Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2008
Reliability of cardiac output calculation by the fick principle and central venous oxygen saturation in emergency conditions.
For many years thermodilution has been the gold standard for determining cardiac output in the critically ill patients. Less invasive methods have recently been introduced. This study aimed at evaluating the agreement between cardiac output (CO) measured by a new Fick method, using central venous saturation (Scvo(2)), and that measured by the classic thermodilution technique, in patients requiring emergent CO evaluation. ⋯ The new method of Fick assessed emergent CO as reliably as the thermodilution, regardless of whether it was low or high. The use of Scvo(2) allows for prompt bedside calculation for most emergency patients.
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J Clin Monit Comput · Aug 2008
Randomized Controlled TrialA randomized-controlled study of intrathecal versus epidural thoracic analgesia in patients undergoing abdominal cancer surgery.
We sought to determine the effectiveness of continuous intrathecal thoracic analgesia (ITA) in comparison with continuous epidural thoracic analgesia (ETA) for the management of postoperative pain after abdominal cancer surgery in a randomised controlled study. ⋯ ITA and ETA produced the same levels of analgesia, without relevant complications.
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J Clin Monit Comput · Aug 2008
Comparative StudyContinuous, non-invasive techniques to determine cardiac output in children after cardiac surgery: evaluation of transesophageal Doppler and electric velocimetry.
Continuous and non-invasive measurement of cardiac output (CO) may contribute helpful information to the care and treatment of the critically ill pediatric patient. Different methods are available but their clinical verification is still a major problem. ⋯ In pediatric patients non-invasive measurement of CO and SV with TED and EV is useful for continuous monitoring after heart surgery. Both new methods seem to underestimate cardiac output in terms of absolute values. However, TED shows tolerable bias and precision and may be helpful for continuous CO monitoring in a deeply sedated and ventilated pediatric patient, e.g. in the operating room or intensive care unit.
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J Clin Monit Comput · Aug 2008
Non-invasive automated measurement of cardiac output during stable cardiac surgery using a fully integrated differential CO(2) Fick method.
To re-evaluate the accuracy and precision of a non-invasive method for measurement of cardiac output based on the differential CO(2) Fick approach using an automated change in respiratory rate delivered by a ventilator under control by a prototype measurement system. ⋯ Acceptable agreement with thermo- dilution during surgery was found, particularly where the ventilatory change involved an increase in respiratory rate from a lower baseline. This approach has potential to be readily integrated into modern anesthesia delivery platforms, allowing routine non-invasive cardiac output measurement.