OBJECTIVE: To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. DESIGN: Prospective direct comparison of the above two techniques. SETTING: Pediatric intensive care unit of a university hospital. PATIENTS: 25 infants and children, aged 1 week to ...

A 26-year-old primigravida who presented to us with threatened preterm labour which was suppressed successfully with sulindac, was found to have a pericardial effusion. Pericardiocentesis was performed because of evidence of right ventricular compression. However, it was complicated by inadvertent puncture of the left ventricle causing cardiac tamponade, and hypovolaemic ...

To manage postcardiotomy patients with cardiopulmonary bypass support (CPS), it is very important to evaluate the native cardiac function. In 5 postcardiotomy cases without CPS, the alternative thermodilution outputs by right ventricular (RV) injection were compared with simultaneous thermodilution outputs by standard right atrial (RA) injection. Cardiac output determined by ...

A new automatic cardiac output control algorithm for an implantable electromechanical total artificial heart (TAH) was developed based on the analysis of motor current waveform without using any transducer. The basic control requirements of an artificial heart can be described in terms of three features: preload sensitivity, afterload insensitivity, and ...

The growing need for more advanced ambulatory monitoring has led to the development of an ambulatory monitor for impedance cardiography (VU-AMD). This paper presents two studies addressing the validity of the VU-AMD. In the first study, the cardiovascular responses of 25 subjects during various conditions were simultaneously recorded with the ...

OBJECTIVE: The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. DESIGN: Cardiac output was simultaneously measured by thermodilution (TD) and a transgastric, pulsed Doppler method. SETTING: The study was carried out ...

The effects of serotonin on continuously recorded cardiac parameters (heart rate, cardiac output, cardiac stroke volume), ventral and dorsal aortic blood pressures, branchial and systemic vascular resistances were investigated in the European eel in vivo. Intravenous administration of serotonin (30 micrograms.kg-1) caused a marked bradycardia (45%) and a simultaneous decrease ...

A 31-year-old woman developed severe ovarian hyperstimulation syndrome (OHSS) after exogenous gonadotropin stimulation for an in vitro fertilization program. Because of refusal of invasive monitoring, thoracic electrical bioimpedance (TEB) was performed to evaluate cardiac function and volume status. TEB pointed out decreased cardiac output (CO: 4.23 liters/min), cardiac index (CI: ...

A thermodilution method of obtaining continuous cardiac outputs represents an improvement in the assessment and treatment of critically ill patients. The critical care nurse assists in placement of the pulmonary artery catheter, which includes a thermal filament for continuous readings of cardiac output, and uses the continuous cardiac output readings ...

Pericardiocentesis is primarily indicated for the management of emergent cardiac tamponade. Insert the needle into the left xiphocostal angle perpendicular to the skin and 3 to 4 mm below the left costal margin (the preferred approach); advance it 5 to 10 mm (or more if necessary) until it reaches the ...

Considerable difficulty may be encountered in controlling persistent venous bleeding from the cut myocardial edges when coronary grafts have to be constructed to a deeply intramyocardial portion of the left anterior descending coronary artery. We describe a safe, inexpensive, and highly effective method of dealing with this problem using muscle ...

BACKGROUND: Few complete studies have been published to validate the agreement between continuous cardiac output and intermittent thermodilution cardiac output. OBJECTIVE: To analyze the agreement between cardiac output measurements by the continuous thermodilution method and the intermittent bolus thermodilution method, using a continuous cardiac output catheter in postoperative cardiothoracic surgery ...

BACKGROUND: Low output syndrome after cardiac operations is associated with high morbidity and mortality rates. The contribution of right ventricular dysfunction to this syndrome has not been fully characterized. The purpose of this study was to evaluate the utility of transesophageal echocardiography to identify the frequency and the in-hospital mortality ...

OBJECTIVES: To evaluate the usefulness of transthoracic electrical bioimpedance in trending changes in cardiac output after cardiac surgery, and to identify predictors of differences between cardiac output measured by thermodilution and transthoracic electrical bioimpedance methods. DESIGN: Prospective repeated-measures study. SETTING: University-affiliated tertiary care center. PATIENTS: Thirty-four adult patients undergoing elective ...

BACKGROUND: Routine closure of the sternum after cardiovascular surgical procedures sometimes causes severe cardiac depression because of a tamponade-like reduction in ventricular filling, leading to cardiogenic shock. Leaving the sternal halves apart, sealing the mediastinum by simply approximating the skin or using a prosthetic patch, and then performing delayed sternal ...

In a pacemaker dependent, 60-year-old man with complete heart block, programming high (5.0 V and 1.0 ms) atrial output and 5.0 volt and 0.5 ms ventricular output while in the DDD mode of a pulse generator, resulted in loss of ventricular channel output with resulting asystole, while the simultaneous, pulse ...

This study provides evidence that acute changes in stroke volume and cardiac output do not result in significant alterations in the anatomic AVA measured with multiplane TEE in patients with AS of moderate or severe degree. Thus, TEE could be useful in the assessment of severity of AS in both ...

