Stroke volume optimization in elective bowel surgery: a comparison between pulse power wave analysis (LiDCOrapid) and oesophageal Doppler (CardioQ)

Nordström, Jan; Hällsjö-Sander, Caroline; Shore, Richard; Björne, Håkan

doi:10.1093/bja/aes399

Cited by 45 publications

(31 citation statements)

References 37 publications

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“…Fluid overload can lead to several harmful effects such as, generalised oedema, hindering tissue healing, detrimental effects on cardio-pulmonary functions, delayed recovery of gut functions [9] , decreased muscular oxygen tension [10] , increased risk of complications [11,12] and is linked to poor survival rates [13] . The effectiveness of intra-operative cardiovascular monitoring to reduce such complications has been proven in other published studies [25][26][27][28][29][30] . On the other hand, hypovolemia can lead to hypoperfusion, circulatory collapse, impaired wound healing, anastomotic leak [14,15] , bacterial translocations and endotoxaemia with activation of the systemic inflammatory response [31] ; all of which account for the need of prolonged stay in high level care facilities post-operatively.…”

Section: Discussionmentioning

confidence: 99%

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

Aslam¹,

Smith²,

Currow³

et al. 2018

MIS

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Aim: Intra-operative cardiac output (CO) monitoring became a standard of care in Northampton General Hospital, UK, at the end of 2013. This study aimed to assess the effectiveness of intra-operative CO monitoring with oesophageal Doppler or LiDCO for patients undergoing elective colorectal surgery for cancer within an enhanced recovery after surgery (ERAS).Methods: Data was prospectively collected over a 5-year period (March 2010 -Feb 2015 for patients undergoing elective colorectal surgery in the practice of a single surgeon. The ERAS protocol was applied for all the patients. There were 69 patients who had intra-operative CO monitoring with oesophageal Doppler or LiDCO and 144 patients who had no intra-operative CO monitoring. Results were analysed for post-operative outcomes (morbidity, mortality, readmission within 30 days, total length of hospital stay and admission to a high level of care facility). Results:There was no significant difference in 30-day morbidity and readmission rates between the two examined groups. Forty-six percent of patients in the intra-operative CO monitoring group were admitted to a low level of care facility (ward) in comparison to 24% of patients in the no intra-operative CO monitoring group (P = 0.01). Conclusion:Using intra-operative CO monitoring singnificantly might reduce the need for admission to critical care. A larger cohort study is needed to further confirm these findings and account for any co-founders.

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Section: Discussionmentioning

confidence: 99%

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

Aslam¹,

Smith²,

Currow³

et al. 2018

MIS

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“…Additionally, a LiDCO rapid version that consists of the previously described pulse power analysis algorithm and does not require calibration at all exists. The LiDCO rapid system is able to do this by the use of patient biometric data, including age, height, and weight, which serve as the calibration for the system [28]. One important limitation for the LiDCO systems requiring calibration is that, in patients receiving lithium therapy, the baseline lithium level will falsely elevate the calculated cardiac output.…”

Section: Methodsmentioning

confidence: 99%

A Review of Intraoperative Goal-Directed Therapy Using Arterial Waveform Analysis for Assessment of Cardiac Output

Mehta

Fernandez-Bustamante

Seres

2014

The Scientific World Journal

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Increasing evidence shows that goal-directed hemodynamic management can improve outcomes in surgical and intensive care settings. Arterial waveform analysis is one of the different techniques used for guiding goal-directed therapy. Multiple proprietary systems have developed algorithms for obtaining cardiac output from an arterial waveform, including the FloTrac, LiDCO, and PiCCO systems. These systems vary in terms of how they analyze the arterial pressure waveform as well as their requirements for invasive line placement and calibration. Although small-scale clinical trials using these monitors show promising data, large-scale multicenter trials are still needed to better determine how intraoperative goal-directed therapy with arterial waveform analysis can improve patient outcomes. This review provides a comparative analysis of the different arterial waveform monitors for intraoperative goal-directed therapy.

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“…The system is easy to set up (1 minute) with the use of only a standard arterial line and any transducer kit and will also offer to the clinician many other important hemodynamic parameters as: SVV, PPV, SVR. Despite the initial enthusiastic approach, LiDCOrapid failed to demonstrate a good correlation for SV values when compared with the PiCCO pulse contour [64] or transesophageal Doppler [65]. Regarding the ability of the LiDCOrapid-SVV to predict the fluid responsiveness, some studies performed in high risk vascular surgery [66] and in cardiac surgery [67] confirmed that this parameter is an adequate predictor of the CO response to fluid administration.…”

Section: Lidcorapid (Lidco Ltd Cambridge Uk)mentioning

confidence: 99%

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Hendy

Bubenek

2016

Rom J Anaesth Int Care

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Hemodynamic monitoring has evolved and improved greatly during the past decades as the medical approach has shifted from a static to a functional approach. The technological advances have led to innovating calibrated or not, but minimally invasive and noninvasive devices based on arterial pressure waveform (APW) analysis. This systematic clinical review outlines the physiologic rationale behind these recent technologies. We describe the strengths and the limitations of each method in terms of accuracy and precision of measuring the flow parameters (stroke volume, cardiac output) and dynamic parameters which predict the fluid responsiveness. We also analyzed the place of the APW monitoring devices in goaldirected therapy (GDT) protocols in cardiac surgical patients. According to the data from the three GDTrandomized control trials performed in cardiac surgery (using two types of APW techniques PiCCO and FloTrac/Vigileo), these devices did not demonstrate that they played a role in decreasing mortality, but only decreasing the ventilation time and the ICU and hospital length of stay.

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Stroke volume optimization in elective bowel surgery: a comparison between pulse power wave analysis (LiDCOrapid) and oesophageal Doppler (CardioQ)

Cited by 45 publications

References 37 publications

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

Does intra-operative cardiac output monitoring improve outcomes for patients undergoing elective colorectal surgery within an enhanced recovery programme?

A Review of Intraoperative Goal-Directed Therapy Using Arterial Waveform Analysis for Assessment of Cardiac Output

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

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