scholarly journals Impact of Maternal Lateral Tilt On Cardiac Output During Caesarean Section Under Spinal Anaesthesia: A Prospective Observational Study

2022 ◽  
Author(s):  
Chiara Sonnino ◽  
Luciano Frassanito ◽  
Alessandra Piersanti ◽  
Pietro Paolo Giuri ◽  
Bruno Antonio Zanfini ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Final Analysis ◽  
Arterial Elastance ◽  
Lateral Tilt ◽  
Non Invasive ◽  
Hemodynamic Variables ◽  
Continuous Hemodynamic Monitoring

Abstract Background: Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). We tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous non-invasive hemodynamic monitoring.Methods: Forty-six patients were included in the final analysis. We considered 4 timepoints of 5 minutes each: T1=baseline with LUD; T2=baseline without LUD; T3=after SA with LUD; T4=after SA without LUD. LUD was then repositioned for CD. Primary outcome was to test if CO decreased from T3 to T4. We also compared CO between T1 and T2 and other hemodynamic variables: mean, systolic and diastolic blood pressure (respectively MAP, SAP and DAP), heart rate (HR), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), contractility (dP/dt), dynamic arterial elastance (Eadyn) at the different timepoints. Data on fetal Apgar scores and umbilical arterial and venous pH were collected.Results: CO did not vary from T3 to T4 [CO mean difference -0.02 L/min [95% CI -0.88 to 0.82; p=1]. No significant variation was registered for any variable at any timepoint. Conclusions: LUD did not show a significant impact on CO during continuous hemodynamic monitoring after SA for CD.Trial registration: (retrospectively registered on 03/12/2021) NCT05143684.

scholarly journals Lactobacillus Kefiri LKF01 (Kefibios®) for Prevention of Diarrhoea in Cancer Patients Treated with Chemotherapy: A Prospective Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 385
Author(s):  
Michele Ghidini ◽  
Mariaceleste Nicoletti ◽  
Margherita Ratti ◽  
Gianluca Tomasello ◽  
Veronica Lonati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Prospective Observational Study ◽  
Primary Outcome ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
High Grade ◽  
Combination Therapies ◽  
Grade 3 ◽  
Lactobacillus Kefiri ◽  
A Prospective Study

Diarrhoea is one of the main side effects that cancer patients face. The literature showsthat the incidence of chemotherapy (CT)-induced diarrhoea (grade 3–4) in treated patients is in the range of 10–20%, particularly after 5-fluorouracil (5-FU) bolus or some combination therapies of irinotecan and fluoropyrimidines. The aim of the present study was to evaluate the clinical effectiveness of Lactobacillus kefiri LKF01 (Kefibios®) in the prevention or treatment of CT-related diarrhoea in the cancer population. We conducted a prospective observational study. Patients enrolled were adults treated for at least four months with 5-FU-based CT. Kefibios® was administered to patients every day. The primary outcome was the evaluation of the incidence of grade 3–4 CT-induced diarrhoea. We included 76 patients in the final analysis. A 6.6% incidence of high-grade diarrhoea was found in the evaluated population (4.7% of patients treated with 5-FU-based therapy and 8.5% of patients treated with capecitabine-based CT). The overall incidence of high-grade diarrhoea observed was higher in the 1st and 2nd cycles (3.9%), with a subsequent sharp reduction from the 3rd cycle (1.3%) and negativisation from the 5th cycle. Lactobacillus kefiri LKF01 (Kefibios®) is safe and effective in preventing severe diarrhoea in cancer patients receiving 5-FU or capecitabine-based treatment.

278 Assessing effects of lateral tilt on cardiac output using a Non-invasive technique

2021 ◽  
Vol 224 (2) ◽  
pp. S182-S183
Author(s):  
Zaid Diken ◽  
Antonio F. Saad ◽  
Sema Hajmurad ◽  
Rakesh Vadhera ◽  
Michelle Simon ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Invasive Technique ◽  
Lateral Tilt ◽  
Non Invasive

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.

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.