When comparing means, there is no difference between right and left SVC saturations, and the difference does not affect cardiac output calculations. Because of the wide variability between right and left SVC saturations and their calculated cardiac output within patients, along with the higher correlation of left versus right SVC ...

A 22-year-old woman was admitted to the hospital with large bilateral pleural effusions and venous thromboembolism. Echocardiography revealed right ventricular diastolic collapse (RVDC) without physical signs of cardiac tamponade. This echocardiographic abnormality disappeared after thoracentesis. The results of this case report would suggest that pleural effusions were responsible for the ...

STUDY OBJECTIVE: This study investigated the long-term course of infarct-related pericarditis and pericardial effusion. Focus was given to the following issues: incidence and timing of pericarditis and pericardial effusion during the acute phase and 3 years follow-up, size, hemodynamic and clinical consequences of effusions, and potential risk of thrombolytic or ...

We have compared the Doppler against the thermodilution technique for measurement of cardiac output in six patients during aortic surgery. The correlation coefficient between the two methods was between 0.76 and 0.84 during the different periods of the operation. Using the integral nomogram instead of direct calibration, the Doppler system ...

The left ventricular ultrasound videointensity of an intravenous injection of sonicated albumin is improved if the agent is diluted with dextrose prior to sonication. The objective of this study was to determine the mechanism for improved left ventricular ultrasound contrast with intravenous sonicated multi-fold dilutions of albumin with dextrose compared ...

It is not clear whether there is any relationship between cardiac output and myocardial blood flow in the infarcted heart. We measured regional myocardial blood flow (RMBF) quantitatively by positron emission tomography (PET) with 13N-ammonia at rest in 18 patients with prior myocardial infarction. RMBF was calculated using the radioactivity ...

Management of critically ill patients is based on knowledge of fundamental physiologic variables. Automatized and continuous measurement of these variables is preferable. A new system based upon the thermodilution method has been developed to measure cardiac output automatically and continuously. We evaluated the system in the potentially unstable perioperative period ...

OBJECTIVE: The aim was to determine whether the metabolic acidosis that develops during severe acute myocardial hypoxia improves or impairs the recovery of cardiac mechanical function during reoxygenation. METHODS: Isolated rat hearts performed external work against a model of the rat systemic vascular impedance. Four groups of 10 hearts were ...

OBJECTIVE: To assess the degree of error of the BoMed NCCOM3 model revision seven (R7) impedance cardiograph in determining stroke volume and estimated cardiac output. DESIGN: Three-group, within-subject, repeated measures design. SAMPLE: Group 1: patients (n = 17) with heart disease undergoing an elective coronary angiogram; group 2: patients (n ...

OBJECTIVE: To evaluate the accuracy of a new continuous cardiac output monitor (one based on the thermodilution principle) in critically ill patients. DESIGN: Criterion standard study. SETTING: Multidisciplinary intensive care unit in a university hospital. PATIENTS: Fourteen critically ill patients, with different diseases, requiring pulmonary artery catheterization. INTERVENTIONS: In two ...

Obstructed pulmonary circulation from an embolism results in dilatation of the right ventricle, which becomes hypokinetic. The subsequent decline in forward cardiac output leads to diminished left ventricular preload. Combined with the reduction in the size of the left ventricular cavity from the flattening of the septum, there is a ...

OBJECTIVES: To compare cardiac output and stroke volume measured by multiplane transesophageal Doppler echocardiography with that measured by the thermodilution technique. DESIGN: Prospective direct comparison of paired measurements by both techniques in each patient. SETTING: Cardiac surgery and myocardial infarction intensive care units. PATIENTS: Twenty-nine patients, mean age (+/- SD) ...

Control of bleeding in areas difficult to suture because of tissue friability, edema, or calcification poses a serious problem in cardiac surgery patients. We report the use of a pedicled pericardial fat pad as an adjunct to the control of bleeding in these difficult-to-suture areas. This technique was used in ...

The objective of this study was to determine the relations between the hallmark circulatory finding of decompensated cirrhosis, a reduced systemic vascular resistance (SVR), and the indices of hepatic decompensation, the accumulation of ascites, and the concentrations of various vasoactive substances. At a university-affiliated teaching hospital, eighteen hospitalized patients with ...

Although the association of the phenothiazines with immunologic abnormalities is well known, reports of clinical lupus erythematosus are rare. We describe a 52-year old schizophrenic man on chronic chlorpromazine therapy who developed fever and pleuropericarditis with cardiac tamponade. Examination of the pleural and pericardial fluids showed anti-nuclear antibodies. The clinical ...

The heart undergoes marked ultrastructural alterations during fetal and postnatal development. Early in fetal development, cardiac myocytes contain abundant pools of glycogen, scattered mitochondria and sparse, peripheral myofibrils. Transverse tubules are absent, and sarcoplasmic reticulum and intercalated discs are poorly developed. During late fetal and early postnatal development, myofibrils extend ...

