Journal of clinical monitoring and computing
-
J Clin Monit Comput · Oct 2015
Hemodynamic volumetry using transpulmonary ultrasound dilution (TPUD) technology in a neonatal animal model.
To analyze changes in cardiac output and hemodynamic volumes using transpulmonary ultrasound dilution (TPUD) in a neonatal animal model under different hemodynamic conditions. 7 lambs (3.5-8.3 kg) under general anesthesia received arterial and central venous catheters. A Gore-Tex(®) shunt was surgically inserted between the descending aorta and the left pulmonary artery to mimic a patent ductus arteriosus. After shunt opening and closure, induced hemorrhagic hypotension (by repetitive blood withdrawals) and repetitive volume challenges, the following parameters were assessed using TPUD: cardiac output, active circulating volume index (ACVI), central blood volume index (CBVI) and total end-diastolic volume index (TEDVI). 27 measurement sessions were analyzed. ⋯ Correlations between changes in COufp and changes in hemodynamic volumes (ACVI 0.83; CBVI 0.84 and TEDVI 0.78 respectively) were (slightly) better than between changes in COufp and changes in heart rate (0.44) and central venous pressure (0.7). Changes in hemodynamic volumes using TPUD were as expected under different conditions. Hemodynamic volumetry using TPUD might be a promising technique that has the potential to improve the assessment and interpretation of the hemodynamic status in critically ill newborns and children.
-
J Clin Monit Comput · Oct 2015
Case ReportsUsefulness of near-infrared spectroscopy in thrombectomy monitoring.
Monitoring recanalization and reperfusion during acute ischemic stroke is a challenge for therapeutic assessment. Near-infrared spectroscopy (NIRS) allows continuous monitoring of the brain regional saturation of oxygen (rSO2). We sought to evaluated rSO2 variation during mechanical thrombectomy during acute ischemic stroke. ⋯ When the procedure succeeded, rSO2 in the infarcted side rise (about 10%) and interhemisperic difference decrease (about 7%). When the procedure failed, rSO2 was the same at the beginning and at the end. NIRS may be useful to monitor recanalization during management of acute ischemic stroke.
-
J Clin Monit Comput · Oct 2015
A web-based Italian survey of current trends, habits and beliefs in hemodynamic monitoring and management.
Significant evidence outlines that the management of the high-risk surgical patient with perioperative hemodynamic optimization leads to significant benefits. This study aimed at studying the current practice of hemodynamic monitoring and management of Italian anesthesiologists. An invitation to participate in a web-based survey was published on the web site of the Società Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva. ⋯ The most used parameter in clinical practice to assess the effects of volume loading were an increase in urine output and arterial blood pressure together with a decrease in heart rate and blood lactates. The 45.1% or the respondents outlined that hemodynamic optimization in the high risk patients is of major clinical value. Our study outlines an important gap between available evidence and clinical practice emphasizing the need for a better awareness, more information and knowledge on the specific topic.