scholarly journals A new electric method for non-invasive continuous monitoring of stroke volume and ventricular volume-time curves

2012 ◽  
Vol 11 (1) ◽  
pp. 51 ◽  
Author(s):  
Maurits K Konings ◽  
Henk G Goovaerts ◽  
Maarten R Roosendaal ◽  
Rienk Rienks ◽  
Ferry M Koevoets ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Continuous Monitoring ◽  
Ventricular Volume ◽  
Non Invasive

scholarly journals Postoperative continuous non-invasive cardiac output monitoring on the ward: a feasibility study

2020 ◽  
Author(s):  
C. E. King ◽  
A. Kermode ◽  
G. Saxena ◽  
P. Carvelli ◽  
M. Edwards ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Clinical Outcomes ◽  
Feasibility Study ◽  
Continuous Monitoring ◽  
Elective Surgery ◽  
Resistance Index ◽  
Stroke Volume Index ◽  
Volume Index ◽  
Cardiac Output Monitoring ◽  
Non Invasive

Abstract Postoperative hypotension is common (occurring in one third of patients) and is associated with worse clinical outcomes. The LiDCO CNAP (continuous non-invasive arterial pressure) device measures haemodynamics but has not been widely adopted in ward environments. Improved early detection of hypotension by CNAP might guide interventions to improve clinical outcomes. We aimed to find the proportion of patients who tolerated LiDCO CNAP for 12 h postoperatively, to unmask episodes of hypotension detected by continuous monitoring and to characterise the haemodynamic profile at the time of hypotension. In this feasibility study, patients undergoing major elective surgery were continuously postoperatively monitored using CNAP. Haemodynamic data gathered from CNAP, including nSVRI (nominal systemic vascular resistance index), nSVI (nominal stroke volume index), SVV (stroke volume variation) and blood pressure, were analysed using Microsoft Excel and GraphPad Prism 8. 104 patients (age (mean ± sd): 68 ± 14, male (56%)) had CNAP sited postoperatively. 39% tolerated the CNAP device for at least 12 h. Within the 104 patients a mean of 81.2 min of hypotension detected by CNAP was not detected by usual care. The proportion of low/normal/high nSVI was 71%, 27% and 2%, nSVRI was 43%, 17% and 40%, respectively. CNAP monitoring was not tolerated for 12 h in the majority of patients. There were many episodes of hypotension unmasked through continuous monitoring. Based on the advanced haemodynamic data provided it is possible that the underlying cause of a third of postoperative hypotensive episodes is vasodilation rather than hypovolaemia. Trial registry number: NCT04010058 (ClinicalTrials.gov) Date of registration: 08/07/2019.

scholarly journals In-Silico Evaluation of Anthropomorphic Measurement Variations on Electrical Cardiometry in Neonates

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 936
Author(s):  
David B. Healy ◽  
Eugene M. Dempsey ◽  
John M. O’Toole ◽  
Christoph E. Schwarz
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
In Silico ◽  
Continuous Monitoring ◽  
Assessment Tools ◽  
Physical Measurement ◽  
Electrical Cardiometry ◽  
Non Invasive ◽  
Weight Measurement ◽  
Proportional Change

Non-invasive cardiac output methods such as Electrical Cardiometry (EC) are relatively novel assessment tools for neonates and they enable continuous monitoring of stroke volume (SV). An in-silico comparison of differences in EC-derived SV in relation to preset length and weight was performed. EC (ICON, Osypka Medical) was simulated using the “demo” mode for various combinations of length and weight representative of term and preterm infants. One-centimetre length error resulted in a SV-change of 1.8–3.6% (preterm) or 1.6–2.0% (term) throughout the tested weight ranges. One-hundred gram error in weight measurement resulted in a SV-change of 5.0–7.1% (preterm) or 1.5–1.8% (term) throughout the tested length ranges. Algorithms to calculate EC-derived SV incorporate anthropomorphic measurements. Therefore, inaccuracy in physical measurement can impact absolute EC measurements. This should be considered in the interpretation of previous findings and the design of future clinical studies of EC-derived cardiac parameters in neonates, particularly in the preterm cohorts where a proportional change was noted to be greatest.

