Continuous cardiac output and hemodynamic monitoring: high temporal correlation between plasma TNF-α and hemodynamic changes during a sepsis-like state in cancer immunotherapy

2003 ◽  
Vol 9 (2) ◽  
pp. 91-95
Author(s):  
Carlos Caorsi ◽  
Enrique Quintana ◽  
Sergio Valdés ◽  
Carlos Muñoz
Keyword(s):  
Cardiac Output ◽  
Cancer Immunotherapy ◽  
Hemodynamic Monitoring ◽  
Temporal Correlation ◽  
Continuous Cardiac Output ◽  
Hemodynamic Changes ◽  
Tnf Α

Responsiveness of Noninvasive Continuous Cardiac Output Monitoring During the Valsalva Maneuver

2018 ◽  
Vol 29 (2) ◽  
pp. 127-132
Author(s):  
L. J. Delaney ◽  
R. Bellomo ◽  
F. van Haren
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Cardiac Index ◽  
Stroke Volume ◽  
Hemodynamic Monitoring ◽  
Valsalva Maneuver ◽  
Cardiac Output Monitoring ◽  
Hemodynamic Changes ◽  
Dynamic Changes ◽  
Output Monitoring

To describe the baseline hemodynamic variables and response time of hemodynamic changes associated with the Valsalva maneuver using noninvasive continuous cardiac output monitoring (Nexfin). Hemodynamic monitoring provides an integral component of advanced clinical care and the ability to monitor response to treatment interventions. The emergence of noninvasive hemodynamic monitoring provides clinicians with an opportunity to monitor and assess patients rapidly with ease of implementation. However, the responsiveness of this method in tracking dynamic changes that occur has not been fully elucidated. A prospective observational study was conducted involving 44 healthy volunteers (age = 38 ±12 years). Participants performed a Valsalva maneuvers to illicit dynamic changes in blood pressure, cardiac output, cardiac index, systemic vascular resistance index (SVRI), and stroke volume. Changes in these hemodynamic parameters were monitored while performing repeated standardized Valsalva maneuvers. Baseline hemodynamic values were obtained in all 44 participants, and showed an interaction with age, accompanying a significant decline in cardiac index ( r = –.66, p < .05) and stroke volume ( r = –.68, p < .05), and an increase in SVRI ( r = .67, p < .05) with increasing age. The Valsalva maneuver, performed in 20 participants, resulted in a change of 10% from baseline blood pressure and cardiac index, which was detected within 4.53 s ( SD = 4.36) and 3.31 s ( SD = 2.21), respectively. Noninvasive continuous cardiac monitoring demonstrated the ability to rapidly detect logical and predictable hemodynamic changes. These observations suggest that such Nexfin technology may have useful clinical applications.

scholarly journals The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

2013 ◽  
Vol 61 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Marc-Olivier Fischer ◽  
Xavier Balaire ◽  
Charles Le Mauff de Kergal ◽  
Clément Boisselier ◽  
Jean-Louis Gérard ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Diagnostic Accuracy ◽  
Transthoracic Echocardiography ◽  
Continuous Cardiac Output

CONTINUOUS CARDIAC OUTPUT MONITORING USING A DOPPLER PULMONARY ARTERY CATHETER

1989 ◽  
Vol 71 (Supplement) ◽  
pp. A388
Author(s):  
R. G. Pearl ◽  
A. Ford ◽  
M. Nassi ◽  
T. Schuenemeyer ◽  
L. Neumann ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Continuous Cardiac Output ◽  
Cardiac Output Monitoring ◽  
Output Monitoring

SEMI INVASIVE CARDIAC OUTPUT MONITORING IN A CARDIAC PATIENT UNDERGOING TOTAL THYROIDECTOMY USING SMARTPHONE APP CAPSTESIA.

2021 ◽  
pp. 4-5
Author(s):  
Santosh Kumar Rai ◽  
Vishal Vashist ◽  
Deepak Bhardwaj ◽  
Bhanu Gupta
Keyword(s):  
Cardiac Output ◽  
Cardiac Index ◽  
Real Time ◽  
Hemodynamic Monitoring ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Output Pulse ◽  
Pressure Variation ◽  
Smartphone App ◽  
Arterial Waveform

Introduction: Advanced hemodynamic monitoring is need of today especially in patients with limited cardiac reserve. With the advent of smartphones & specially designed applications, hemodynamic monitoring becomes quite easy. Materials & Methods: Patient was pre – medicated with Inj. Fentanyl & inj. Glycopyrrolate, induced with Inj. Etomidate & Inj. Vecuronium and maintained with mixture ofIsourane, Nitrous Oxide & Oxygen. An arterial line was secured in Left Radial Artery. We used the CAPSTESIA app to take picture of the arterial waveform using a smartphone. Demographic data of the patient was fed in the app. App used it's pre- fed algorithm to give the real time Cardiac Output, Pulse Pressure variations, Cardiac Index based upon the arterial waveform. Results: Using the application we were able to monitor the cardiac output of the patient in real time using semi- invasive means. It enabled us to regulate the uid management of the patient and avoid any adverse cardiac events (hypotension). With Pulse Pressure variation also available in real time, we were able to restrict use of vasopressors since the Left Ventricle Ejection Fraction of the patient was 35 % on ECHO. Surgery was conducted without any untoward event. Patient was successfully extubated and sent to PACU. Conclusions:Advanced hemodynamic monitoring is time consuming using manual methods. We found the smartphone app CAPSTESIA pretty useful for semi-invasive hemodynamic monitoring of the Cardiac Output, Pulse Pressure variation, Cardiac Index,etc in real time.

