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Total 32 results found since Jan 2013.
“The peripheral perfusion index discriminates haemodynamic responses to induction of general anaesthesia”
AbstractInduction of general anaesthesia is often accompanied by hypotension. Standard haemodynamic monitoring during anaesthesia relies on intermittent blood pressure and heart rate. Continuous monitoring systemic blood pressure requires invasive or advanced modalities creating a barrier for obtaining important information of the circulation. The Peripheral Perfusion Index (PPI) is obtained non-invasively and continuously by standard photoplethysmography. We hypothesized that different patterns of changes in systemic haemodynamics during induction of general anaesthesia would be reflected in the PPI. Continuous values of ...
Source: Journal of Clinical Monitoring and Computing - June 8, 2023 Category: Information Technology Source Type: research
Hypotension Prediction Index guided Goal Directed therapy and the amount of Hypotension during Major Gynaecologic Oncologic Surgery: a Randomized Controlled clinical Trial
AbstractIntraoperative hypotension (IOH) is associated with increased morbidity and mortality. Hypotension Prediction Index (HPI) is a machine learning derived algorithm that predicts IOH shortly before it occurs. We tested the hypothesis that the application of the HPI in combination with a pre-defined Goal Directed Therapy (GDT) hemodynamic protocol reduces IOH during major gynaecologic oncologic surgery. We enrolled women scheduled for major gynaecologic oncologic surgery under general anesthesia with invasive arterial pressure monitoring. Patients were randomized to a GDT protocol aimed at optimizing stroke volume inde...
Source: Journal of Clinical Monitoring and Computing - April 29, 2023 Category: Information Technology Source Type: research
Point of care transthoracic echocardiography for the prediction of post – spinal anesthesia hypotension in elderly patients with cardiac diseases and left ventricular dysfunction
AbstractIn elderly patients with cardiac diseases, changes in cardiovascular physiology diminish cardiovascular reserve and predispose to hemodynamic instability after spinal anesthesia; hence, such patients could be at risk of postoperative complications. Additionally, transthoracic echocardiography (TTE) is used in clinical practice to evaluate cardiovascular hemodynamics. Therefore, we hypothesized that echocardiographic measurements could display significant diagnostic power in the prediction of post - spinal anesthesia hypotension in elderly patients with cardiac diseases and reduced left ventricular ejection fraction...
Source: Journal of Clinical Monitoring and Computing - February 21, 2023 Category: Information Technology Source Type: research
Relationships between common carotid artery blood flow and anesthesia, pneumoperitoneum, and head-down tilt position: a linear mixed-effect analysis
Conclusion: CCA blood flow was significantly decreased by anesthesia induction. Inducing pneumoperitoneum, with or without the head-down tilt position, did not further decrease CCA blood flow if the cardiac index remained unchanged. The cardiac index and stroke volume index were significantly associated with CCA blood flow.Clinical trial registration: Clinicaltrials.gov (NCT04233177, January 18, 2020).
Source: Journal of Clinical Monitoring and Computing - December 4, 2022 Category: Information Technology Source Type: research
Indicators of haemodynamic instability and left ventricular function in a porcine model of esmolol induced negative inotropy
AbstractTo investigate if the Hypotension Prediction Index was an early indicator of haemodynamic instability in a negative inotropy porcine model, and to assess the correlation of commonly measured indicators of left ventricular systolic function. Eight anaesthetised pigs were volume resuscitated and then underwent an incremental infusion of esmolol hydrochloride (0-3000 mg/hr), following which it was then reduced in a stepwise manner. Full haemodynamic measurements were taken at each stage and measurements of left ventricular systolic function including left ventricular stroke work index, ejection fraction and peripher...
Source: Journal of Clinical Monitoring and Computing - November 6, 2022 Category: Information Technology Source Type: research
Continuous transthoracic echocardiographic monitoring for changes in maternal cardiac hemodynamics during cesarean section under combined epidural –spinal anesthesia: a prospective, observational study
In conclusion, continuous transthoracic echocardiographic monitoring revealed that there were significant changes in hemodynamic parameters during cesarean section after delivery of the newborn and placenta, which warranted furt her investigation.
Source: Journal of Clinical Monitoring and Computing - September 24, 2022 Category: Information Technology Source Type: research
Featured review: Does the type of anaesthesia for recanalisation therapies for acute ischaemic stroke affect patient outcomes?
Wednesday, August 3, 2022
Source: Cochrane News and Events - August 3, 2022 Category: Information Technology Authors: Lydia Parsonson Source Type: news
Changes in corrected carotid flow time induced by recruitment maneuver predict fluid responsiveness in patients undergoing general anesthesia
AbstractNon-invasive methods to assess patients ’ fluid responsiveness during lung-protective ventilation are needed. We hypothesized changes in the corrected carotid flow time induced by the recruitment maneuver predict fluid responsiveness under general anesthesia. Thirty patients undergoing general anesthesia in the supine position were pros pectively enrolled. The study protocol was conducted when the patient was hemodynamically stable during surgery. Flow time was measured on Doppler images of the common carotid artery. Carotid flow time, heart rate, stroke volume, stroke volume variation, and pulse pressure variati...
