Non-invasive hemodynamic monitoring in trauma patients

Kuster, Matthias; Exadaktylos, Aristomenis K.; Schnüriger, Beat

doi:10.1186/s13017-015-0002-0

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…Data obtained with the USCOM correlates well with data from other standard hemodynamic methods for animal studies, adults, neonates, and children. [8][9][10][11] The estimation of CO and SVRI measured with USCOMs are comparable to the results of pulmonary artery catheter thermodilution in children with normal cardiac anatomy. [11] Therefore, this study used a non-invasive bedside hemodynamic monitor, to identify the initial hemodynamic profile and determine the fluid responsiveness of children with DSS.…”

Section: Discussionsupporting

confidence: 53%

Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings

Rusmawatiningtyas¹,

Wiguna²,

Kumara³

et al. 2019

AJP

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Background: Fluid therapy for dengue shock syndrome (DSS) requires a dynamic approach that involves monitoring of the pathophysiological processes as well as the preload, contractility, and afterload assessment during the course dengue infection. Hemodynamically unstable DSS patients received in referral setting often complicated by fluid overload and secondary infection. Objective: This study aims to provide hemodynamic profiles and fluid responsiveness of pediatric patients admitted to the PICU with DSS. Methods: Hemodynamic profiles, laboratories, and demographic data were collected from patients aged 1 month to 18 years old with DSS who were admitted to the Pediatric Intensive Care Unit (PICU) at Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January to December 2016. Hemodynamic profiles were assessed in clinically shock and not clinically shock group at PICU admission using the non-invasive Ultrasonic Cardiac Output Monitor (USCOM). Fluid responsiveness in clinically shock group was evaluated after fluid challenge with 10 ml/kgBW crystalloid or colloid. Results: Eighty six subjects were included in this study. Sixty six subjects were admitted to PICU with clinically shock condition. This group received less intravenous fluid than hemodynamically stable group (6.9 vs 7.52 ml/kgBW/hour respectively), had higher mean hematocrit level (42.09% vs 40.32% respectively), had higher hematocrit level during PICU stay (43.37% vs 42.06% respectively), significantly higher percentage to receive inotropes agent (62,1% vs 5%, p 0,000) and longer duration of inotropes usage (23,5 vs 0 hours, p 0.72). From the clinically shock patients admitted to PICU, only 19,69% were fluid responsive. Other subjects in this group with fluid non responsive state, 90,38% had low inotropic index and high systemic vascular resistance index. Among 8 patients in clinically shock group who died during PICU stay, 6 of them had low cardiac Index, fluid non responsive condition, low inotropic index and high systemic vascular resistance index. Conclusion: Only a small percentage of DSS patients with clinically shock admitted to the PICU were fluid responsive. Majority of DSS cases in children had low inotropy index and high systemic vascular resistance index.

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Section: Discussionsupporting

confidence: 53%

Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings

Rusmawatiningtyas¹,

Wiguna²,

Kumara³

et al. 2019

AJP

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“…The initial assessment of these patients and decisions regarding further administration of resuscitatory fluid or blood products are accomplished by monitoring the patients’ vital signs, especially blood pressure, heart rate, and urine output. However, there are cases in which the clinical picture is difficult to interpret because of the presence of pain, hyper/hypothermia, neurogenic or cardiogenic shock, or other factors [ 14 ]. An ideal monitoring device for such patients would be noninvasive, small in size, transportable, and easy to use and understand.…”

Section: Discussionmentioning

confidence: 99%

Urine flow rate monitoring in hypovolemic multiple trauma patients

et al. 2017

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BackgroundThe urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported.MethodsThe study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 multiple trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised.ResultsThe urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p < 0.001 and 0.006 respectively). Statistical analysis by the Pearson method demonstrated a strong direct correlation between decreased urine flow rate variability and decreased urine output per hour (R = 0.17; P = 0.009), decreased mean arterial blood pressure (R = 0.24; p = 0.001), and increased heart rate (R = 0.205; p = 0.001).ConclusionThese findings suggest that minute-to-minute urine flow rate variability is a reliable incipient marker of hypovolemia and that it should therefore take its place among the parameters used to monitor the hemodynamic status of critically ill multiple trauma patients.

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“…Se utiliza en la evaluación de pacientes con choque hemorrágico y está asociado con alteración de la perfusión tisular y malos desenlaces cuando el valor es ≥ 0.8 4 . La alteración del IS debe alertar para corroborar hipoperfusión tisular, aunque existen situaciones en los cuales el IS puede estar normal a pesar de hipoperfusión, como por ejemplo bloqueos en la conducción cardiaca, marcapaso cardiaco, disminución de estimulación adrenérgica por fármacos hipnóticos sedantes o lesión medular, por citar algunos 5 .…”

Section: íNdice De Choqueunclassified

Evaluación hemodinámica en escenarios con recursos limitados

Zamora-Gómez¹,

Toledo-Rivera²,

Gorordo-Delsol³

et al. 2019

REIE

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sin embargo, muchos hospitales operan con recursos limitados. Esta heterogeneidad es habitual en países de todos los niveles socioeconómicos, por ello el médico debe aprender las bases fisiológicas y los métodos simples, de los que se dispone en la mayoría de los entornos, y evaluar las ventanas clínicas y paraclínicas de forma sistematizada para detectar e intervenir de forma eficaz en pro de la salud del paciente. Este trabajo sintetiza tres aspectos clínicos: el análisis de la captación, traslado, entrega y consumo de oxígeno y cómo modificar estos pasos de forma sencilla con el soporte gasométrico y ecográfico.

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Non-invasive hemodynamic monitoring in trauma patients

Cited by 20 publications

References 17 publications

Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings

Initial Hemodynamic Profiles of Children with Dengue Shock Syndrome in Referral Settings

Urine flow rate monitoring in hypovolemic multiple trauma patients

Evaluación hemodinámica en escenarios con recursos limitados

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