Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2012
Multicenter Study Comparative StudyMulticenter study verifying a method of noninvasive continuous cardiac output measurement using pulse wave transit time: a comparison with intermittent bolus thermodilution cardiac output.
Many technologies have been developed for minimally invasive monitoring of cardiac output. Estimated continuous cardiac output (esCCO) measurement using pulse wave transit time is one noninvasive method. Because it does not require any additional sensors other than those for conducting 3 basic forms of monitoring (electrocardiogram, pulse oximeter wave, and noninvasive (or invasive) arterial blood pressure measurement), esCCO measurement is potentially useful in routine clinical circulatory monitoring for any patient including low-risk patients. We evaluated the efficacy of noninvasive esCCO using pulse wave transit time in this multicenter study. ⋯ The efficacy of noninvasive esCCO technology was compared with TDCO in 213 cases. Five hundred eighty-seven datasets comparing esCCO and TDCO showed close correlation and small bias and precision, which were comparable to current arterial waveform analysis technologies.
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Anesthesia and analgesia · Jul 2012
Absence of tachycardia during hypotension in children undergoing craniofacial reconstruction surgery.
Tachycardia is a baroreceptor-mediated response to hypotension. Heart rate (HR) behavior in the setting of hypotension in anesthetized children is not well characterized. We conducted this study to assess the relationship between HR and hypotension in a population of anesthetized children experiencing massive blood loss. Our primary hypothesis was that HR would be increased with the onset of hypotension associated with hypovolemia in comparison with time points without hypotension. ⋯ In this study of anesthetized children younger than 24 months undergoing surgery with massive blood loss, hypotension was not associated with an increased HR. HR does not appear to be a useful indicator of hypovolemia in this population.
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Anesthesia and analgesia · Jul 2012
The ability of anesthesia providers to visually estimate systolic pressure variability using the "eyeball" technique.
Systemic arterial respiratory variation has been shown to be a reliable predictor of changes in cardiac output after fluid administration. Arterial respiratory variation is often estimated from visual examination of the arterial waveform tracing. Our goal in this study was to assess the ability of anesthesia providers to visually estimate systolic pressure variation (SPV) as a percentage of systolic blood pressure (SPV). ⋯ Visual estimates of respiratory variation are within clinically reasonable limits 82% of the time and lead to erroneous management decisions in 4.4% of measurements.