Perioperative sequential monitoring of hemodynamic parameters in patients with pheochromocytoma using the Non-Invasive Cardiac System (NICaS)

Matsuda, Yayoi; Kawate, Hisaya; Shimada, Shingo; Matsuzaki, Chitose; Nagata, Hiromi; Adachi, Masahiro; Ohnaka, Keizo; Nomura, Masatoshi; Takayanagi, Ryoichi

doi:10.1507/endocrj.ej13-0471

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…In addition, IT is more accurate when measuring cardiac output in adults compared with neonates. 15 IT used for adults relies on analyzing the change of body resistance of each heart beat; the final cardiac output data obtained by SV are then calculated. Some studies suggest that there may be differences in body surface area, weight, and circulatory system pathway between neonates and adults; thus, the current formula needs to be corrected to further improve the precision of impedance measurement for neonatal cardiac output.…”

Section: Discussionmentioning

confidence: 99%

Consistency between Impedance Technique and Echocardiogram Hemodynamic Measurements in Neonates

Lin

Xie

et al. 2020

Am J Perinatol

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Objective The aim of this study was to validate impedance technique (IT) by investigating the agreement in cardiac output measurements performed by IT and echocardiography (ECHO). Study design This is a prospective observational study, including a total of 30 neonates who underwent hemodynamic measurements by IT and ECHO. To determine the agreement between both methods, we performed IT to measure stroke volume (SV-IT) and cardiac output (CO-IT) immediately before or after ECHO to measure SV (SV-ECHO) and CO (CO-ECHO). The precision and accuracy of the IT relative to ECHO were assessed. Results SV-ECHO and SV-IT were (4.45 ± 0.78) and (4.54 ± 0.81) mL, respectively. The bias and limits of agreement of SV-IT were 0.09 mL and ( –1.92 to 1.73) mL, respectively. The true precision of SV-IT was 27.3%. Furthermore, CO-ECHO and CO-IT were (0.62 ± 0.12) and (0.61 ± 0.12) L/min, respectively. The bias and LoA of CO-IT were 0.01L/min and (–0.33 to 0.31) L/min, respectively. The true precision of CO-IT was 28.3%. Conclusion Agreement between the IT and ECHO in the cardiac output measurement appeared acceptable. However, the accuracy and precision of the IT approach should be further investigated using a larger sample.

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Section: Discussionmentioning

confidence: 99%

Consistency between Impedance Technique and Echocardiogram Hemodynamic Measurements in Neonates

Lin

Xie

et al. 2020

Am J Perinatol

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“…[2649] Usefulness of noninvasive methods for cardiac output estimation and stroke volume variation to diagnose fluid deficit has also been revealed in patients with PCC recently. [5051] Fluid therapy is a vital but complex component of perioperative management in patients with PCC and PGL. While under-hydration will lead to severe hypotension after tumor resection over-hydration can lead to pulmonary edema and congestive heart failure in an already compromised heart.…”

Section: Anaesthetic Managementmentioning

confidence: 99%

Current perioperative management of pheochromocytomas

Ramachandran

Rewari

2017

Indian J Urol

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Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, 123I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging. Before surgical removal of the tumors, the optimization of blood pressure, as well as intravascular volume, is an important measure to avoid and suppress perioperative adverse hemodynamic events. Preoperative preparation includes the use of alpha-adrenergic antagonists, beta-adrenergic antagonists with or without other antihypertensive agents, fluid therapy as well as insulin therapy for hyperglycemia if required. Due attention should be given to type and dose of alpha-receptor antagonists to be used and the duration of this therapy to achieve an optimal level of preoperative “alpha-blockade.” Despite this preoperative preparation, many patients will have hypertensive crises intraoperatively which need to be promptly and carefully managed by the anesthesia team which requires intensive and advanced monitoring techniques. The most common complication after tumor removal is hypotension which may require fluid therapy and vasopressor support for a few hours. With advancement in surgical and anesthetic techniques, the incidence of severe morbidity and mortality associated with the surgery is low in high volume centers.

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“…One pair of electrodes is placed on the wrist over the radial artery, and the other pair is placed on the contralateral ankle over the posterior tibial artery. [ 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

“…There is limited literature on NICaS™ derived hemodynamic parameters and its validation with invasive techniques in cardiac surgery. [ 6 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients

et al. 2020

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Background: Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS™ with the thermodilution technique using pulmonary artery catheter in post-operative cardiac surgical patients. Materials and Methods: This was a prospective observational clinical study conducted at a tertiary care hospital. 23 adult patients in the age range of 18-65 years who had undergone for elective coronary artery bypass grafting were included in the study. Results: Spearman's correlation coefficient of cardiac index between continuous Thermodilution (cTD) and Non-Invasive Cardiac System (NICaS™) showed a good correlation (r = 0.765, 95% confidence interval 0.70 to 0.82, P < 0.0001). There was a good correlation between cTD and NICaS™ for cardiac output (r = 0.759, 95% confidence interval 0.69 to 0.81, P < 0.0001), Bland-Altman plot for cardiac index between cTD and NICaS™ showed a mean bias of −0.66 ± 0.6919 with limits of agreement being −2.02 to 0.6936. Bland-Altman plot for cardiac output between cTD and NICaS™ showed a mean bias of −1.0386 ± 1.17 with limits of agreement being −3.34 to + 1.26. Percentage error for cardiac index and cardiac output were 64.78% and 64% respectively. Polar plot analysis showed an angular bias of 6.32° with radial limits of agreement being −8.114° to 20.75° for cardiac index and angular bias of 5.6682° with radial limits of agreement being −9.1422° to 20.4784° for cardiac output. Conclusion: NICaS™ demonstrated a good trending ability for both CI and CO. However, NICaS™ derived parameters are not interchangeable with the values derived from continuous thermodilution technique.

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Perioperative sequential monitoring of hemodynamic parameters in patients with pheochromocytoma using the Non-Invasive Cardiac System (NICaS)

Cited by 11 publications

References 17 publications

Consistency between Impedance Technique and Echocardiogram Hemodynamic Measurements in Neonates

Consistency between Impedance Technique and Echocardiogram Hemodynamic Measurements in Neonates

Current perioperative management of pheochromocytomas

Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients

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