, such as an increase in cardiac output and upper body blood flow (UBBF). In patients with CVC as vascular access, we measured once per minute intradialytic central-venous oxygen saturation (ScvO₂) and hemoglobin levels simultaneously using the Crit-Line Monitor. Under conditions of stable upper body oxygen consumption and arterial oxygen saturation, ScvO₂ and hemoglobin concentration allows the calculation of estimated UBBF (eUBBF). In a quality improvement project, we used ScvO₂ and eUBBF to track the hemodynamic changes accompanying AVF maturation. Results: Out of 11 patients (9 incident to HD, 1 female, age 61 ± 13 years), AVF maturation was successful in 9. In 1 patient, the AVF did not mature. One patient died from sudden cardiac death with a maturing AVF. In the 9 patients with successful AVF maturation, ScvO₂ increased from 60.9 ± 2.7% prior to AVF creation to 73.4 ± 3.6% a week after AVF creation (19.6 ± 6.3% increase). eUBBF increased from 1.3 ± 0.3 to 2.2 ± 0.6 L/min (62.7 ± 37.5% increase); no material ScvO₂ or eUBBF changes occurred in the other 2 patients. Conclusion: Our results indicate the potential utility of ScvO₂ and eUBBF to track the hemodynamic response to AVF maturation. To what extent these insights translate into shortening of the time between AVF creation and successful cannulation warrants further investigations.

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Noninvasive Measurement of Cardiac Output in Hemodialysis Patients by Task Force Monitor: A Comparison with the Transonic System

Cited by 22 publications

References 25 publications

Impaired hemodynamic response to meal intake in insulin-resistant subjects: an impedance cardiography approach

Impaired hemodynamic response to meal intake in insulin-resistant subjects: an impedance cardiography approach

Utilization of impedance cardiography in noninvasive assessment of hemodynamic status in cirrhotic patients

Tracking Arteriovenous Fistula Maturation: A Novel Approach

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