Clinical validation of the non-invasive cardiac output monitor USCOM-1A in critically ill patients

Lelyveld-Haas, L. E. M. van; Zanten, Arthur R. H. van; Borm, George F.; Tjan, D H T

doi:10.1017/s0265021508004882

Cited by 42 publications

(34 citation statements)

References 31 publications

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“…Suprasternal Doppler measures blood flow through the aortic valve enabling non-invasive assessment of stroke volume and cardiac output (USCOM, USCOM Ltd., Sydney, Australia). Suprasternal Doppler has been validated against other measures of stroke volume in the emergency department, operating room and intensive care unit and shown to increase in response to PLR, [18, 19]. We therefore used this technique as a non-invasive reference standard for changes in stroke volume with a PLR in this study.…”

Section: Introductionmentioning

confidence: 99%

The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study

Peachey

Tang

Baker

et al. 2016

Scand J Trauma Resusc Emerg Med

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Background: Assessment of circulating volume and the requirement for fluid replacement are fundamental to resuscitation but remain largely empirical. Passive leg raise (PLR) may determine fluid responders while avoiding potential fluid overload. We hypothesised that inferior vena cava collapse index (IVCCI) and carotid artery blood flow would change predictably in response to PLR, potentially providing a non-invasive tool to assess circulating volume and identifying fluid responsive patients. Methods: We conducted a prospective proof of concept pilot study on fasted healthy volunteers. One operator measured IVC diameter during quiet respiration and sniff, and carotid artery flow. Stroke volume (SV) was also measured using suprasternal Doppler. Our primary endpoint was change in IVCCI after PLR. We also studied changes in IVCCI after "sniff", and correlation between carotid artery flow and SV. Results: Passive leg raise was associated with significant reduction in the mean inferior vena cava collapsibility index from 0.24 to 0.17 (p < 0.01). Mean stroke volume increased from 56.0 to 69.2 mL (p < 0.01). There was no significant change in common carotid artery blood flow. Changes in physiology consequent upon passive leg raise normalised rapidly. Discussion: Passive leg raise is associated with a decrease of IVCCI and increase in stroke volume. However, the wide range of values observed suggests that factors other than circulating volume predominate in determining the proportion of collapse with respiration. Conclusion: In contrast to other studies, we did not find that carotid blood flow increased with passive leg raise. Rapid normalisation of post-PLR physiology may account for this.

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Section: Introductionmentioning

confidence: 99%

The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study

Peachey

Tang

Baker

et al. 2016

Scand J Trauma Resusc Emerg Med

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“…Followingashortbootingtimethedevicecanbeusedimmediately.Moreover,thetechniqueisreportedtobeeasytouse afterashortteachingperiod [30,31].Validationandreliability studies have been carried out in intensive care studies against invasive hemodynamic monitoring devices such as pulmonary artery catheter and other thermodilution techniqueswithprovenhighcorrelation [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Anthracycline-Induced Cardiotoxicity: Cardiac Monitoring by Continuous Wave-Doppler Ultrasound Cardiac Output Monitoring and Correlation to Echocardiography

Geiger¹,

Stemmler²,

Suhl³

et al. 2012

Onkologie

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Background: Anthracyclines are agents with a wellknown cardiotoxicity. The study sought to evaluate the hemodynamic response to an anthracycline using realtime continuous-wave (CW)-Doppler ultrasound cardiac output monitoring (USCOM) and echocardiography in combination with serum biomarkers. Methods: 50 patients (26 male, 24 female, median age 59 years) suffering from various types of cancer received an anthracycline-based regimen. Patients’ responses were measured at different time points (T0 prior to infusion, T1 6 h post infusion, T2 after 1 day, T3 after 7 days, and T4 after 3 months) with CW-Doppler ultrasound (T0–T4) and echocardiography (T1, T4) for hemodynamic parameters such as stroke volume (SV; SV_USCOM ml) and ejection fraction (EF; EF_{echocardiography}%) and with NT-pro-BNP and hs-Troponin T (T0–T4). Results: During the 3-month observation period, the relative decrease in the EF determined by echocardiography was –2.1% (△T0–T4, T0 71 ± 7.8%, T4 69.5 ± 7%, p = 0.04), whereas the decrease in SV observed using CW-Doppler was –6.5% (△T0–T4, T0 54 ± 19.2 ml, T4 50.5 ± 20.6 ml, p = 0.14). The kinetics for serum biomarkers were inversely correlated. Conclusions: Combining real-time CW-Doppler USCOM and serum biomarkers is feasible for monitoring the immediate and chronic hemodynamic changes during an anthracycline-based regimen; the results obtained were comparable to those from echocardiography.

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“…The technique is reported to be easily learned after a short period by non-physicians [29,30]. Previously reported trials investigated the accuracy of USCOM in various settings and most of them found an acceptable agreement between the USCOM CO measurements and those determined by a thermodilution-based method [15,29,22,[31][32][33][34]16,35,20]. Although, it is critical to report, that an inferior accuracy for USCOM was reported by other authors who found that CO measurements by USCOM do not reliably represent absolute values as compared to pulmonary artery catheter thermodilution technique [36,35].…”

Section: Discussionmentioning

confidence: 99%

“…However, arrhythmia, infection and possible pulmonary artery disruption have always been concerns related to the use of a PAC and led to a growing interest in the development of non-invasive hemodynamic monitoring devices [11][12][13]. One less invasive thermodilution-based technique consists of the pulse induced cardiac output device (PiCCO) but exclusively ultrasound-based devices as the USCOM monitor are entirely non-invasive methods for measuring CO [14][15][16][17][18][19][20]. Beside accuracy and the method related risks another crucial criterion consists of the time required for the determination of CO [21].…”

Section: Anesthesiology and Clinical Science Issn 2049-9752mentioning

confidence: 99%

Hemodynamic monitoring by USCOM during rapid sequence intubation (RSI) with Etomidate/Fentanyl or Ketamine/Midazolam

Joachim¹,

Geiger²,

Strecker³

et al. 2012

J Anesthesiol Clin Sci

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Clinical validation of the non-invasive cardiac output monitor USCOM-1A in critically ill patients

Abstract: The correlation between the two techniques was acceptable, although relevant systematic and variable errors were detected. USCOM-1A provided adequate data to distinguish non-invasively different shock types in ICU patients.

Cited by 42 publications

References 31 publications

The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study

The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study

Anthracycline-Induced Cardiotoxicity: Cardiac Monitoring by Continuous Wave-Doppler Ultrasound Cardiac Output Monitoring and Correlation to Echocardiography

Hemodynamic monitoring by USCOM during rapid sequence intubation (RSI) with Etomidate/Fentanyl or Ketamine/Midazolam

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