scholarly journals Endothelial Rap1B mediates T-cell exclusion to promote tumor growth -a novel mechanism underlying vascular immunosuppression

2021 ◽  
Author(s):  
Guru Prasad Sharma ◽  
Ramoji Kosuru ◽  
Sribalaji Lakshmikanthan ◽  
Shikan Zheng ◽  
Yao Chen ◽  
...  
Keyword(s):  
T Cells ◽  
Tumor Growth ◽  
Cancer Immunotherapy ◽  
Small Gtpase ◽  
Vascular Endothelial ◽  
Promote Tumor Growth ◽  
Tnf Α ◽  
Inflammatory Stimuli ◽  
Endothelial Growth Factor

Overcoming vascular immunosuppression: lack of endothelial cell (EC) responsiveness to inflammatory stimuli in the proangiogenic environment of tumors, is essential for successful cancer immunotherapy. The mechanisms through which Vascular Endothelial Growth Factor (VEGF) modulates tumor EC response to exclude T cells are not well understood. The goal was to determine the role of EC Rap1B, a small GTPase that positively regulates VEGFangiogenesis during development, in tumor growth in vivo. Using mouse models of Rap1B deficiency, Rap1B+/- and EC-specific Rap1B KO (Rap1BiΔEC) we demonstrate that EC Rap1B restricts tumor growth and angiogenesis. More importantly, EC-specific Rap1B deletion leads to an altered tumor microenvironment with increased recruitment of leukocytes and increased activity of tumor CD8+ T cells. We find that tumor growth, albeit not angiogenesis, is restored in Rap1BiΔEC mice by depleting CD8+ T cells. Mechanistically, global transcriptome analysis indicated upregulation of the tumor cytokine, TNF-α, -induced signaling and NFκB transcriptional activity in Rap1B-deficient ECs. Functionally, EC Rap1B deletion led to upregulation of NFκB activity and enhanced Cell Adhesion Molecules (CAMs) expression in TNF-α stimulated ECs. Importantly, CAM expression was upregulated also in tumor ECs from Rap1BiΔEC mice, vs. controls. Significantly, deletion of Rap1B abrogated VEGF immunosuppressive downregulation of CAM expression, demonstrating that Rap1B is essential for VEGF-suppressive signaling. Thus, our studies identify a novel endothelial-endogenous mechanism underlying VEGF-dependent desensitization of EC to pro-inflammatory stimuli. Significantly, they identify EC Rap1 as a potential novel vascular target in cancer immunotherapy.

IMMEDIATE HEMODYNAMIC EFFECTS OF ISOPROTERENOL

1963 ◽  
Vol 41 (1) ◽  
pp. 1949-1953 ◽  
Author(s):  
Margaret Beznák ◽  
P. Hacker
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Oxygen Consumption ◽  
Subcutaneous Injection ◽  
Direct Action ◽  
Peripheral Resistance ◽  
Oxygen Demand ◽  
Hemodynamic Effects ◽  
Hemodynamic Changes ◽  
Histological Damage

Subcutaneous injection of 40 mg/kg isoproterenol is followed within 2 minutes by a fall in blood pressure and peripheral resistance, by tachycardia, and by an increase in cardiac output. It seems likely that these hemodynamic changes are a consequence of a direct action of isoproterenol on the myocardium. Isoproterenol also causes a significant increase in the oxygen consumption of the rats. The increased oxygen demand of the tissues may play a role in maintaining the hemodynamic changes for periods of more than an hour after isoproterenol. Signs of histological damage in the myocardium begin to appear without affecting the function of the cardiovascular system, as measured by the tests used.

Comparison of continuous with intermittent bolus thermodilution cardiac output measurements

1995 ◽  
Vol 4 (6) ◽  
pp. 460-465 ◽  
Author(s):  
CE Ditmyer ◽  
M Shively ◽  
DB Burns ◽  
RT Reichman
Keyword(s):  
Cardiac Output ◽  
Intraclass Correlation ◽  
Continuous Cardiac Output ◽  
Cardiac Output Monitoring ◽  
Monitoring Method ◽  
Convenience Sample ◽  
Thermodilution Cardiac Output ◽  
Intermittent Bolus ◽  
Thermodilution Method ◽  
Cardiac Output Measurements

BACKGROUND: Few complete studies have been published to validate the agreement between continuous cardiac output and intermittent thermodilution cardiac output. OBJECTIVE: To analyze the agreement between cardiac output measurements by the continuous thermodilution method and the intermittent bolus thermodilution method, using a continuous cardiac output catheter in postoperative cardiothoracic surgery patients. METHODS: A convenience sample of 14 adult cardiothoracic surgical patients with thermodilution pulmonary artery catheters placed preoperatively was used. A total of 214 comparison measurements of cardiac output by both the continuous and intermittent thermodilution methods were taken on patient admission to the critical care unit, every 4 hours, and with any change greater than 10% from baseline readings. RESULTS: The intraclass correlation between continuous cardiac output and intermittent cardiac output was .89. The limits of agreement were -1.34 to 1.18 L/min, indicating that in 95% of readings the difference between continuous cardiac output and intermittent cardiac output were within this range. CONCLUSIONS: The continuous cardiac output monitoring method shows clinically acceptable agreement with the intermittent cardiac output method.

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