Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmonary bypass

Chauhan, Sandeep; Saxena, Nita; Mehrotra, Santosh; Rao, Beeraka Heramba; Sahu, Manoj Kumar

doi:10.1053/cr.2000.5855

Cited by 42 publications

(14 citation statements)

References 8 publications

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“…An arterial pressure difference between the femoral artery and the radial artery is often observed during liver transplantation [28]. This is similar to that observed after cardiopulmonary bypass in cardiac surgery or deep hypothermic circulatory arrest and is often caused by peripheral arterial vasodilation [29,30]. Therefore, the high PG in our patients may reflect severe peripheral arterial vasodilation.…”

Section: B Asupporting

confidence: 81%

Ability of dynamic preload indices to predict fluid responsiveness in a high femoral-to-radial arterial pressure gradient: a retrospective study

Ju¹,

Yeon²,

Lee³

et al. 2021

Anesth Pain Med

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Background: Dynamic preload indices may predict fluid responsiveness in end-stage liver disease. However, their usefulness in patients with altered vascular compliance is uncertain. This study is the first to evaluate whether dynamic indices can reliably predict fluid responsiveness in patients undergoing liver transplantation with a high femoral-to-radial arterial pressure gradient (PG).Methods: 80 liver transplant recipients were retrospectively categorized as having a normal (n = 56) or high (n = 24, difference in systolic pressure ≥ 10 mmHg and/or mean pressure ≥ 5 mmHg) femoral-to-radial arterial PG, measured immediately after radial and femoral arterial cannulation. The ability of dynamic preload indices (stroke volume variation, pulse pressure variation [PPV], pleth variability index) to predict fluid responsiveness was assessed before the surgery. Fluid replacement of 500 ml of crystalloid solution was performed over 15 min. Fluid responsiveness was defined as ≥ 15% increase in the stroke volume index. The area under the receiver-operating characteristic curve (AUC) indicated the prediction of fluid responsiveness.Results: Fourteen patients in the normal, and eight in the high PG group were fluid responders. The AUCs for PPV in the normal, high PG groups and total patients were 0.702 (95% confidence interval [CI] 0.553–0.851, P = 0.008), 0.633 (95% CI 0.384–0.881, P = 0.295) and 0.667 (95% CI 0.537–0.798, P = 0.012), respectively. No other index predicted fluid responsiveness.Conclusion: PPV can be used as a dynamic index of fluid responsiveness in patients with end-stage liver disease but not in patients with altered vascular compliance.

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Section: B Asupporting

confidence: 81%

Ability of dynamic preload indices to predict fluid responsiveness in a high femoral-to-radial arterial pressure gradient: a retrospective study

Ju¹,

Yeon²,

Lee³

et al. 2021

Anesth Pain Med

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“…To eliminate errors from damping and frequency change, the natural frequency and damping coefficient for each system was determined by the flush method. 8,9 After these monitoring settings, appropriately sized cuff CNAP sensors (Infinity CNAP, Draeger) were placed on the patient's index and middle fingers of the same extremity as the arterial catheter. A brachial noninvasive blood pressure (NIBP) cuff for calibration was placed on the contralateral arm and measurements were performed at 30-minute intervals.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation

Araz¹,

Zeyneloğlu²,

Pirat³

et al. 2015

Exp Clin Transplant

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“…In theory, the proposed method is equally applicable to both upper body and lower body circulations. However, its applicability to lower body arterial branch is of particular interest, since clinical problems and diseases (e.g., peripheral vascular disease due to atherosclerosis and arterial stenosis) associated with increased peripheral resistance (and thus increased wave reflection) is more commonly found in the lower body arterial branch, such as femoral and tibial arteries [32]- [34].…”

Section: B Data Processing and Analysismentioning

confidence: 99%

Quantification of Wave Reflection Using Peripheral Blood Pressure Waveforms

Kim

Fazeli

McMurtry

et al. 2015

IEEE J. Biomed. Health Inform.

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This paper presents a novel minimally invasive method for quantifying blood pressure (BP) wave reflection in the arterial tree. In this method, two peripheral BP waveforms are analyzed to obtain an estimate of central aortic BP waveform, which is used together with a peripheral BP waveform to compute forward and backward pressure waves. These forward and backward waves are then used to quantify the strength of wave reflection in the arterial tree. Two unique strengths of the proposed method are that 1) it replaces highly invasive central aortic BP and flow waveforms required in many existing methods by less invasive peripheral BP waveforms, and 2) it does not require estimation of characteristic impedance. The feasibility of the proposed method was examined in an experimental swine subject under a wide range of physiologic states and in 13 cardiac surgery patients. In the swine subject, the method was comparable to the reference method based on central aortic BP and flow. In cardiac surgery patients, the method was able to estimate forward and backward pressure waves in the absence of any central aortic waveforms: on the average, the root-mean-squared error between actual versus computed forward and backward pressure waves was less than 5 mmHg, and the error between actual versus computed reflection index was less than 0.03.

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Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmonary bypass

Cited by 42 publications

References 8 publications

Ability of dynamic preload indices to predict fluid responsiveness in a high femoral-to-radial arterial pressure gradient: a retrospective study

Ability of dynamic preload indices to predict fluid responsiveness in a high femoral-to-radial arterial pressure gradient: a retrospective study

Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation

Quantification of Wave Reflection Using Peripheral Blood Pressure Waveforms

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