scholarly journals Prevalence of lactic acidaemia in patients with advanced heart failure and depressed cardiac output

2016 ◽  
Vol 19 (8) ◽  
pp. 1027-1033 ◽  
Author(s):  
Luigi Adamo ◽  
Michael E. Nassif ◽  
Erik Novak ◽  
Shane J. LaRue ◽  
Douglas L. Mann
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Advanced Heart Failure ◽  
Lactic Acidaemia

Can measurement of mixed venous oxygen saturation replace measurement of cardiac output in patients with advanced heart failure?

1998 ◽  
Vol 7 (5) ◽  
pp. 374-380 ◽  
Author(s):  
A Gawlinski
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Ejection Fraction ◽  
Oxygen Saturation ◽  
Advanced Heart Failure ◽  
Mixed Venous Oxygen Saturation ◽  
Venous Oxygen Saturation ◽  
Vasoactive Medications ◽  
Mixed Venous ◽  
Low Ejection Fraction

BACKGROUND: Nursing care of patients with advanced heart failure with low ejection fraction requires strict management of IV fluids. Measurement of mixed venous oxygen saturation offers advantages over measurement of cardiac output because no administration of fluid is required and data are obtained continuously. OBJECTIVES: To determine the relationship between mixed venous oxygen saturation and cardiac output in patients with advanced heart failure who have low ejection fraction and to determine if use of vasoactive medications alters the relationship between mixed venous oxygen saturation and cardiac output. METHODS: Simultaneously obtained measurements of mixed venous oxygen saturation and cardiac output were compared in 42 patients with advanced heart failure with ejection fractions of 30% or less (mean, 19.5%). RESULTS: Correlation between mixed venous oxygen saturation and cardiac output was r = 0.54 (P < .001). For subjects not receiving vasoactive medications (n = 28), r = 0.52 (P = .004); for those receiving vasoactive medications (n = 14), r = 0.57 (P = .03). CONCLUSIONS: Similar correlations in the groups receiving and not receiving vasoactive medications suggest that even with pharmacological support, changes in mixed venous oxygen saturation may not be reflected by concomitant changes in cardiac output. Measurement of mixed venous oxygen saturation should not replace measurement of cardiac output for clinical decision making in patients with advanced heart failure with low ejection fraction.

scholarly journals Nitroprusside Improves Hemodynamic Indices and Clinical Outcomes in Patients with Advanced Heart Failure and Low Cardiac Output

2007 ◽  
Vol 13 (6) ◽  
pp. S167
Author(s):  
W. Mullens ◽  
Z. Abrahams ◽  
H.N. Skouri ◽  
R.C. Starling ◽  
D.O. Taylor ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Clinical Outcomes ◽  
Advanced Heart Failure ◽  
Low Cardiac Output

scholarly journals OVERESTIMATION OF CARDIAC OUTPUT DUE TO INTRACARDIAC SHUNTING IN ADVANCED HEART FAILURE

2021 ◽  
Vol 77 (18) ◽  
pp. 2292
Author(s):  
Matthew Evans ◽  
William Mostertz ◽  
Carson Keck ◽  
Jeffrey Yourshaw ◽  
Ryan Tedford
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Advanced Heart Failure ◽  
Intracardiac Shunting

scholarly journals 568 Echocardiography and impedance cardiography as determinants of successful slow Levosimendan infusion in patients with acute advanced heart failure

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Gaetano Ruocco ◽  
Guido Pastorini ◽  
Mauro Feola
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Impedance Cardiography ◽  
Global Longitudinal Strain ◽  
Advanced Heart Failure ◽  
Non Invasive ◽  
Dimensional Echocardiography ◽  
Invasive Measurement