Source: Journal of Clinical Monitoring and Computing - June 30, 2021 Category: Information Technology Source Type: research
Altered microvascular reactivity assessed by near-infrared spectroscopy after hepato-pancreato-biliary surgery
This study aimed to evaluate changes in microvascular reactivity (MVR) before and after major abdominal surgery, assessed by near-infrared spectroscopy in conjunction with a vascular occlusion test. This prospective observational study included 50 adult patients who underwent hepato-pancreato-biliary surgery lasting ≥ 8 h. MVR was assessed by tissue oxygen saturation (StO2) changes in the plantar region of the foot during 3 min of vascular occlusion and subsequent release under general anesthesia before and after surgery. The primary outcome was alteration in the recovery slope of StO2 (RecStO2) and recovery time...
Source: Journal of Clinical Monitoring and Computing - April 7, 2021 Category: Information Technology Source Type: research
Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study
AbstractIt remains unclear whether reduced myocardial contractility, venous dilation with decreased venous return, or arterial dilation with reduced systemic vascular resistance contribute most to hypotension after induction of general anesthesia. We sought to assess the relative contribution of various hemodynamic mechanisms to hypotension after induction of general anesthesia with su fentanil, propofol, and rocuronium. In this prospective observational study, we continuously recorded hemodynamic variables during anesthetic induction using a finger-cuff method in 92 non-cardiac surgery patients. After sufentanil adminis...
Source: Journal of Clinical Monitoring and Computing - February 1, 2021 Category: Information Technology Source Type: research
The Peripheral Perfusion Index tracks systemic haemodynamics during general anaesthesia
AbstractStable intraoperative haemodynamics are associated with improved outcome and even short periods of instability are associated with an increased risk of complications. During anaesthesia intermittent non-invasive blood pressure and heart rate remains the cornerstone of haemodynamic monitoring. Continuous monitoring of systemic blood pressure or even -flow requires invasive or advanced modalities creating a barrier for obtaining important real-time haemodynamic insight. The Peripheral Perfusion Index (PPI) is obtained continuously and non-invasively by standard photoplethysmography. We hypothesized that changes in ...
Source: Journal of Clinical Monitoring and Computing - October 11, 2020 Category: Information Technology Source Type: research
Featured Review: Oxygen therapy in adult intensive care patients with acute respiratory distress syndrome
Approaches to guiding oxygen therapy in adult intensive care patients with acute respiratory distress syndromeAcute respiratory distress syndrome (ARDS) is a very severe breathing problem with a high mortality rate (chance of dying). It has many potential causes, including viral infections such as COVID-19, and there are no specific treatments for it except for giving patients oxygen via a ventilator (artificial breathing machine) on an intensive care unit, often for long periods of time. However, large amounts of oxygen (either a high concentration of oxygen or oxygen administered for a long period of time) are known to i...
Source: Cochrane News and Events - August 31, 2020 Category: Information Technology Authors: Katie Abbotts Source Type: news
The value of a superior vena cava collapsibility index measured with a miniaturized transoesophageal monoplane continuous echocardiography probe to predict fluid responsiveness compared to stroke volume variations in open major vascular surgery: a prospective cohort study
AbstractSuperior vena cava collapsibility index (SVC-CI) and stroke volume variation (SVV) have been shown to predict fluid responsiveness. SVC-CI has been validated only with conventional transoesophageal echocardiography (TEE) in the SVC long axis, on the basis of SVC diameter variations, but not in the SVC short axis or by SVC area variations. SVV was not previously tested in vascular surgery patients. Forty consecutive adult patients undergoing open major vascular surgical procedures received 266 intraoperative volume loading tests (VLTs), with 500 ml of gelatine over 10 min. The hSVC-CI was measured using a miniatu...
Source: Journal of Clinical Monitoring and Computing - May 7, 2020 Category: Information Technology Source Type: research
Featured review: Corticosteroids for treating sepsis
The authors reviewed the evidence on the effect on death of using corticosteroids in children and adults with sepsis.Sepsis is present when an infection is complicated by organ failure. People develop rapid breathing, hypotension (low blood pressure), and mental confusion. Sepsis can interfere with the effectiveness of the body ’s corticosteroids, which serve as a key defence against infection. Corticosteroids have been given for decades to people with infection resulting from various causes.The review included 61 trials (12,192 participants). Fifty-eight trials compared corticosteroids to no corticosteroids (placebo o...
Source: Cochrane News and Events - December 9, 2019 Category: Information Technology Authors: Katie Abbotts Source Type: news
Phenylephrine increases cardiac output by raising cardiac preload in patients with anesthesia induced hypotension
AbstractInduction of general anesthesia frequently induces arterial hypotension, which is often treated with a vasopressor, such as phenylephrine. As a pure α-agonist, phenylephrine is conventionally considered to solely induce arterial vasoconstriction and thus increase cardiac afterload but not cardiac preload. In specific circumstances, however, phenylephrine may also contribute to an increase in venous return and thus cardiac output (CO). The aim o f this study is to describe the initial time course of the effects of phenylephrine on various hemodynamic variables and to evaluate the ability of advanced hemodynamic mon...
Source: Journal of Clinical Monitoring and Computing - October 27, 2018 Category: Information Technology Source Type: research