We describe the complications of pericardiocentesis and their management in an 18 year-old man. This patient was admitted because of dyspnea and was found on echocardiogram to have cardiac tamponade with coexisting left ventricular dysfunction. He developed acute left ventricular failure with severe pulmonary edema immediately after pericardiocentesis. This complication ...

Considering the heart as a physical pump cardiac efficiency is calculated from the ratio of cardiac work performed to the maximum level of energy of the heart. The aim of the study was to compare cardiac efficiency with cardiac output and right ventricular ejection fraction. Nine patients scheduled for coronary ...

OBJECTIVE: To determine the effect of patient position on the reproducibility of cardiac output measurements. DESIGN: Prospective, two-group quasi-experimental design. Convenience sample. SETTING: The study involved two intensive care units in two adult acute care hospitals. PATIENTS: Thirty patients admitted to the intensive care unit who had a thermodilution pulmonary ...

The role of neuropeptide Y (NPY) in the regulation of cardiac function was compared in mammalian and fish hearts. In mammalian heart, most studies have shown that neuropeptide Y inhibits coronary flow and exerts a negative inotropic effect in isolated perfused hearts and cardiac muscles. The mechanisms involved in the ...

OBJECTIVE: Evaluation of continuous cardiac output monitoring based on the thermodilution technique in the critically ill. DESIGN: Prospective clinical investigation. SETTING: A surgical intensive care unit of a university hospital. PATIENTS: Thirty-five critically ill patients (trauma and/or sepsis patients), who needed pulmonary artery catheterization. The patients were prospectively studied according ...

The use of hypotensive anesthesia is contraindicated in patients with ventricular dysfunction, even though afterload reduction often improves ventricular performance. The purpose of this study was to prospectively assess systemic hemodynamic responses to deliberate hypotension with epidural anesthesia in patients with chronic left ventricular dysfunction. Hemodynamic measurements were performed in ...

Transesophageal echocardiography is becoming increasingly popular as a method of intraoperative monitoring because it can be performed continuously, does not transgress the sterile operative field, and provides data with regard to valve function, ventricular volumes, and contractility. Recently it was suggested that it can be used to measure cardiac output; ...

This study was conducted to establish the validity of left-sided cardiac output measurement with a Swan-Ganz catheter and assess its accuracy in estimating mitral valve area (MVA) by the Gorlin formula. The use of right-sided cardiac output after balloon mitral valvotomy (BMV) can give inaccurate measurements for Gorlin-derived MVA because ...

The reliability of automated acoustic quantification (AQ) in yielding real-time left ventricular (LV) area, volume, and ejection fraction has been validated. The purpose of this study was to explore the potential of AQ in providing accurate immediate determination of cardiac output in critically ill patients. A total of 48 patients ...

1. Calcium channel blockers increase cardiovascular morbidity and mortality in patients with left ventricular dysfunction. These adverse effects are probably related to the negative inotropic effect of calcium channel blockers and/or a neurohormonal activation. 2. The present study was designed to examine, in conscious dogs, the acute haemodynamic and sympathetic ...

OBJECTIVE: To evaluate the incidence, characteristics, and haemodynamic consequences of pericardial effusion after cardiac surgery. DESIGN: Clinical, echocardiographic, and Doppler evaluations before and 8 days after cardiac surgery; with echocardiographic and Doppler follow up of patients with moderate or large pericardial effusion after operation. SETTING: Patients undergoing cardiac surgery at ...

Pulsus paradoxus is an exaggerated fall in systolic blood pressure with inspiration (usually greater than 10 mm). Understanding the accuracy of pulsus paradoxus for a diagnosis of cardiac tamponade requires a consideration of the mechanisms underlying its genesis, and a knowledge of its presence in other conditions and its variable ...

Monitoring of paediatric anaesthesia has become increasingly more complex in recent years and this is particularly true of cardiac anaesthesia. The purpose of this review is to give a comprehensive update of published material related to both routine and specialized cardiac monitoring. Routine monitoring can be particularly affected by the ...

STUDY OBJECTIVE: The purpose of this study was to evaluate the effect of thermistor position with varying injectate temperatures on the reproducibility of thermodilution cardiac output determination. The key hypothesis to be tested was that the positioning of the proximal thermistor at the right atrial port would improve the reproducibility ...

OBJECTIVE: To compare measurements of cardiac output utilizing an improved transtracheal Doppler technology with measurements obtained using two-dimensional echocardiography. DESIGN: Prospective, descriptive study. SETTING: Cardiovascular intensive care unit at a university medical center. PATIENTS: Fourteen children ranging in age from 14 days to 3 yrs (mean 1.3 +/- .97 yrs) ...

No measurement of myocardial performance currently available in the ICU can be regarded is ideal. Table 2 summarises the main features of the major monitoring techniques. As many of the indices of myocardial performance are interdependent, quantifying the contribution of each component to overall cardiac function is not possible currently, ...

Recent echocardiographic ABD algorithms can estimate LV volume on-line from a single long-axis plane. The objective of this study was to assess the capability and limitations of transesophageal ABD to estimate stroke volume and cardiac output in patients before and after coronary artery bypass surgery by correlating these data with ...