scholarly journals Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Silvia Fiorelli ◽  
Gelsomina Capua ◽  
Cecilia Menna ◽  
Claudio Andreetti ◽  
Elisabetta Giorni ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Function ◽  
Transesophageal Echocardiography ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Linear Regression Analysis ◽  
Surgical Correction ◽  
Percentage Error ◽  
Congenital Deformity ◽  
Cardiac Output Monitoring

Abstract Background Pectus excavatum (PE), a congenital deformity of the chest wall, can lead to cardiac compression and related symptoms. PE surgical repair can improve cardiac function. Intraoperative transesophageal echocardiography (TEE) has been successfully employed to assess intraoperative hemodynamic variations in patients undergoing PE repair. FloTrac/Vigileo™ system (Edwards Life-sciences Irvine, CA) (FT/V) is a minimally invasive cardiac output monitoring system. This retrospective study aimed to assess hemodynamic changes in surgical repair of PE using FT/V and concordance with parameters measured by TEE. Results N=19 patients submitted to PE repair via Ravitch or Nuss technique were enrolled. Intraoperative cardiac assessments simultaneously obtained via TEE and FT/V system were investigated. The agreement between TEE-derived cardiac output (CO-TEE) and FT/V system parameter (COAP) was evaluated. The relationship between COTEE and COAP was analyzed for all data using linear regression analysis. A significant correlation between COAP and COTEE values (R = 0.65, p < 0.001) was found. Bland-Altman analysis of COAP and COTEE showed a bias of 0.13 L/min and a limit of agreement of − 2.33 to 2.58 L/min, with a percentage error of 48%. Intraoperative measurements by TEE and FT/V both showed a significant increase in CO after surgical correction of PE (p < 0.005). Conclusions FT/V system compared to TEE in hemodynamic monitoring during PE surgery yielded clinically unacceptable results due to a high percentage error. After surgical correction of PE, CO, measured by TEE and FT/V, significantly improved.

Comparison of estimation of cardiac output using an uncalibrated pulse contour method and echocardiography during veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2019 ◽  
Vol 35 (5) ◽  
pp. 397-401
Author(s):  
Ottavia Bond ◽  
Selene Pozzebon ◽  
Federico Franchi ◽  
Federica Zama Cavicchi ◽  
Jacques Creteur ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Extracorporeal Membrane Oxygenation ◽  
Linear Regression Analysis ◽  
Pulse Contour ◽  
Contour Method ◽  
Cardiac Output Monitoring ◽  
Membrane Oxygenation ◽  
Output Monitoring ◽  
Pulse Contour Method

Introduction: During veno-venous extracorporeal membrane oxygenation, cardiac output monitoring is essential to assess tissue oxygen delivery. Adequate arterial oxygenation depends on the ratio between the extracorporeal pump blood flow and the cardiac output. The aim of this study was to compare estimates of cardiac output and blood flow/cardiac output ratios made using an uncalibrated pulse contour method with those made using echocardiography in patients treated with veno-venous extracorporeal membrane oxygenation. Methods: Cardiac output was estimated simultaneously using a pulse contour method (MostCareUp; Vygon, Encouen, France) and echocardiography in 17 hemodynamically stable patients treated with veno-venous extracorporeal membrane oxygenation. Comparisons were made using Bland–Altman and linear regression analysis. Results: There were significant correlations between cardiac output estimated using pulse contour method and echocardiography and between blood flow/cardiac output estimated using pulse contour method and blood flow/cardiac output estimated using echocardiography (r = 0.84, p < 0.001 and r = 0.87, p < 0.001, respectively). Bland–Altman analysis showed a good agreement (bias −0.20 ± 0.50 L/min) and a low percentage of error (25%) for the cardiac output values estimated by the two methods. The bias between the blood flow/cardiac output ratios obtained with the two methods was 5.19% ± 12.3% (percentage of error = 28.1%). Conclusions: The pulse contour method is a valuable alternative to echocardiography for the assessment of cardiac output and the blood flow/cardiac output ratio in patients treated with veno-venous extracorporeal membrane oxygenation.

scholarly journals Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Sophia Horster ◽  
Hans-Joachim Stemmler ◽  
Nina Strecker ◽  
Florian Brettner ◽  
Andreas Hausmann ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Prospective Observational Study ◽  
University Hospital ◽  
Percentage Error ◽  
Cardiac Output Monitoring ◽  
Saps Ii Score ◽  
The Mean ◽  
Output Monitoring ◽  
Clinical Conditions ◽  
Cardiac Output Measurements

USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring). The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points) on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (). Seventy paired left-sided CO measurements (transaortic access = COUS-A) were obtained. The mean COUS-Awere 6.55 l/min (±2.19) versus COPiCCO6.5 l/min (±2.18). The correlation coefficient was . Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min) leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO). It seems to be appropriate in situations where CO measurements are most pertinent to patient management.

