Complications of invasive hemodynamic monitoring in the intensive care unit

Sladen, Arnold

doi:10.1016/0011-3840(88)90009-3

Cited by 22 publications

(4 citation statements)

References 190 publications

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“…A review by Sladen [2] showed no statistical difference in complications between internal jugular or in infraclavicular subclavian approaches. Arterial injury can cause local haematoma, haemothorax, false aneurysm, arteriovenous fistula or even cerebral infarction [4].…”

Section: Discussionmentioning

confidence: 99%

Fatal subclavian artery haemorrhage

1995

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Section: Discussionmentioning

confidence: 99%

Fatal subclavian artery haemorrhage

1995

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“…reduce the morbidity seen with invasive devices such as the AL, which despite being regarded as the gold standard measurement technique within intensive care units, is associated with a high prevalence of infection and local vascular damage (8).…”

Section: Bp Hemodynamic Monitoring By Non-invasive Means Couldmentioning

confidence: 99%

“…Albeit providing accurate and continuous BP measurements, the AL is an invasive method with several potential adverse effects and complications (6). It requires operation by skilled personnel and has a cumbersome setting with monitors, cables and wires connected to the patient (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Blood Pressure Monitoring After Cardiac Surgery Using a Wearable, Non-invasive Sensor

et al. 2021

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Background: Continuous blood pressure (BP) measurement in intensive care units is based on arterial line (AL) transducers, sometimes associated with clinical complications. Our objective was to evaluate continuous BP measurements obtained from a non-invasive, wireless photoplethysmography (PPG)-based device using two distinct configurations (wristwatch and chest-patch monitors) compared to an AL.Methods: In this prospective evaluation study, comparison of the PPG-based devices to the AL was conducted in 10 patients immediately following cardiac surgery. Pulse rate (PR), systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were recorded using both the AL and the PPG-based devices simultaneously for an average of 432 ± 290 min starting immediately after cardiac surgery. Bland-Altman plots and Pearson's correlations were used to assess the accuracy and degree of agreement between techniques.Results: A total of ~4,000 data points were included in the final analysis. AL measurements for PR, SBP, DBP and MAP were significantly (p < 0.001) and strongly correlated with both the wristwatch (r = 0.99, r = 0.94, r = 0.93 and r = 0.96, respectively) and the chest-patch (r = 0.99, r = 0.95, r = 0.93 and r = 0.95, respectively) monitors. Both configurations showed a marginal bias of <1 mmHg for BP measurements and <1 beat/min for PR [95% limits of agreement −3,3 beat/min; BP measurements: (−6)–(−10), 6–10 mmHg] compared to AL measurements.Conclusion: The PPG-based devices offer a high level of accuracy for cardiac-related parameters compared to an AL in post-cardiac surgery patients. Such devices could provide advanced monitoring capabilities in a variety of clinical settings, including immediate post-operative and intensive care unit settings.Clinical Trial Registration:www.clinicaltrials.gov, NCT03603860.

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“…A low compliance diaphragm, in the transducer creates a reproducible volume change in response to the applied pressure change. The volume change alters the resistance of a Wheatstone bridge and is thus converted into an electrical signal [53]. The pressure is displayed both in wave form and digitally in most systems.…”

Section: Photoplethysmographymentioning

confidence: 99%

Routine Monitoring of Critically I11 Patients

Curley

Smyrnios

1990

J Intensive Care Med

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The explosion in computer use and technology during the past several decades has dramatically changed criti cal care. All vital signs can now be monitored accu rately, noninvasively, and continuously. We examined the predominantly noninvasive methods of monitor ing temperature, arterial blood pressure, heart rate and rhythm, respiratory mechanics, and gas exchange that can be used continuously on almost every patient in the intensive care unit. We conclude that temperature should be measured either intermittently with a rectal thermometer or continuously with a rectal, bladder, or great vessel thermocouple or thermistor probe. Arterial pressure should be measured either intermittently with a sphygmomanometer and cuff or continuously with an indwelling arterial catheter, except in specific situa tions when automated indirect monitoring may be use ful. Electrocardiographic rhythm monitoring has been clearly shown to improve prognosis in patients after acute myocardial infarction and should be universal in all intensive care units. Ischemia monitoring may prove beneficial, but its role has not been clearly defined. Re spiratory inductance plethysmography is effective in measuring respiratory rate, tidal volume, and breathing pattern. Pulse oximetry is useful in detecting occult hy poxemia. It should be continuous on most patients. Transcutaneous oxygen and carbon dioxide measure ment has a limited role in monitoring gas exchange and perfusion. Capnography also has a limited role in the intensive care unit but is more helpful in the operating room.

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Complications of invasive hemodynamic monitoring in the intensive care unit

Cited by 22 publications

References 190 publications

Fatal subclavian artery haemorrhage

Fatal subclavian artery haemorrhage

A Pilot Study of Blood Pressure Monitoring After Cardiac Surgery Using a Wearable, Non-invasive Sensor

Routine Monitoring of Critically I11 Patients

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