Abstract Aims Despite new therapeutic options, patients with heart failure (HF) still progress to advanced stage. Among new therapeutic options, Levosimendan was recently approved in order to treat patients hospitalized for acute decompensated heart failure (ADHF) with severe systolic dysfunction. The pharmacological effects of Levosimendan consist of inotropy, vasodilatation, and cardioprotection through the increase of calcium sensitivity. These effects should be monitored with echocardiography and in particular with speckle tracking and tri-dimensional echocardiography which appear to be useful in LV systolic function detection and monitoring. In this study we aim to evaluate the effect of slow infusion of Levosimendan on the non-invasive measurement of cardiac output, the speckle tracking parameters and the tri-dimensional echocardiography measurements in advanced ADHF patients. Methods and results This is a prospective observational study evaluating Levosimendan efficacy through advanced echocardiography. We enrolled 11 patients with diagnosis of ADHF who respect the recent ESC criteria of ‘advanced heart failure’. Patients underwent to blood sample examination to measure electrolytes, creatinine, and NTproBNP. Patients underwent to advanced echocardiography examination (performed for each patient pre- and post-Levosimendan infusion) with tri-dimensional echocardiography and global longitudinal strain assessment. Furthermore patients underwent to non-invasive cardiac output and cardiac index collection through impedance cardiography pre- and post-Levosimendan infusion. All patients were followed for 30 days after discharge for all cause of mortality and HF re-hospitalization. A total of 11 patients affected by advanced ADHF were included in this study. Mean age was 73.8 ± 4.7 years. 72.7% (n 8) patients were men. 81.9% (n 9) of patients recognize ischaemic heart disease as HF etiology. At admission mean systolic arterial pressure was 100 ± 17 mmHg, mean NTproBNP was 24 445 ± 12 194 pg/ml and mean serum creatinine was 1.55 ± 0.84 mg/dl. At tri-dimensional echocardiography mean LV ejection fraction (LVEF) was 19.7 ± 5.7% and at bi-dimensional echocardiography mean tricuspid anular plane systolic excursion (TAPSE) and pulmonary arterial systolic pressure (PASP) were, respectively, 12.5 ± 2.7 mm and 48 ± 16 mmHg. Mean LV global longitudinal strain (GLS) was −3.0 ± 1.8. Mean furosemide in-hospital infusion was 306 ± 102 mg/die and mean urine output 1436 ± 496 ml. None developed significant ventricular or supraventricular arrhythmias. All patients were treated with betablockers during infusion. At 30 days of follow-up two patients died and 1 patient was re-hospitalized. Evaluating the differences among our variables pre- and post-Levosimendan infusion, we found that NTproBNP was significantly reduced post-Levosimendan infusion (P = 0.01). Among ICG non-invasive measurement, we found significant differences in stroke volume (SV) and cardiac output (CO) in terms of significant improvement (P = 0.001 for both). Analysing tri-dimensional echocardiography variables, we observed a significant improvement of LVEF (P = 0.003), SV (P = 0.03) and 3-D LV GLS (P = 0.002). Furthermore, we observed a significant reduction in end-systolic volume (ESV) post-Levosimendan infusion (P = 0.02). Among bi-dimensional echocardiography measurements, there was a significant reduction in end-diastolic diameter of right ventricle (EDDRV) and in B-lines count (respectively, P = 0.02 and P = 0.002). Moreover, we observed a significant improvement in TAPSE (P = 0.003) and in LV GLS (P = 0.004). Conclusions Our study showed that slow Levosimendan infusion (12.5 mg at velocity of 0.05–1 mcg/kg/min) without bolus could be considered in advanced ADHF patients to improve cardiac performance without severe adverse events. ICG and echocardiography in-hospital evaluation seemed to be necessary to understand treatment success and patients status improvement as well as cardiac function benefit.

scholarly journals LVOT VTI OUTPERFORMS EJECTION FRACTION AND DOPPLER-DERIVED CARDIAC OUTPUT FOR PREDICTING OUTCOMES IN A SELECT ADVANCED HEART FAILURE COHORT

2016 ◽  
Vol 67 (13) ◽  
pp. 1702
Author(s):  
Christina Tan ◽  
Ajay Srivastava ◽  
David Rubenson ◽  
Michael Smith ◽  
Rajeev Mohan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Output ◽  
Ejection Fraction ◽  
Advanced Heart Failure
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