Safety and efficacy of pulse-induced contour cardiac output monitoring in elderly patients with coronary artery disease and severe heart failure at coronary care units

Li-ping, Qi; Liu, Hongwei; Changming, Huang; Bai, Yulong; Li, Ang

doi:10.3389/fcvm.2022.910898

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…The objective of the optimization first needs to be determined. As the optimization objectives for LPM individualization, the haemodynamic indicators should be able to be used to observe the acute responses of EECP through noninvasive clinical measurement 25–27 . In clinical EECP therapy, relevant and easily measurable indicators are usually brachial aortic pressure (BAP), CO, and ICAF.…”

Section: Methodsmentioning

confidence: 99%

“…As the optimization objectives for LPM individualization, the haemodynamic indicators should be able to be used to observe the acute responses of EECP through noninvasive clinical measurement. [25][26][27] In clinical EECP therapy, relevant and easily measurable indicators are usually brachial aortic pressure (BAP), CO, and ICAF. BAP and CO can be used to evaluate the therapeutic effect of EECP on coronary heart disease, while ICAF can be used to evaluate the therapeutic effect on stroke.…”

Section: Patient-specific Global Haemodynamic Simulation Of Eecpmentioning

confidence: 99%

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A real‐time patient‐specific treatment strategy for enhanced external counterpulsation

Li,

Liu,

et al. 2024

Numer Methods Biomed Eng

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Diastolic/systolic blood pressure ratio (D/S) ≥ 1.2 is the gold standard of enhanced external counterpulsation (EECP) treatment, but it does not show a clear clinical correspondence with the configuration of the EECP mode. As such, a single target results in different treatment effects in different individuals. The local haemodynamic effect (wall shear stress, WSS) of EECP on vascular endothelial cells is conducive to promote the growth of collateral circulation vessels and restore the blood supply distal to the stenosis lesion. Considering the haemodynamic effects of WSS on human arteries, this study developed a real‐time patient‐specific treatment strategy of EECP for patients with cardio‐cerebrovascular diseases. Based on patient‐specific haemodynamic data from 113 individuals, an optimization algorithm was developed to achieve the individualization of a 0D lumped‐parameter model of the human circulatory system, thereby simulating the patient‐specific global haemodynamic effects. 0D/3D coupled cardio‐cerebrovascular models of two subjects were established to simulate the local WSS. We then established statistical models to evaluate clinically unmeasurable WSS based on measurable global haemodynamic indicators. With the aim of attaining appropriate area‐ and time‐averaged WSS (ATAWSS, 4–7 Pa), as evaluated by global haemodynamic indicators, a closed‐loop feedback tuning method was developed to provide patient‐specific EECP treatment strategies. Results showed that for clinical data collected from 113 individuals, the individualized 0D model can accurately simulate patient‐specific global haemodynamic effects (average error <5%). Based on two subjects, the statistical models can be used to evaluate local ATAWSS (error <6%) for coronary arteries and for cerebral arteries. An EECP mode planned by the patient‐specific treatment strategy can promote an appropriate ATAWSS within a 16 s calculation time. The real‐time patient‐specific treatment strategy of EECP is expected to improve the long‐term outcome for each patient and have potential clinical significance.

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Section: Methodsmentioning

confidence: 99%

Section: Patient-specific Global Haemodynamic Simulation Of Eecpmentioning

confidence: 99%

A real‐time patient‐specific treatment strategy for enhanced external counterpulsation

Li,

Liu,

et al. 2024

Numer Methods Biomed Eng

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“…pre-ejection period (PEP), left ventricular ejection time (LVET)] are measured by a non-invasive haemodynamic monitoring technique -Task Force Monitor (TFM). Such techniques are considered an alternative to invasive haemodynamic monitoring in intensive care units [16]. In the authors' opinion, this is the first study that evaluates heart contractility parameters after acute sleep fragmentation in laboratory conditions.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular and autonomic consequences of sleep fragmentation

