The effect of lung injury and excessive lung fluid, on impedance cardiac output measurements, in the critically ill

2000 ◽  
Vol 26 (6) ◽  
pp. 679-685 ◽  
Author(s):  
L. A.H. Critchley ◽  
R. M. Calcroft ◽  
P. Y. H. Tan ◽  
J. Kew ◽  
J. A.J. H. Critchley
Keyword(s):  
Cardiac Output ◽  
Lung Injury ◽  
Critically Ill ◽  
Lung Fluid ◽  
Cardiac Output Measurements

scholarly journals Feasibility of cardiac output measurements in critically ill patients by medical students

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Geert Koster ◽  
Thomas Kaufmann ◽  
Bart Hiemstra ◽  
Renske Wiersema ◽  
Madelon E. Vos ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Critical Care ◽  
Medical Students ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Left Ventricular ◽  
Percentage Error ◽  
Poor Agreement ◽  
Cardiac Output Measurements

Abstract Background Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts necessary for novices to attain images of sufficient quality. There is no data on medical students performing CCUS for the measurement of cardiac output (CO), a hemodynamic variable of importance for daily critical care. Objective The aim of this study was to explore the agreement of cardiac output measurements as well as the quality of images obtained by medical students in critically ill patients compared to the measurements obtained by experts in these images. Methods In a prospective observational cohort study, all acutely admitted adults with an expected ICU stay over 24 h were included. CCUS was performed by students within 24 h of admission. CCUS included the images required to measure the CO, i.e., the left ventricular outflow tract (LVOT) diameter and the velocity time integral (VTI) in the LVOT. Echocardiography experts were involved in the evaluation of the quality of images obtained and the quality of the CO measurements. Results There was an opportunity for a CCUS attempt in 1155 of the 1212 eligible patients (95%) and in 1075 of the 1212 patients (89%) CCUS examination was performed by medical students. In 871 out of 1075 patients (81%) medical students measured CO. Experts measured CO in 783 patients (73%). In 760 patients (71%) CO was measured by both which allowed for comparison; bias of CO was 0.0 L min−1 with limits of agreement of − 2.6 L min−1 to 2.7 L min−1. The percentage error was 50%, reflecting poor agreement of the CO measurement by students compared with the experts CO measurement. Conclusions Medical students seem capable of obtaining sufficient quality CCUS images for CO measurement in the majority of critically ill patients. Measurements of CO by medical students, however, had poor agreement with expert measurements. Experts remain indispensable for reliable CO measurements. Trial registration Clinicaltrials.gov; http://www.clinicaltrials.gov; registration number NCT02912624

Dobutamine Pharmacokinetics and Cardiovascular Responses in Critically Ill Neonates

PEDIATRICS ◽  
1992 ◽  
Vol 89 (1) ◽  
pp. 47-51
Author(s):  
Alma M. Martinez ◽  
Jamés F. Padbury ◽  
Siang Thio
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Cardiovascular Responses ◽  
Threshold Value ◽  
Constant Infusion ◽  
Plasma Catecholamine ◽  
First Order Kinetics ◽  
Critically Ill Neonates ◽  
The Mean ◽  
Cardiac Output Measurements

The pharmacokinetics and pharmacodynamics of dobutamine were studied in 13 critically ill neonates requiring inotropic support. Dobutamine was administered as a constant infusion in increasing doses of 2.5, 5, and 7.5 µg/kg per minute. During dobutamine infusions, there were significant increases in cardiac output measurements above preinfusion values. There were no statistically significant changes in systolic or diastolic blood pressure or heart rate during the infusions. The mean calculated threshold value, or the minimum plasma concentration necessary for a change in cardiac output, was 39±8 ng/mL. The mean plasma clearance rate was 90±38 mL/min per kilogram and was most consistent with first-order kinetics over the range of dosages studied. Plasma catecholamine levels were unchanged during the dobutamine infusions. These data suggest that dobutamine is an effective but limited inotropic agent in the neonate. Dobutamine may be most beneficial when cardiogenic failure is present.

A COMPARISON OF TRANSESOPHAGEAL DOPPLER, THERMODILUTION AND FICK CARDIAC OUTPUT MEASUREMENTS IN CRITICALLY ILL PATIENTS

1998 ◽  
Vol 26 (Supplement) ◽  
pp. 62A ◽  
Author(s):  
Joseph Cuschieri ◽  
Emanuel Rivers ◽  
James Caruso ◽  
Gregory Hays ◽  
Barry Dereczyk ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Transesophageal Doppler ◽  
Cardiac Output Measurements

scholarly journals Safety aspects of the PiCCO thermodilution-cardiac output catheter during magnetic resonance imaging at 3 Tesla

2021 ◽  
Author(s):  
Marieke Voet ◽  
Christiaan G. Overduin ◽  
Ernst L. Stille ◽  
Jurgen J. Fütterer ◽  
Joris Lemson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Output ◽  
Magnetic Resonance ◽  
Critically Ill ◽  
Cardiac Output Monitoring ◽  
Measured Temperature ◽  
Resonance Imaging ◽  
Worst Case ◽  
Thermodilution Cardiac Output ◽  
3T Mri

AbstractThermodilution cardiac output monitoring, using a thermistor-tipped intravascular catheter, is used in critically ill patients to guide hemodynamic therapy. Often, these patients also need magnetic resonance imaging (MRI) for diagnostic or prognostic reasons. As thermodilution catheters contain metal, they are considered MRI-unsafe and advised to be removed prior to investigation. However, removal and replacement of the catheter carries risks of bleeding, perforation and infection. This research is an in vitro safety assessment of the PiCCO™ thermodilution catheter during 3 T Magnetic Resonance Imaging (3T-MRI).  In a 3T-MRI environment, three different PiCCO™ catheter sizes were investigated in an agarose-gel, tissue mimicking phantom. Two temperature probes measured radiofrequency-induced heating; one at the catheter tip and one at a reference point. Magnetically induced catheter dislocation was assessed by visual observation as well as by analysis of the tomographic images. For all tested catheters, the highest measured temperature increase was 0.2 °C at the center of the bore and 0.3 °C under “worst-case” setting for the tested MRI pulse sequences. No magnetically induced catheter displacements were observed. Under the tested circumstances, no heating or dislocation of the PiCCO™ catheter was observed in a tissue mimicking phantom during 3T-MRI. Leaving the catheter in the critically ill patient during MRI investigation might pose a lower risk of complications than catheter removal and replacement.

Non-invasive cardiac output assessment in critically ill paediatric patients

2014 ◽  
Vol 69 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Theeranan Wongsirimetheekul ◽  
Anant Khositseth ◽  
Rojjanee Lertbunrian
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Non Invasive ◽  
Paediatric Patients
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