Surgical repair of pectus excavatum relieves right heart chamber compression and improves cardiac output in adult patients—an intraoperative transesophageal echocardiographic study

2015 ◽  
Vol 210 (6) ◽  
pp. 1118-1125 ◽  
Author(s):  
Chieh-Ju Chao ◽  
Dawn E. Jaroszewski ◽  
Preetham N. Kumar ◽  
MennatAllah M. Ewais ◽  
Christopher P. Appleton ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Adult Patients ◽  
Right Heart ◽  
Heart Chamber ◽  
Echocardiographic Study

scholarly journals CARDIAC FUNCTION DURING MINI-INVASIVE REPAIR OF PECTUS EXCAVATUM WITH THE NUSS PROCEDURE

2021 ◽  
Vol 74 (8) ◽  
pp. 1809-1815
Author(s):  
Ulbolhan A. Fesenko ◽  
Ivan Myhal
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Cardiac Index ◽  
Stroke Volume ◽  
Cardiac Function ◽  
Epidural Anaesthesia ◽  
Pectus Excavatum ◽  
Stroke Volume Index ◽  
Volume Index ◽  
Nuss Procedure

The aim of the study was to analyze cardiac function during Nuss procedure under the combination of general anesthesia with different variants of the regional block. Materials and methods: The observative prospective study included 60 adolescents (boys/girls=47/13) undergone Nuss procedure for pectus excavatum correction under the combination of general anaesthesia and regional blocks. The patients were randomized into three groups (n=20 in each) according to the perioperative regional analgesia technique: standart epidural anaesthesia (SEA), high epidural anaesthesia (HEA) and bilateral paravertebral anaesthesia (PVA). The following parameters of cardiac function were analyzed: heart rate, estimated cardiac output (esCCO), cardiac index (esCCI), stroke volume (esSV) and stroke volume index (esSVI) using non-invasive monitoring. Results: Induction of anesthesia and regional blocks led to a significant decrease in esCCO (-9.4%) and esCCI (-9.8%), while esSV and esSVI remained almost unchanged in all groups (H=4.9; p=0.09). At this stage, the decrease in cardiac output was mainly due to decreased heart rate. At the stage of sternal elevation we found an increase in esSV, which was more pronounced in the groups of epidural blocks (+23.1% in HEA and +18.5% in SEA). After awakening from anesthesia and tracheal extubation esSV was by 11% higher than before surgery without ingergroup difference. Conclusions: The Nuss procedure for pectus excavatum correction lead to improved cardiac function. increase in stroke volume and its index were more informative than cardiac output and cardiac index which are dependent on heart rate that is under the influence of anaesthesia technique.

Cardiac Function Assessed by Transesophageal Echocardiography During Pectus Excavatum Repair

2010 ◽  
Vol 89 (1) ◽  
pp. 240-243 ◽  
Author(s):  
Thorsten Krueger ◽  
Pierre-Guy Chassot ◽  
Michel Christodoulou ◽  
Cai Cheng ◽  
Hans-Beat Ris ◽  
...  
Keyword(s):  
Cardiac Function ◽  
Transesophageal Echocardiography ◽  
Pectus Excavatum

Are Noninvasive Continuous Cardiac Output Monitoring Interchangeable with Esophageal Doppler?