scholarly journals Evaluating the Possibility of Translating Technological Advances in Non-Invasive Continuous Lactate Monitoring into Critical Care

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 879
Author(s):  
Robert D. Crapnell ◽  
Ascanio Tridente ◽  
Craig E. Banks ◽  
Nina C. Dempsey-Hibbert
Keyword(s):  
Critical Care ◽  
Continuous Monitoring ◽  
Performance Monitoring ◽  
Plasma Concentrations ◽  
Lactate Production ◽  
Anaerobic Exercise ◽  
Response To Treatment ◽  
Diverse Range ◽  
Non Invasive ◽  
Technological Advances

Lactate is widely measured in critically ill patients as a robust indicator of patient deterioration and response to treatment. Plasma concentrations represent a balance between lactate production and clearance. Analysis has typically been performed with the aim of detecting tissue hypoxia. However, there is a diverse range of processes unrelated to increased anaerobic metabolism that result in the accumulation of lactate, complicating clinical interpretation. Further, lactate levels can change rapidly over short spaces of time, and even subtle changes can reflect a profound change in the patient’s condition. Hence, there is a significant need for frequent lactate monitoring in critical care. Lactate monitoring is commonplace in sports performance monitoring, given the elevation of lactate during anaerobic exercise. The desire to continuously monitor lactate in athletes has led to the development of various technological approaches for non-invasive, continuous lactate measurements. This review aims firstly to reflect on the potential benefits of non-invasive continuous monitoring technology within the critical care setting. Secondly, we review the current devices used to measure lactate non-invasively outside of this setting and consider the challenges that must be overcome to allow for the translation of this technology into intensive care medicine. This review will be of interest to those developing continuous monitoring sensors, opening up a new field of research.

Effects of positive end-expiratory pressure on the right ventricle

1986 ◽  
Vol 61 (3) ◽  
pp. 819-826 ◽  
Author(s):  
R. J. Henning
Keyword(s):  
Stroke Volume ◽  
Right Ventricular ◽  
Positive Pressure Ventilation ◽  
Ventricular Volume ◽  
Positive Pressure ◽  
Right Ventricular Volume ◽  
Positive End Expiratory Pressure ◽  
Lung Water ◽  
Fluid Infusion ◽  
Lung Water Content

Transmural cardiac pressures, stroke volume, right ventricular volume, and lung water content were measured in normal dogs and in dogs with oleic acid-induced pulmonary edema (PE) maintained on positive-pressure ventilation. Measurements were performed prior to and following application of 20 cmH2O positive end-expiratory pressure (PEEP). Colloid fluid was given during PEEP for ventricular volume expansion before and after the oleic acid administration. PEEP significantly increased pleural pressure and pulmonary vascular resistance but decreased right ventricular volume, stroke volume, and mean arterial pressure in both normal and PE dogs. Although the fluid infusion during PEEP raised right ventricular diastolic volumes to the pre-PEEP level, the stroke volumes did not significantly increase in either normal dogs or the PE dogs. The fluid infusion, however, significantly increased the lung water content in the PE dogs. Following discontinuation of PEEP, mean arterial pressure, cardiac output, and stroke volume significantly increased, and heart rate did not change. The failure of the stroke volume to increase despite significant right ventricular volume augmentation during PEEP indicates that positive-pressure ventilation with 20 cmH2O PEEP decreases right ventricular function.

scholarly journals Non-Invasive Scale Measurement of Cardiac Output Compared with the Gold-Standard Direct Fick Method: A Feasibility Study

2021 ◽  
Author(s):  
Daniel Yazdi ◽  
Sarin Patel ◽  
Suriya Sridaran ◽  
Evan Wilson ◽  
Sarah Smith ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Exercise Test ◽  
Gold Standard ◽  
Cardiopulmonary Exercise Test ◽  
Cardiac Monitoring ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
The Mean

