The precision of PiCCO<sup>®</sup>measurements in hypothermic post‐cardiac arrest patients

Tagami, Takashi; Kushimoto, Shigeki; Tosa, Ryoichi; Omura, Mariko; Hagiwara, Junichiro; Hirama, Hisao; Yokota, Hiroyuki

doi:10.1111/j.1365-2044.2011.06981.x

Cited by 51 publications

(31 citation statements)

References 39 publications

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“…The principal of correct patient positioning is applicable to all anaesthesia procedures and is not limited to laryngoscopy [1]. I agree with Al-Jadidi et al [2] and El-Orbany et al [3] that, during direct laryngoscopy, appropriate head and neck position is essential to acquire optimum alignment and view of the glottis.…”

supporting

confidence: 67%

“…Distractions during critical phases of anaesthesia such as induction have a detrimental effect on clinicians' performance, and increase the chance of an error, supporting the concept of a 'sterile cockpit' in anaesthetic practice [1]. Auditory alarms are known to attract attention more quickly and reliably than visual signals, but multiple similar alarms can create confusion [2].…”

Section: Equipment Manufacturers Must Differentiate Auditory Alarms Fmentioning

confidence: 99%

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The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

2012

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supporting

confidence: 67%

Section: Equipment Manufacturers Must Differentiate Auditory Alarms Fmentioning

confidence: 99%

The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

2012

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“…However, if necessary, a colder or higher volume bolus can be tried in order to obtain a ΔT° > 0.2°C. Tagami et al performed TPTD in patients under therapeutic hypothermia and found that the measurements were not only feasible but also precise [65,66].…”

Section: Step 9 Check δT°mentioning

confidence: 99%

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Hofkens¹,

Verrijcken²,

Merveille³

et al. 2015

Anaesthesiol Intensive Ther

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Background: Haemodynamic monitoring with transpulmonary thermodilution (TPTD) is less invasive than a pulmonary artery catheter, and is increasingly used in the Intensive Care Unit and the Operating Room. Optimal treatment of the critically ill patient demands adequate, precise and continuous monitoring of clinical parameters. Little is known about staff knowledge of the basic principles and practical implementation of TPTD measurements at the bedside. The aims of this review are to: 1) present the results of a survey on the knowledge of TPTD measurement among 252 nurses and doctors; and 2) to focus on specific situations and common pitfalls in order to improve patient management in daily practice. Methods: Web-based survey on knowledge of PiCCO technology (Pulsion Medical Systems, Feldkirchen, Germany), followed by PubMed and Medline search with review of the relevant literature regarding the use of TPTD in specific situations. Results: In total, 252 persons participated in the survey: 196 nurses (78%) and 56 medical doctors (22%) of whom 17 were residents in training. Knowledge on the use of TPTD appears to be suboptimal, with an average score of 58.3%. Doctors performed better than nurses (62.7% vs 57.0%, P = 0.012). About 190 out of 252 (75.4%) scored at least 50% but only 45 respondents (17.9%) obtained a score of 70% or more. Having five years of PiCCO experience was present in 15.8% of the participants and this was correlated to passing the test, defined as obtaining a test result of ≥ 50% (P = 0.07) or obtaining a test result of ≥ 70% (P = 0.05). There were no other parameters significantly predictive for obtaining a result above 50% or above 70% such as gender or doctor versus nurse or Belgian versus Dutch residency, or years of ICU experience. High quality education of nursing and medical staff is necessary to perform the technique correctly and to analyse and interpret the information that can be obtained. Visual inspection of thermodilution curves is important as this can point towards specific pathology. Interpretation of the parameters that can be obtained with TPTD in specific conditions is discussed. Finally, a practical approach is given in ten easy steps for nurses and doctors. Conclusion: TPTD has gained its place in the haemodynamic monitoring field, but, as with any technique, its virtue is only fully appreciated with correct use and interpretation.

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“…Its additive advantage is the possibility to measure dynamic variables in fluid management. Tagami et al validated this method in post-cardiac arrest patients even if therapeutic hypothermia (32-34°C) was used [57].…”

Section: Transpulmonary Thermodilution Devices Like Picco™ (Pulse Indmentioning

confidence: 99%

Strategies of Neuroprotection after Successful Resuscitation

Kovács¹,

Zima²

2017

Resuscitation Aspects

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Post-cardiac arrest syndrome (PCAS) incorporates post-cardiac arrest brain injury, postcardiac arrest myocardial dysfunction, systemic ischemia/reperfusion syndrome and the precipitating pathology. Brain injury remains the leading cause of death in the postcardiac arrest period. One of our main goals during post-resuscitation care is to guide a proper neuroprotective strategy. We are going to summarize the tools of neuroprotection in post-cardiac arrest therapy. The role of normoxia/normocapnia, normoglycemia, seizure control, sedation and pharmacologic strategies will be discussed in brief. The handling of temperature management and the management of hemodynamic variables to secure satisfactory cerebral perfusion will be worked out in details. Targeted temperature management is the main tool of neuroprotection in post-cardiac arrest therapy. We are going to conclude the principles of temperature control after successful resuscitation pointing out its beneficial effects. This method has also several complications that are going to be discussed highlighting its hemodynamic impacts. There is no evidence about target hemodynamic parameters during post-cardiac arrest syndrome to maintain cerebral perfusion neither about the most effective hemodynamic monitoring system. We are presenting preliminary data of our study where we investigate the effect of PiCCO™ (Pulse index Continous Cardiac Output) monitoring on the outcome in this patient group.Keywords: post-cardiac arrest syndrome, post-cardiac arrest brain injury, post-resuscitation therapy, targeted temperature management, hemodynamic parameters IntroductionSudden cardiac arrest is one of the leading causes of death in Europe [1]. The outcome is still very poor: the hospital discharge varies between 7 and 10% after out-of-hospital cardiac arrest (OHCA) and it is approximately 25% after in-hospital cardiac arrest (IHCA) [1]. The chain of © 2017 The Author(s). Licensee InTech. This chapter is 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.survival describes links that lead to a successful resuscitation [2]. The fourth element covers proper post-resuscitation care to restore quality of life. It is well known that the management of post-resuscitation cardiac arrest syndrome affects outcome and it is an important part of the resuscitation process. Pointing out the growing importance of post-resuscitation therapy, the European Resuscitation Council (ERC) introduced a separate chapter about post-resuscitation care in the 2015 guidelines [3]. One of the key elements to improve survival rate after sudden cardiac arrest may be the enhancement of post-resuscitation therapy.The post-cardiac arrest brain injury remains the main cause of mortality in the post-cardiac arrest period, being as high as 68% after OHCA and 25% after IHCA [4]. These data show that one of our leading goa...

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The precision of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

Cited by 51 publications

References 39 publications

The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Strategies of Neuroprotection after Successful Resuscitation

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The precision of PiCCO®measurements in hypothermic post‐cardiac arrest patients

Cited by 51 publications

References 39 publications

The accuracy of PiCCO®measurements in hypothermic post‐cardiac arrest patients

The accuracy of PiCCO®measurements in hypothermic post‐cardiac arrest patients

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Strategies of Neuroprotection after Successful Resuscitation

Contact Info

Product

Resources

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The precision of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

The accuracy of PiCCO^®measurements in hypothermic post‐cardiac arrest patients