Validation of the USCOM-1A cardiac output monitor in hemodynamic unstable intensive care patients (original) (raw)
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British Journal of Anaesthesia, 2011
† The pressure recording analytical method (PRAM) is a recent development of uncalibrated pulsecontour analysis-based methods for CO determination. † 46 paired CO measurements of PRAMand thermodilution-CO were obtained in 23 patients after cardiac surgery. † Large differences between PRAM-CO and ThD-CO were found with percentage error of 87%. † PRAM-CO cannot replace thermodilution-CO in cardiac surgery patients. Background. Pulse-contour analysis method (PCM) cardiac output (CO) monitors are increasingly used for CO monitoring during anaesthesia and in the critically ill. Very recently, several systems have been introduced that do not need calibration; among them the pressure recording analytical method (PRAM). Sparse data comparing the accuracy of the PRAM-CO with conventional thermodilution CO (ThD-CO) in cardiac surgery patients are available. Methods. In this prospective comparison study, paired CO measurements with a pulmonary artery catheter and a PRAM monitoring set were obtained 20-30 min apart (t1, t2) in 23 extubated patients on the first postoperative day after cardiac surgery. Data were analysed by the Bland-Altman method. Results. A total of 46 paired CO measurements (23 for each interval) were collected. The Bland-Altman analysis showed a mean difference (bias) of 0.0 litre min 21 and limits of agreement (1.96 SD) of 4.53 to 24.54 litre min 21 [upper 95% confidence interval (CI), 3.26-5.80; lower 95% CI, 25.8 to 23.27]. The percentage error (1.96 SD/mean of the reference method) was 87%. Conclusions. These results question the reliability of the PRAM technology for the determination of CO in postoperative cardiac surgery patients.
Clinical assessment of level of sedation in the intensive care unit: a correlation study
Critical Care, 2001
Model-based neuro-fuzzy control of FiO 2 for intensive care mechanical ventilation HF Kwok, GH Mills, M Mahfouf, DA Linkens P3 Comparison of closed with open tracheal aspiration system A Sanver, A Topeli, Y Çetinkaya, S Kocagöz, S Ünal P4 A laboratory assessment of the learning and retention of skills required to use the Combitube and Laryngeal Mask Airway by non-anaesthetists C Coles, C Elding, M Mercer P5 Pediatric airway exchange catheter can be a lifesaving device for the adult patients who have risk factors for difficult tracheal reintubation L Dosemeci, F Gurpinar, M Yilmaz, A Ramazanoglu P6 Cricothyroidotomy for elective airway management in critically ill trauma patients SM Wanek, EB Gagnon, C Rehm, RJ Mullins P7 Comparison of two percutaneous tracheostomy techniques I . Ö Akinci, P Ozcan, S Tug v rul, N Çakar, F Esen, L Telci, K Akpir P8 Percutaneous tracheostomy in patients with ARDS on HFOV S Shah, M Read, P Morgan P9 The dilatational tracheotomy -minimally-invasive, bed-side, inexpensive -but safe? MG Baacke, I Roth, M Rothmund, L Gotzen P10 Combination stenting for central airway stenosis P11 Ulcerative laryngitis in children admitted to intensive care M Hatherill, Z Waggie, L Reynolds, A Argent P12 Bronchial asthma in intensive care department: the factors influencing on exacerbation severity TA Pertseva, KE Bogatskaya, KU Gashynova P13 Severe BOOP M Mer, R Taylor, GA Richards P14 Facial continuous positive airway pressure therapy for cardiogenic pulmonary oedema: a study of its efficacy in an emergency department setting within the UK C Read, P16 Noninvasive positive pressure ventilation in patients with blunt chest trauma and acute respiratory failure S Milanov, M Milanov P17 Helium-oxygen (He-O 2 ) enhances oxygenation and increases carbon dioxide clearance in mechanically ventilated patients JAS Ball, R Cusack, A Rhodes, RM Grounds P18 Optimal method of flow and volume monitoring in patients mechanically ventilated with helium-oxygen (He-O 2 ) mixtures JAS Ball, A Rhodes, RM Grounds P19 Lessons learned from airway pressure release ventilation LJ Kaplan, H Bailey P20 Patient controlled pressure support ventilation D Chiumello, P Taccone, L Civardi, E Calvi, M