AbstractBackgroundObjective markers of cardiac function are limited in the outpatient setting and may be beneficial for monitoring patients with chronic cardiac conditions.ObjectiveWe assess the accuracy of a scale, with the ability to capture ballistocardiography, electrocardiography, and impedance plethysmography signals from a patient’s feet while standing on the scale, in measuring stroke volume and cardiac output compared to the gold-standard direct Fick method.MethodsThirty-two patients with unexplained dyspnea undergoing level 3 invasive cardiopulmonary exercise test at a tertiary medical center were included in the final analysis. We obtained scale and direct Fick measurements of stroke volume and cardiac output before and immediately after invasive cardiopulmonary exercise test.ResultsStroke volume and cardiac output from a cardiac scale and the direct Fick method correlated with r = 0.81 and r = 0.85, respectively (P < 0.001 each). The mean absolute error of the scale estimated stroke volume was -1.58 mL, with a 95% limits of agreement (LOA) of -21.97 mL to 18.81 mL. The mean error for the scale estimated cardiac output was -0.31 L/min, with a 95% LOA of -2.62 L/min to 2.00 L/min. The change in stroke volume and cardiac output before and after exercise were 78.9% and 96.7% concordant, respectively between the two measuring methods.ConclusionsThis novel scale with cardiac monitoring abilities may allow for non-invasive, longitudinal measures of cardiac function. Using the widely accepted form factor of a bathroom scale, this method of monitoring can be easily integrated into a patient’s lifestyle.

Transcutaneous Oxygen Tension Measurements in Newborn Infants

PEDIATRICS ◽  
1975 ◽  
Vol 55 (2) ◽  
pp. 232-235
Author(s):  
Gosta Rooth
Keyword(s):  
Continuous Monitoring ◽  
Newborn Infants ◽  
Arterial Oxygen ◽  
Invasive Technique ◽  
Clinical Experiences ◽  
Transcutaneous Oxygen Tension ◽  
Transcutaneous Oxygen ◽  
Non Invasive ◽  
Oxygen Tensions ◽  
A New Technique

Attention is called in this brief review article to the development and clinical uses of a new technique for monitoring blood oxygen tensions in newborn infants. This technique uses an electrode recently developed by Huch et al. in Germany to measure arterial oxygen tensions directly through the skin. This device allows for continuous monitoring with a non-invasive technique. The method is now in use in European hospitals. Clinical experiences are cited to document its usefulness.

scholarly journals Right ventricular myocardial work: proof-of-concept for non-invasive assessment of right ventricular function

2020 ◽  
Author(s):  
Steele C Butcher ◽  
Federico Fortuni ◽  
Jose M Montero-Cabezas ◽  
Rachid Abou ◽  
Mohammed El Mahdiui ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Stroke Volume ◽  
Right Ventricular ◽  
Systolic Function ◽  
Stroke Volume Index ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Non Invasive ◽  
Echocardiographic Parameters ◽  
Global Work

Abstract Aims Right ventricular myocardial work (RVMW) is a novel method for non-invasive assessment of right ventricular (RV) function utilizing RV pressure–strain loops. This study aimed to explore the relationship between RVMW and invasive indices of right heart catheterization (RHC) in a cohort of patients with heart failure with reduced left ventricular ejection fraction (HFrEF), and to compare values of RVMW with those of a group of patients without cardiovascular disease. Methods and results Non-invasive analysis of RVMW was performed in 22 HFrEF patients [median age 63 (59–67) years] who underwent echocardiography and invasive RHC within 48 h. Conventional RV functional measurements, RV global constructive work (RVGCW), RV global work index (RVGWI), RV global wasted work (RVGWW), and RV global work efficiency (RVGWE) were analysed and compared with invasively measured stroke volume and stroke volume index. Non-invasive analysis of RVMW was also performed in 22 patients without cardiovascular disease to allow for comparison between groups. None of the conventional echocardiographic parameters of RV systolic function were significantly correlated with stroke volume or stroke volume index. In contrast, one of the novel indices derived non-invasively by pressure–strain loops, RVGCW, demonstrated a moderate correlation with invasively measured stroke volume and stroke volume index (r = 0.63, P = 0.002 and r = 0.59, P = 0.004, respectively). RVGWI, RVGCW, and RVGWE were significantly lower in patients with HFrEF compared to a healthy cohort, while values of RVGWW were significantly higher. Conclusion RVGCW is a novel parameter that provides an integrative analysis of RV systolic function and correlates more closely with invasively measured stroke volume and stroke volume index than other standard echocardiographic parameters.

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