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“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

Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study
ConclusionIn hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI.
Source: Journal of Clinical Monitoring and Computing - March 18, 2023 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

A new photoplethysmographic device for continuous assessment of urethral mucosa perfusion: evaluation in a porcine model
This study proposes to evaluate an innovative device consisting of an indwelling urinary catheter equipped with a photoplethysmography (PPG) sensor in contact with the urethral mucosa that provides a continuous index called urethral perfusion index (uPI). The goal of this study was to determine if the uPI could bring out tissue perfusion modifications induced by hypotension and vasopressors in a porcine model. Twelve piglets were equipped for heart rate, MAP, cardiac index, stroke volume index, systemic vascular resistance index and uPI monitoring. The animals were exposed to different levels of mean arterial pressure (MAP...
Source: Journal of Clinical Monitoring and Computing - May 1, 2020 Category: Information Technology Source Type: research

Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres?
AbstractChanges in stroke volume (deltaSV) induced by a lung recruitment manoeuvre (LRM) have been shown to accurately predict fluid responsiveness during protective mechanical ventilation. Cardiac output monitors are used in a limited number of surgical patients. In contrast, all patients are monitored with a pulse oximeter, that may enable the continuous monitoring of a peripheral perfusion index (PI). We postulated that changes in PI (deltaPI) may reflect deltaSV during brief modifications of cardiac preload. We studied 47 patients undergoing neurosurgery and ventilated with a tidal volume of 6 –8 ml/kg. All patients ...
Source: Journal of Clinical Monitoring and Computing - December 17, 2019 Category: Information Technology Source Type: research

Increased volumes of mildly elevated capillary transit time heterogeneity positively predict favorable outcome and negatively predict intracranial hemorrhage in acute ischemic stroke with large vessel occlusion.
CONCLUSION: An increased volume of mildly elevated CTH is a positive predictor of favorable outcome and a negative predictor for ICH in patients with acute ischemic stroke and mismatch undergoing ET. KEY POINTS: • The classification of potentially salvageable tissue and infarct core based on traditional net perfusion parameters (as Tmax or CBF) does not account for the microvascular distribution of blood. • However, the microvascular distribution of blood, as indexed by the capillary transit time heterogeneity (CTH), directly affects the availability of oxygen within the hypoperfused tissue and should therefore be...
Source: Methods of Information in Medicine - March 17, 2019 Category: Information Technology Authors: Potreck A, Loebel S, Pfaff J, Østergaard L, Mouridsen K, Radbruch A, Bendszus M, Mundiyanapurath S Tags: Eur Radiol Source Type: research

A novel method to assess pial collateralization from stroke perfusion MRI:  subdividing Tmax into anatomical compartments.
CONCLUSIONS: Perfusion delay in the pial compartment, as evaluated by TMACS, closely reflects the extent of pial collaterals in gold-standard DSA. TMACS and mismatch ratio were found to be complementary predictors of a favourable clinical outcome, each adding independent predictive information. KEY POINTS: • MRI-DSC perfusion delay specific in the pial compartment reflects leptomeningeal collateralization. • A novel quantitative- and observer-independent marker of collateral status (TMACS) is introduced. • Quantification of collateral status leads to an independent predictor of neurological outcome. PMID: 2...
Source: Methods of Information in Medicine - January 31, 2017 Category: Information Technology Authors: Potreck A, Seker F, Hoffmann A, Pfaff J, Nagel S, Bendszus M, Heiland S, Pham M Tags: Eur Radiol Source Type: research

A novel method to assess pial collateralization from stroke perfusion MRI: subdividing Tmax into anatomical compartments.
CONCLUSIONS: Perfusion delay in the pial compartment, as evaluated by TMACS, closely reflects the extent of pial collaterals in gold-standard DSA. TMACS and mismatch ratio were found to be complementary predictors of a favourable clinical outcome, each adding independent predictive information. KEY POINTS: • MRI-DSC perfusion delay specific in the pial compartment reflects leptomeningeal collateralization. • A novel quantitative- and observer-independent marker of collateral status (TMACS) is introduced. • Quantification of collateral status leads to an independent predictor of neurological outcome. PMID: 2...
Source: Methods of Information in Medicine - May 23, 2016 Category: Information Technology Authors: Potreck A, Seker F, Hoffmann A, Pfaff J, Nagel S, Bendszus M, Heiland S, Pham M Tags: Eur Radiol Source Type: research

Time-dependent parameter of perfusion imaging as independent predictor of clinical outcome in symptomatic carotid artery stenosis.
CONCLUSION: As they stood out in multivariate regression and are objective and reproducible parameters, PWI-derived volumes of Tmax ≥8 s and TTP ≥6 s might be superior to degree of stenosis and visually assessed TTP maps in predicting short term patient outcome. Future studies should assess if perfusion weighted imaging might guide the selection of patients for recanalization procedures. PMID: 27094741 [PubMed - in process]
Source: Methods of Information in Medicine - April 22, 2016 Category: Information Technology Authors: Mundiyanapurath S, Ringleb PA, Diatschuk S, Eidel O, Burth S, Floca R, Möhlenbruch M, Wick W, Bendszus M, Radbruch A Tags: BMC Neurol Source Type: research

Tissue perfusion and oxygenation to monitor fluid responsiveness in critically ill, septic patients after initial resuscitation: a prospective observational study
Abstract Fluid therapy after initial resuscitation in critically ill, septic patients may lead to harmful overloading and should therefore be guided by indicators of an increase in stroke volume (SV), i.e. fluid responsiveness. Our objective was to investigate whether tissue perfusion and oxygenation are able to monitor fluid responsiveness, even after initial resuscitation. Thirty-five critically ill, septic patients underwent infusion of 250 mL of colloids, after initial fluid resuscitation. Prior to and after fluid infusion, SV, cardiac output sublingual microcirculatory perfusion (SDF: sidestream dark field i...
Source: Journal of Clinical Monitoring and Computing - January 20, 2015 Category: Information Technology Source Type: research

ANTONIA Perfusion and Stroke. A Software Tool for the Multi-purpose Analysis of MR Perfusion-weighted Datasets and Quantitative Ischemic Stroke Assessment.
PMID: 25301390 [PubMed - as supplied by publisher]
Source: Methods of Information in Medicine - October 10, 2014 Category: Information Technology Authors: Forkert ND, Cheng B, Kemmling A, Thomalla G, Fiehler J Tags: Methods Inf Med Source Type: research