Słomko

Kujawski

Kowara

et al. 2023

Medical Research Journal

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Introduction: Sleep disruption is commonly found in normal individuals and those with sleep disorders.Risk factors for sleep fragmentation involve a combination of lifestyle, environmental, psychosocial factors and/or medical conditions. The main objective of this study was to analyse the impact of acute, induced sleep fragmentation upon autonomic cardiovascular regulation, measured by a non-invasive haemodynamic measurement technique. Material and methods:The authors analysed beat-to-beat measurements of haemodynamic and autonomic parameters at 5-time points during sleep fragmentation: 9:00 a.m. (baseline), 9:00 p.m., 00:30 a.m., 4:00 a.m., and 7:30 a.m. Differences in the mean values for chronotropic parameters, cardiac contractility, parameters related to blood pressure regulation and workload of the left ventricle, and autonomic parameters were examined in seventeen healthy male volunteers. Direct results obtained from every time point were analysed using analysis of variance with repeated measures or the Friedman rank sum test.Results: Sleep fragmentation had a significant negative impact on haemodynamic parameters related to cardiac contractility (SV p < 0.001, IC p < 0.001, HI p < 0.001); parameters related to workload of the left ventricle (CO p < 0.001, LVWI p < 0.001, ACI p < 0.001); parameters related to blood pressure regulation (sBP p = 0.001, TPR p < 0.001); on chronotropic parameters (HR p < 0.001, PEP p < 0.001, LVET p < 0.001) and an indicator of cardiac autonomic regulation: LF-RRI (p = 0.001).Conclusions: Acute sleep fragmentation can modify haemodynamic control and autonomic cardiovascular regulation in healthy men; the most important changes were seen in the morning hours (4:00 a.m.).Therefore, conditions of chronic sleep fragmentation (e.g. shift work, uniformed services, clinicians), might lead to disturbance in the autonomic nervous system and therefore to problems with homeostasis in the cardiovascular system. Future research is needed in standardized conditions with large-scale studies to clarify the effects of chronic sleep fragmentation.

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“…Such monitoring has been successful and proved to be useful in a group of fragile patients suffering from severe heart disease. While PAP is known as an independent risk factor for one-month mortality among these patients, it has been shown that monitoring as in PICCO, where ELWI is estimated, may enable an accurate decision in regard to fluid therapy as well as antidiuretic drugs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment

Miszczenkow,

Krzych

2023

JCM

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Background: Pulmonary artery catheters are widely used for hemodynamical monitoring in critically ill patients. Acute brain injury is among the severe conditions treated in an intensive care unit. The advanced monitoring of hemodynamical parameters, fluid balance and adequate administered treatment based on those values are components of goal-directed therapy. Methods: A prospective observational study included adult patients who were hospitalized in the ICU due to acute bran injury, excluding brain oedema after cardiac arrest. Each patient had PAC inserted and hemodynamic data were collected during the first 3 days of the ICU stay every 6 h. Patients were divided into two groups based on the endpoint: the survivors and the deceased. Results: Length of stay in hospital differed between patiens. All patients, regardless of their outcome, had noradrenaline administered. The initial values of PAP differed between the groups (p = 0.05). There were positive correlations noticed between noradrenaline dose, CVP and fluid balance when compared to PCWP in a group of survivors and a positive correlation in the fluid balance when compared to PAP and PVRI. Lactate serum concentrations presented a correlation with the dose of noradrenaline in both groups. Conclusions: Upon acute brain injury, values of PVRI and PAP increase. This is corelated with fluid load and worsened by an excessive fluid treatment in the case of an inconsiderate approach for stabilizing the patient hemodynamically. PAC may present limited advantages in terms of PAP and PVRI control during the treatment.

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Safety and efficacy of pulse-induced contour cardiac output monitoring in elderly patients with coronary artery disease and severe heart failure at coronary care units

Cited by 6 publications

References 21 publications

A real‐time patient‐specific treatment strategy for enhanced external counterpulsation

A real‐time patient‐specific treatment strategy for enhanced external counterpulsation

Cardiovascular and autonomic consequences of sleep fragmentation

Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment

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