2020 ◽  
Vol 103 (6) ◽  
pp. 541-547
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Correlation Coefficient ◽  
Percentage Error ◽  
Cardiac Output Monitoring ◽  
Esophageal Doppler ◽  
Limits Of Agreement ◽  
Pulse Wave Transit Time ◽  
Output Monitoring ◽  
Trending Ability

Objective: To compare the trending ability, accuracy, and precision of non-invasive stroke volume (SV) measurement based on a bioreactance technique and measurement of the pulse wave transit time (PWTT) versus the esophageal Doppler monitoring (EDM). Materials and Methods: Two hundred twenty-seven paired measurements from 10 patients who underwent abdominal surgery under general anesthesia were included for SV measurements. Pearson’s correlation coefficient was calculated, and Bland-Altman analysis was performed to evaluate the agreement between EDM and bioreactance (EDM-bioreactance) and between EDM and PWTT (EDM-PWTT). Results: EDM-bioreactance had a correlation coefficient of 0.75 (95% confidence interval [CI] 0.62 to 0.78; p<0.001), bias of 0.28 ml (limits of agreement –30.92 to 31.38 ml), and percentage error of 46.82%. EDM-PWTT had a correlation coefficient of 0.48 (95% CI 0.44 to 0.72; p<0.001), bias of –0.18 ml (limits of agreement –40.28 to 39.92 ml), and percentage error of 60.17%. A subgroup analysis of data from patients who underwent crystalloid loading was performed to detect the trending ability. The four-quadrant plot analysis between EDM-bioreactance and EDM-PWTT demonstrated concordance rates of 70.00% and 73.68%, respectively. Conclusion: SV measurement based on bioreactance technique and measurement of PWTT are not interchangeable with EDM. Trial registration: Thai Clinical Trials Registry, TCTR 20181217003 Keywords: Stroke volume, Cardiac output, Doppler, Perioperative care, Pulse, Time

Pectus Excavatum

2018 ◽  
Author(s):  
Priti G. Dalal ◽  
Meghan Whitley
Keyword(s):  
Epidural Analgesia ◽  
Surgical Procedures ◽  
Pectus Excavatum ◽  
Surgical Repair ◽  
Congenital Deformity ◽  
Shortness Of Breath ◽  
Thoracic Epidural ◽  
Breathing Exercises ◽  
Breath Management ◽  
Thoracoscopic Technique

Pectus excavatum is a funnel-shaped congenital deformity of the chest. Although the deformity can appear minimal at birth, it may be progressive. There may be cardiac or pulmonary compromise in addition to subjective complaints of pain and shortness of breath. Management ranges from breathing exercises to surgical repair with mobilization of the sternum and ribs. This can be performed using an open or thoracoscopic technique. Complications of surgical repair include atelectasis and pneumothorax. Significant pain is associated with the surgical procedures and multimodal analgesic therapy, including thoracic epidural analgesia and intravenous narcotics, are typically used. This chapter discusses the etiology and management of pectus excavatum.

Noninvasive Cardiac Output Monitoring Using Electrical Cardiometry and Outcomes in Critically Ill Children

2020 ◽  
Author(s):  
Lydia Sumbel ◽  
Muthiah R. Annamalai ◽  
Aanchal Wats ◽  
Mohammed Salameh ◽  
Arpit Agarwal ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Respiratory Failure ◽  
Critically Ill ◽  
Linear Regression Analysis ◽  
Critically Ill Children ◽  
Cardiac Output Monitoring ◽  
Electrical Cardiometry ◽  
Hemodynamic Assessment ◽  
Inotrope Score ◽  
Output Monitoring

AbstractCardiac output (CO) measurement is an important element of hemodynamic assessment in critically ill children and existing methods are difficult and/or inaccurate. There is insufficient literature regarding CO as measured by noninvasive electrical cardiometry (EC) as a predictor of outcomes in critically ill children. We conducted a retrospective chart review in children <21 years, admitted to our pediatric intensive care unit (PICU) between July 2018 and November 2018 with acute respiratory failure and/or shock and who were monitored with EC (ICON monitor). We collected demographic information, data on CO measurements with EC and with transthoracic echocardiography (TTE), and data on ventilator days, PICU and hospital days, inotrope score, and mortality. We analyzed the data using Chi-square and multiple linear regression analysis. Among 327 recordings of CO as measured by EC in 61 critically ill children, the initial, nadir, and median CO (L/min; median [interquartile range (IQR)]) were 3.4 (1.15, 5.6), 2.39 (0.63, 4.4), and 2.74 (1.03, 5.2), respectively. Low CO as measured with EC did not correlate well with TTE (p = 0.9). Both nadir and mean CO predicted ventilator days (p = 0.05 and 0.01, respectively), and nadir CO was correlated with peak inotrope score (correlation coefficient of –0.3). In our cohort of critically ill children with respiratory failure and/or shock, CO measured with EC did not correlate with TTE. Both nadir and median CO measured with EC predicted outcomes in critically ill children.

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