Mondino, N Bottino, P Caironi P21 Impact of weaning failure in the evolution of patients under mechanical ventilation A Bruhn, P22 Abstract withdrawn P23 Rapid reduction of oxygenation index by employment of a recruitment technique in patients with severe ARDS GA Richards, H White, M Hopley P24 The effects of recruitment maneuver on oxygenation in primary and secondary adult respiratory distress syndrome S Tug v rul, N Çakar, IÖ Akinci, P Ergin Özcan, M Tug v rul, F Esen, L Telci, K Akpir Contents Available online http://ccforum.com/supplements/5/S1 Critical Care Vol 5 Suppl 1 Contents P25 Comparison of the P/V curve obtained by the supersyringe and the optoelectronic plethysmography D Chiumello, E Calvi, E Noe', L Civardi, E Carlesso, A Aliverti, R Dellacà P26 Assessment of static compliance and estimated lung recruitment as a tool for PEEP setting in ARDS patients P Dostal, V Cerny, R Parizkova P27 Positive end-expiratory pressure does not increase intraocular pressure in patients with intracranial pathology K Kokkinis, P Manolopoulou, J Katsimpris, S Gartaganis P28 Effects of lung recruitment and PEEP after CPB on pressure-absolute volume curves T Dyhr, A Larsson P29 The histopathological changes comparison in healthy rabbit lung ventilated with ZEEP, Sigh and PEEP Ç Yardimci, G Meyanci, H Öz, I Paksoy
Canadian Journal of Anaesthesia, 1995
The purpose of the studywas to compare cardiac output (CO) measurement by continuous (CTD) with that by conventional thermodilution (TD) in critically ill patients. In 19 of 20 critically ill patients requiring a pulmonary artery catheterism, 105 paired CO measurements were performed by both CTD and TD Regression analysis showed that: CTD CO = L18 TD CO -0.47. Correlation coefficient was 0.96. Bias and limit of agreement were -0.8 and 2.4 L" rain -1, respectively. When a Bland and Altman diagram was constructed according to cardiac index ranges, biases were -0.2 and -0.3 and-0.8 L" min -1" m -2 and limits of agreement were 0.3, 0.7 and L6 L. rain -1" ra -2 for low (<2.5 L" rain -1" m-2), normal (between 2.5 and 4.5 L" min -t" m -z) and high (~ 4.5 L" rain -t" m -z) cardiac indexes, respectively. It is concluded that CTD, compared with TD, is a reliable method of measuring CO especially when cardiac index is _<4.5 L" min -l" m -2.
Journal of Clinical Monitoring and Computing, 2014
Continuous respiratory assessment is especially important during post-operative care following extubation. Respiratory depression and subsequent adverse outcomes can arise due to opioid administration and/or residual anesthetics. A non-invasive respiratory volume monitor (RVM) has been developed that provides continuous, real-time, measurements of minute ventilation (MV), tidal volume (TV), and respiratory rate (RR) via a standardized set of thoracic electrodes. Previous work demonstrated accuracy of the RVM versus standard spirometry and its utility in demonstrating response to opioids in postoperative patients. This study evaluated the correlation between RVM measurements of MV, TV and RR to ventilator measurements during general anesthesia (GA). Continuous digital RVM and ventilator traces, as well as RVM measurements of MV, TV and RR, were analyzed from ten patients (mean 62.6 ± 7.4 years; body mass index 28.6 ± 5.2 kg/m 2) undergoing surgery with GA. RVM data were compared to ventilator data and bias, precision and accuracy were calculated. The average MV difference between the RVM and ventilator was-0.10 L/min (bias:-1.3 %, precision: 6.6 %, accuracy: 9.0 %. The average TV difference was 40 mL (bias: 0.4 %, precision: 7.3 %, accuracy: 9.1 %). The average RR difference was-0.22 breaths/ minute (bias:-1.8 %, precision: 3.7 % accuracy: 4.1 %). Correlations between the RVM traces and the ventilator were compared at various points with correlations[0.90 throughout. Pairing the close correlation to ventilator measurements in intubated patients demonstrated by this study with previously described accuracy compared to spirometry in nonintubated patients, the RVM can be considered to have the capability to provide continuity of ventilation monitoring post-extubation This supports the use of real-time continuous