Radial Mean Arterial Pressure Reliably Reflects Femoral Mean Arterial Pressure in Uncomplicated Pediatric Cardiac Surgery

Çetin, Seçil; Pirat, Arash; Kundakci, A; Camkiran, Aynur; Zeyneloğlu, Pınar; Özkan, Murat; Arslan, G.

doi:10.1053/j.jvca.2013.02.029

Cited by 5 publications

(7 citation statements)

References 23 publications

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“…Femoral artery catheterisation is the reference technique for continuous blood pressure (BP) monitoring, as it reflects central BP (aorta) [ 234 ]. BP measured via a radial artery catheter is closely correlated with BP measured via a femoral artery catheter in the operating room and in paediatric intensive care, except in the particular setting of aortic clamping [ 235 – 237 ]. Catheter dysfunction was more frequent with radial artery catheters in children under the age of 13 months and weighing less than 8 kg in the study by Shin et al [ 236 ].…”

Section: Summary Of the Resultsmentioning

confidence: 99%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

127

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The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections’ prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Antiseptic- or antibiotic-impregnated CVC should likely not be used (GRADE 2, for children and adults). Catheter dressings should likely not be changed before the 7th day, except when the dressing gets detached, soiled or impregnated with blood (GRADE 2− adults). CHG dressings should likely be used (GRADE 2+). For adults and children, ultrasound guidance should be used to reduce mechanical complications in case of internal jugular access (GRADE 1), subclavian access (Grade 2) and femoral venous, arterial radial and femoral access (Expert opinion). For children, an ultrasound-guided supraclavicular approach of the brachiocephalic vein was recommended to reduce the number of attempts for cannulation and mechanical complications. Based on scarce publications on diagnostic and therapeutic strategies and on their experience (expert opinion), the panel proposed definitions, and therapeutic strategies.

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Section: Summary Of the Resultsmentioning

confidence: 99%

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Timsit

Baleine

Bernard

et al. 2020

Ann. Intensive Care

127

View full text Add to dashboard Cite

show abstract

“…It was found that the increase of MAP from 65 mmHg to normal level can improve microcirculation (15) in patients with hypertensive septic shock. The mean arterial pressure of radial artery reliably reflects the mean arterial pressure (16) in simple cardiac surgery in children.…”

Section: Discussionmentioning

confidence: 99%

Lund exhaust on hemodynamic parameters and inflammatory mediators in patients undergoing cardiac valve replacement under cardiopulmonary bypass

et al. 2018

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The effect of Lund exhaust technique on hemodynamics and inflammatory mediators in patients undergoing cardiac valve replacement under cardiopulmonary bypass was evaluated. A total of 60 patients with heart disease undergoing elective heart valve replacement under elective cardiopulmonary bypass were randomly divided into Lund exhaust group (group A) and control group (group B), with 30 patients in each group. Group A underwent Lund exhaust during cardiopulmonary bypass, while group B was identical to group A except for not using the Lund exhaust technique during cardiopulmonary bypass. The hemodynamic parameters at different time-points showed that the indexes of MAP, PASP, CO, CI, PCWP, CVP and SVR in T1, T2, T3 and T4 moments between group A and group B were statistically significant (p<0.05). There was no statistical significance in IL-6, IL-8, IL-10, TNF-α and TIMP-1 between group A and group B patients at the T0 moment (p>0.05). The levels of IL-6, IL-8, IL-10, TNF-α and TIMP-1 in group B patients at T1, T2, T3 and T4 moments were statistically significant compared with those in group A (p<0.05). The IL-6, IL-8, TNF-α indexes of group B patients were statistically significant at the T5 moment compared with those in group A (p<0.05). The IL-10 and TIMP-1 of two groups were not statistically significant at the T5 moment. The operating time, CPB time, aortic clamp time, intraoperative blood loss, postoperative tube time, ICU stay time, hospital stay time and pulmonary infection of patients in group A were significantly less than those in group B. In conclusion, Lund exhaust technology can significantly reduce the fluctuation of hemodynamics, decrease the expression of inflammatory factors, improve lung function, and is conducive to the rehabilitation of patients.

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“…Even given that children may have age-related differences in vascular mechanical characteristics, [39,40] systolic arterial pressure measured in peripheral artery is still displayed lower value than central arterial pressure in the weaning period. [8] Collectively, the decrease in pulse wave velocity caused by decreased arterial elasticity may induce discrepancies of pressure rise and peak pressure between aortic and radial arterial waveforms related to CPB. In consequence, we can observe that the radial dP/dt max was lower than the Ao dP/dt max , and there was a weak correlation between the 2 values immediately after CPB.…”

Section: Discussionmentioning

confidence: 99%

“…[7,8] Moreover, the relationship between the Ao dP/dt max and peripheral arterial dP/dt max during cardiac surgery in children remains uncertain, especially during the period of weaning from CPB. Therefore, we investigated the relationship between the aortic and radial dP/dt max immediately after weaning from CPB in pediatric congenital heart surgery.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of the maximum rate of pressure rise in the central and peripheral arteries after weaning from cardiopulmonary bypass in pediatric congenital heart surgery

et al. 2016

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The maximum rate of pressure rise (dP/dtmax) in radial artery has been proposed as a noninvasive surrogate of aortic dp/dtmax, reflecting left ventricular (LV) contractility in children. The aim of this study was to investigate relationship between aortic and radial dp/dtmax at weaning from cardiopulmonary bypass (CPB) and usefulness of these indices for estimating postoperative outcomes in pediatric congenital heart surgery.Aortic and radial arterial pressure waveforms were analyzed simultaneously during weaning from CPB in 29 congenital heart surgery. The maximum first derivatives of aortic and radial arterial waveforms were calculated and averaged from 3 consecutive respiratory cycles. We obtained the maximum vasoactive inotropic score during the first 36 postoperative hours, LV ejection fraction, and fractional shortening on transthoracic echocardiography performed within postoperative day 7.A significant difference between aortic and radial dP/dtmax was observed (mean difference 356 mm Hg/s, 44% of averages), and radial dP/dtmax was weakly correlated with aortic dP/dtmax (r =0.373, P = 0.047). Aortic dP/dtmax was significantly associated with the maximum vasoactive inotropic score (P < 0.001), postoperative LV ejection fraction (P = 0.018), and fractional shortening (P = 0.015); however, radial dP/dtmax was not. On Receiver operating characteristic analysis, aortic dP/dtmax had a greater area under the curve than radial dP/dtmax in predicting higher vasoactive inotropic score (0.827 vs 0.673).Immediately after CPB in pediatric congenital heart surgery, radial dP/dtmax may not replace aortic dP/dtmax because of a discrepancy between central and peripheral arterial waveforms. In this critical period, aortic dP/dtmax can be useful to estimate postoperative ventricular function rather than peripherally derived dP/dtmax.

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Radial Mean Arterial Pressure Reliably Reflects Femoral Mean Arterial Pressure in Uncomplicated Pediatric Cardiac Surgery

Cited by 5 publications

References 23 publications

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit

Lund exhaust on hemodynamic parameters and inflammatory mediators in patients undergoing cardiac valve replacement under cardiopulmonary bypass

Usefulness of the maximum rate of pressure rise in the central and peripheral arteries after weaning from cardiopulmonary bypass in pediatric congenital heart surgery

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