MATHEMATICAL MODELING OF STROKE VOLUME FROM THE PERIPHERAL BLOOD FLOW FOR NON INVASIVE PLETHYSMOGRAPHIC MEASUREMENT OF CARDIAC OUTPUT AND ITS VALIDATION

2017 ◽  
Vol 29 (06) ◽  
pp. 1750041
Author(s):  
Pranali Choudhari ◽  
M. S. Panse
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Stroke Volume ◽  
Peripheral Blood ◽  
Clinical Medicine ◽  
Patient Specific ◽  
Peripheral Blood Flow ◽  
Lung Water ◽  
Non Invasive ◽  
Multiple Variable

The ability to accurately measure Cardiac Output (CO) is important in clinical medicine as it helps in improving diagnosis of abnormalities and appropriate disease management. In spite of being an important vital parameter, it is still missing from the screens of the bedside monitors employed today. This could be due to the invasiveness of the method or the discomfort in the measurement. Invasive methods are most accurate but can be best suited for the intensive care units (ICUs) and surgeries, but for bedside measurement these methods add an unnecessary risk to the life of the patient. The existing non-invasive method employed for CO measurement is the thoracic bioimpedance method, which is risky for patients with cardiovascular diseases and inaccurate for patients with extra vascular lung water. This paper presents a novel method of CO measurement from the peripheral blood flow, which fairly overcomes the disadvantages of the existing method. The impedance pulse has been acquired across the wrist, instead of the thorax. A new stroke volume equation has been modeled by carrying out the finite element simulation of the blood flow and multiple variable regression to incorporate the patient specific factors. The stroke volume thus obtained has been validated for 57 subjects.

A NON-INVASIVE, ACCURATE METHOD FOR DETERMINING SMALL STROKE VOLUME CARDIAC OUTPUT

1995 ◽  
Vol 23 (Supplement) ◽  
pp. A194
Author(s):  
Lisa D. Cox ◽  
Susan R. Blumenthal ◽  
Joe Messick ◽  
Anne Hakenewerth ◽  
James Norton
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Accurate Method ◽  
Non Invasive ◽  
Small Stroke

scholarly journals Vital signs of severe COVID-19 patients during inter-hospital helicopter transfer

2021 ◽  
Author(s):  
Cornelis Slagt ◽  
Eduard Johannes Spoelder ◽  
Marijn Cornelia Theresia Tacken ◽  
Maartje Frijlink ◽  
Sjoerd Servaas ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Intensive Care ◽  
The Netherlands ◽  
Stroke Volume ◽  
Critically Ill ◽  
Systemic Vascular Resistance ◽  
Vital Signs ◽  
Intensive Care Patients ◽  
Non Invasive ◽  
The Impact

Abstract Background: During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were not only transferred between hospitals by ambulance, but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the impact of helicopter transport on critically ill patients, and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated severe COVID-19 intensive care patients, with special focus on take-off, midflight, and landing. Methods: All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch ‘Lifeliner 5’ HEMS team and who were fully monitored including non-invasive cardiac output, were included in this study. Three 10 minute timeframes (take-off, midflight and landing) were defined for analysis. Continuous data of vital parameters heartrate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and non-invasive cardiac output using electrical cardiometry were collected and stored at a 1 minute interval. Data were analysed for differences over time within the timeframes using 1-way analysis of variance. Significant differences were checked for clinical relevance. Results: Ninety-eight patients were included in the analysis. During take-off an increase was noticed in cardiac output (from 6.7 to 8.1 Lmin-1; P<0.0001) which was determined by a decrease in systemic vascular resistance (from 1068 to 750 dyne·s·cm−5, P<0.0001) accompanied by an increase in stroke volume (from 92.0 to 110.2 ml, P<0.0001). Other parameters were unchanged during take-off and mid-flight. During the landing cardiac output and stroke volume slightly decreased (from 7.9 to 7.1 Lmin-1, P<0.0001 and from 108.3 to 100.6 ml, P<0.0001 respectively) and total systemic vascular resistance increased (P<0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians. Conclusions: Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs. This study this has been assessed by the medical ethical committee Arnhem-Nijmegen, the Netherlands (identifier 2021-7313). The committee waived the need for informed consent. The study was registered at www.trialregister.nl (identifier NL9307).

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