Hemodynamic monitoring by transpulmonary thermodilution and pulse contour analysis in critically ill children

Traditional, static measures of resuscitation, such as vital signs, central venous pressure, and pulmonary arterial pressure, provide momentary glimpses evolving hemodynamic states. In patients with shock, these measures of resuscitation are poor indicators of response to therapy. As a result, dynamic assessments of cardiovascular status are now used in critically ill patients to facilitate resuscitation. Some of these approaches focus on fluid responsiveness. These assessments allow care to be tailored to each patient’s response to interventions. An evolving aspect of hemodynamic monitoring is evaluation of the adequacy of tissue perfusion and oxygen delivery. In this review, we consider the use of arterial, central venous, and pulmonary arterial blood pressure monitoring; echocardiography; transesophageal Doppler technology; pulse contour analysis; bioimpedance and bioreactance; and partial rebreathing monitoring modalities to assess hemodynamic status in critically ill patients. This review contains 22 figures, 5 tables, and 38 references. Key words: echocardiography, esophageal Doppler technology, invasive and noninvasive hemodynamic monitoring, pulse contour analysis, shock

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Comparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs

Journal of Veterinary Internal Medicine ◽

10.1111/jvim.13984 ◽

2016 ◽

Vol 30 (4) ◽

pp. 941-950 ◽

Cited By ~ 5

Author(s):

N.A. Garofalo ◽

F.J. Teixeira‐Neto ◽

J.C. Rodrigues ◽

S.A. Cerejo ◽

A.J.A. Aguiar ◽

...

Keyword(s):

Cardiac Output ◽

Pulmonary Artery ◽

Transpulmonary Thermodilution ◽

Pulse Contour Analysis ◽

Pulse Contour ◽

Contour Analysis ◽

Thermodilution Cardiac Output ◽

Anesthetized Dogs ◽

Cardiac Output Measurements

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Noninvasive Cardiac Output Determination Using Applanation Tonometry-Derived Radial Artery Pulse Contour Analysis in Critically Ill Patients

Yearbook of Critical Care Medicine ◽

10.1016/s0734-3299(08)79155-x ◽

2009 ◽

Vol 2009 ◽

pp. 81-82

Author(s):

T. Dorman

Keyword(s):

Cardiac Output ◽

Critically Ill ◽

Radial Artery ◽

Critically Ill Patients ◽

Pulse Contour Analysis ◽

Pulse Contour ◽

Applanation Tonometry ◽

Contour Analysis ◽

Noninvasive Cardiac Output ◽

Cardiac Output Determination

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Comparison of pulse contour analysis by Pulsioflex and Vigileo to measure and track changes of cardiac output in critically ill patients

British Journal of Anaesthesia ◽

10.1093/bja/aeu375 ◽

2015 ◽

Vol 114 (2) ◽

pp. 235-243 ◽

Cited By ~ 34

Author(s):

X. Monnet ◽

S. Vaquer ◽

N. Anguel ◽

M. Jozwiak ◽

F. Cipriani ◽

...

Keyword(s):

Cardiac Output ◽

Critically Ill ◽

Critically Ill Patients ◽

Pulse Contour Analysis ◽

Pulse Contour ◽

Contour Analysis

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Transpulmonary Thermodilution Cardiac Output and Pulse Contour Analysis Continuous Cardiac Output in a Swine Model of Severe Hemorrhagic Shock: Comparison with Pulmonary Artery Cardiac Output

Academic Emergency Medicine ◽

10.1197/j.aem.2004.02.069 ◽

2004 ◽

Vol 11 (5) ◽

pp. 520-520

Author(s):

J. E. Manning

Keyword(s):

Cardiac Output ◽

Pulmonary Artery ◽

Hemorrhagic Shock ◽

Transpulmonary Thermodilution ◽

Pulse Contour Analysis ◽

Pulse Contour ◽

Continuous Cardiac Output ◽

Swine Model ◽

Contour Analysis ◽

Thermodilution Cardiac Output

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Nexfin Noninvasive Continuous Hemodynamic Monitoring: Validation against Continuous Pulse Contour and Intermittent Transpulmonary Thermodilution Derived Cardiac Output in Critically Ill Patients

The Scientific World JOURNAL ◽

10.1155/2013/519080 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 32

Author(s):

Koen Ameloot ◽

Katrijn Van De Vijver ◽

Ole Broch ◽

Niels Van Regenmortel ◽

Inneke De laet ◽

...

Keyword(s):

Cardiac Output ◽

Critically Ill ◽

Critically Ill Patients ◽

Pulse Contour Analysis ◽

Pulse Contour ◽

Time Interval ◽

Medical Systems ◽

Contour Analysis ◽

Limits Of Agreement ◽

Polar Plot

Introduction. Nexfin (Bmeye, Amsterdam, Netherlands) is a noninvasive cardiac output (CO) monitor based on finger arterial pulse contour analysis. The aim of this study was to validate Nexfin CO (NexCO) against thermodilution (TDCO) and pulse contour CO (CCO) by PiCCO (Pulsion Medical Systems, Munich, Germany).Patients and Methods. In a mix of critically ill patients (n=45), NexCO and CCO were measured continuously and recorded at 2-hour intervals during the 8-hour study period. TDCO was measured at 0–4–8 hrs.Results. NexCO showed a moderate to good (significant) correlation with TDCO (R20.68,P<0.001) and CCO (R20.71,P<0.001). Bland and Altman analysis comparing NexCO with TDCO revealed a bias (± limits of agreement, LA) of 0.4 ± 2.32 L/min (with 36% error) while analysis comparing NexCO with CCO showed a bias (±LA) of 0.2 ± 2.32 L/min (37% error). NexCO is able to follow changes in TDCO and CCO during the same time interval (level of concordance 89.3% and 81%). Finally, polar plot analysis showed that trending capabilities were acceptable when changes in NexCO (ΔNexCO) were compared toΔTDCO andΔCCO (resp., 89% and 88.9% of changes were within the level of 10% limits of agreement).Conclusion. we found a moderate to good correlation between CO measurements obtained with Nexfin and PiCCO.

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