Cardiac output monitoring by pressure recording analytical method in cardiac surgery

Giomarelli, Pierpaolo; Biagioli, Bonizella; Scolletta, Sabino

doi:10.1016/j.ejcts.2004.05.025

Cited by 80 publications

(46 citation statements)

References 20 publications

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“…Arterial pressure was recorded at 1,000 Hz and analyzed using PRAM [8][9][10] . The hemodynamic variables obtained by this monitoring system were: systolic, diastolic, dicrotic and mean arterial pressures (mm Hg); CO (l/min); SV (ml); CPO (W); dP/ dt max (mm Hg/s); CCE (units) [12][13][14] , and SVR (dyn ؒ s/cm 5 ).…”

Section: Measurement Of Hemodynamic Parameters By Prammentioning

confidence: 99%

“…The hemodynamic effects of SCUF on cardiac output (CO), capillary pulmonary pressure, right atrial pressure and systemic vascular resistance (SVR), investigated by means of pulmonary artery catheterization, have previously been reported, but in clinical practice pulmonary artery catheterization is limited by its invasiveness [7] . The pressure recording analytical method (PRAM) is a minimally invasive approach to monitor hemodynamic changes and requires only cannulation of the radial artery; it has been validated in several published reports also in comparison with pulmonary artery catheterization [8][9][10] . PRAM is able to provide 'novel' hemodynamic parameters related to the overall performance of the cardiovascular system, to cardiac function or myocardial contractility, e.g.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Efficiency Improvement after Slow Continuous Ultrafiltration Is Assessed by Beat-to-Beat Minimally Invasive Monitoring in Congestive Heart Failure Patients: A Preliminary Report

Giglioli¹,

Landi²,

Gensini

et al. 2009

Blood Purif

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Background: We have evaluate the effect of slow continuous ultrafiltration (SCUF) on cardiac output (CO) and other hemodynamic parameters related to the overall performance of the cardiovascular system in patients with congestive heart failure (CHF). Minimally invasive hemodynamic monitoring was performed via the radial artery using a pressure recording analytical method (PRAM) during SCUF treatment. Patients and Methods: Using PRAM, hemodynamic changes were assessed in 15 CHF patients (New York Heart Association (NYHA) class III–IV) treated with fluid overload removal by ultrafiltration. We analyzed the clinical and hemodynamic data recorded from 6 h before to 36 h after SCUF treatment. Results: Fluid removal was associated with clinical improvements, reductions in weight (7.4%, p < 0.01), edema and dyspnea, increased response to diuretics, and reductions in NYHA class (3.5 ± 0.52 to 2.4 ± 0.63, p < 0.01) and plasma pro-B-type natriuretic peptide (BNP) levels (21,810 ± 13,016 to 8,581 ± 5,549 pg/ml, p < 0.05). Clinical improvement was associated with significant variations in stroke volume (+17%, p < 0.05), CO (+19%, p < 0.05), cardiac power output (+19%, p < 0.05), dP/dt_max (+49%, p < 0.01), cardiac cycle efficiency (CCE; +0.44 units, p < 0.01), systemic vascular resistances (SVR; –12%, p < 0.05) and dicrotic pressure (–10%, p < 0.05) with respect to their baseline values. No significant variations in heart rate, and systolic and mean blood pressure were observed. Pro-BNP levels were found to correlate positively with both SVR (r = 0.96, p = 0.002) and NYHA class (r = 0.96, p = 0.037) and negatively with dP/dt_max (r = –0.83, p = 0.039), CCE (r = –0.93, p = 0.011) and CO (r = –0.94, p = 0.014). Conclusions: In CHF patients, ultrafiltration improves not only CO, as previously reported, but also contractile cardiac efficiency and performance. The PRAM system, a minimally invasive method, was able to record hemodynamic changes during SCUF treatment.

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Section: Measurement Of Hemodynamic Parameters By Prammentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cardiac Efficiency Improvement after Slow Continuous Ultrafiltration Is Assessed by Beat-to-Beat Minimally Invasive Monitoring in Congestive Heart Failure Patients: A Preliminary Report

Giglioli¹,

Landi²,

Gensini

et al. 2009

Blood Purif

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show abstract

“…or extrinsic (air bubble, resonance phenomenon) disturbances will lead to incorrect hemodynamic measurements. Giomarelli et al [78] demonstrated in stable CABG patients (at different stages from induction to postoperative ICU) a good agreement between PRAM-CO and PAC-TD CO measurements but more recent studies did not confirm at all this relationship [79].…”

Section: Mostcare / Pram (Vytech Health Padova Italy)mentioning

confidence: 95%

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Hendy

Bubenek

2016

Rom J Anaesth Int Care

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Hemodynamic monitoring has evolved and improved greatly during the past decades as the medical approach has shifted from a static to a functional approach. The technological advances have led to innovating calibrated or not, but minimally invasive and noninvasive devices based on arterial pressure waveform (APW) analysis. This systematic clinical review outlines the physiologic rationale behind these recent technologies. We describe the strengths and the limitations of each method in terms of accuracy and precision of measuring the flow parameters (stroke volume, cardiac output) and dynamic parameters which predict the fluid responsiveness. We also analyzed the place of the APW monitoring devices in goaldirected therapy (GDT) protocols in cardiac surgical patients. According to the data from the three GDTrandomized control trials performed in cardiac surgery (using two types of APW techniques PiCCO and FloTrac/Vigileo), these devices did not demonstrate that they played a role in decreasing mortality, but only decreasing the ventilation time and the ICU and hospital length of stay.

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“…PRAM has been validated so far in a porcine model under various hemodynamic states [19] and in humans undergoing cardiac surgery [20]. Similar to other devices that use pulse contour analysis, the accuracy of PRAMderived cardiac output is aff ected by the quality of the pressure signal and by factors that interfere with the ability to detect a pressure signal.…”

Section: Pulse Pressure Analysismentioning

confidence: 99%

Cardiac Output Monitoring: An Integrative Perspective

Alhashemi¹,

Cecconi²,

Hofer³

2011

Annual Update in Intensive Care and Emergency Medicine 2011

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Cardiac output monitoring by pressure recording analytical method in cardiac surgery

Cited by 80 publications

References 20 publications

Cardiac Efficiency Improvement after Slow Continuous Ultrafiltration Is Assessed by Beat-to-Beat Minimally Invasive Monitoring in Congestive Heart Failure Patients: A Preliminary Report

Cardiac Efficiency Improvement after Slow Continuous Ultrafiltration Is Assessed by Beat-to-Beat Minimally Invasive Monitoring in Congestive Heart Failure Patients: A Preliminary Report

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Cardiac Output Monitoring: An Integrative Perspective

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