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Robert A Phillips - One of the best experts on this subject based on the ideXlab platform.

  • noninvasive Cardiac Output accuracy between the ultrasound Cardiac Output Monitor and the esophageal doppler Monitor
    Critical Care, 2007
    Co-Authors: Robert Bilkovski, J Martini, Robert A Phillips
    Abstract:

    The hypothesis is that measurement of the Cardiac index (CI) is accurate between the ultrasound Cardiac Output Monitor (USCOM) and the esophageal Doppler Monitor (EDM). The EDM is a minimally invasive device that has demonstrated strong correlation with Cardiac Output measurements obtained by thermodilution. A disadvantage of the EDM is the need for probe placement in the esophagus, effectively limiting its use to mechanically ventilated patients. The USCOM, in contrast, can measure Cardiac hemodynamics by use of a CW Doppler probe placed on the skin to measure blood flow across either the aortic or pulmonic valve.

  • feasibility of preclinical Cardiac Output and systemic vascular resistance in hems in thoracic pain the ultrasonic Cardiac Output Monitor
    Air Medical Journal, 2006
    Co-Authors: Karsten Knobloch, V Hubrich, P Rohmann, M Lupkemann, T Gerich, Christian Krettek, Robert A Phillips
    Abstract:

    Abstract Background Cardiac Output (CO) and systemic vascular resistance (SVR) are important hemodynamic parameters in emergency patients and for clinical early goal-directed therapy. This study evaluated the feasibility of CO and SVR determination using preclinical continuous wave Doppler ultrasound in a helicopter emergency medical service (HEMS) on emergency patients presenting with or without thoracic pain as a pilot observational study. Methods Forty-four consecutive medical emergency patients (62.8 ± 22 years of age, 23 males) were classified at the scene as with (15 patients, 69 ± 14 years of age, 40% male) or without (29 patients, 60 ± 25 years of age, 59% male) thoracic pain by an emergency physician. Hemodynamic parameters were determined based on continuous wave Doppler noninvasively (USCOM, Sydney, Australia): stroke volume (SV), CO, Cardiac index (CI), minute distance (MD), and SVR. Results Noninvasive SV, MD, CO, CI, and SVR determination is feasible using preclinical ultrasound in HEMS. Thoracic pain patients had higher SVR (2,709 ± 891 vs 1,499 ± 661 dyne*sec*cm-5) and lower CO/CI (3.37 ± 1.1 vs 5.06 ± 2.9 L/min, CI: 1.67 ± 0.58 vs 3.18 ± 1.34 L/min/m2) as well as a reduced aortic minute distance (11.2 ± 3.3 m/min vs 19.1 ± 8 m/min, P = .001) than patients without thoracic pain. Highest Cardiac Outputs were measured during and within 30 minutes after seizures (n = 5, 7.5 ± 3.05 L/min). The range of CO measured in six cardiopulmonary resuscitation patients was 2.7 to 12 L/min; the level of CO was not associated with the establishing of sustained circulation. Conclusions Determining SV, CO/CI, and SVR in different emergency situations in HEMS using rapid CW Doppler ultrasound is feasible. Thoracic pain patients have increased SVR and lower CO/CI and reduced aortic minute distance than do non–thoracic pain patients in the preclinical setting.

  • testing the reliability of a new ultrasonic Cardiac Output Monitor the uscom by using aortic flowprobes in anesthetized dogs
    Anesthesia & Analgesia, 2005
    Co-Authors: L A H Critchley, Zhi Y Peng, Robert A Phillips
    Abstract:

    We have used an animal model to test the reliability of a new portable continuous-wave Doppler ultrasonic Cardiac Output Monitor, the USCOM. In six anesthetized dogs, Cardiac Output was measured with a high-precision transit time ultrasonic flowprobe placed on the ascending aorta. The dogs' Cardiac Output was increased with a dopamine infusion (0-15 mug (.) kg(-1) (.) min(-1)). Simultaneous flowprobe and USCOM Cardiac Output measurements were made. Up to 64 pairs of readings were collected from each dog. Data were compared by using the Bland and Altman plot method and Lin's concordance correlation coefficient. A total of 319 sets of paired readings were collected. The mean (+/-SD) Cardiac Output was 2.62 +/- 1.04 L/min, and readings ranged from 0.79 to 5.73 L/min. The mean bias between the 2 sets of readings was -0.01 L/min, with limits of agreement (95% confidence intervals) of -0.34 to 0.31 L/min. This represents a 13% error. In five of six dogs, there was a high degree of concordance, or agreement, between the 2 methods, with coefficients >0.9. The USCOM provided reliable measurements of Cardiac Output over a wide range of values. Clinical trials are needed to validate the device in humans.

Urs Bauersfeld - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of the aesculon Cardiac Output Monitor by subxiphoidal doppler flow measurement in children with congenital heart defects
    European Journal of Anaesthesiology, 2009
    Co-Authors: Maren Tomaske, Walter Knirsch, Oliver Kretschmar, Christian Balmer, A Schmitz, Urs Bauersfeld, Katja Woitzek, M Weiss
    Abstract:

    BACKGROUND AND OBJECTIVE: To evaluate the noninvasive electrical velocimetry (Aesculon) Monitor for Cardiac Output (CO) by subxiphoidal Doppler flow measurement in children. METHODS: CO was determined at the end of diagnostic or interventional Cardiac catheterization for congenital heart defects. Standard ECG surface electrodes were attached in a vertical direction to the patients' left middle and lower neck, and lower thorax at the level of the heart and xiphoid process. Aesculon CO data were compared with a simultaneously measured CO by the subxiphoidal Doppler flow measurement technique. For each patient, measurements were repeated three times within 5 min. Whitney U-test, simple regression and Bland-Altman analysis were performed to compare CO values obtained by the two techniques. Data are given as range (median). RESULTS: A total of 36 children aged 5.7 (0.5-16.0) years were investigated. CO values obtained by Aesculon Monitor [0.55-5.58 (2.62) l min] and subxiphoidal Doppler flow measurements [0.62-6.27 (3.05) l min] differed significantly between both methods (P = 0.04). Simple regression analysis revealed moderate correlation between CO values obtained from the two techniques (r = 0.5544, P < 0.001). Bias between the two methods was 0.31 l min with a precision of 1.92 l min. CONCLUSION: We conclude that electrical velocimetry using the Aesculon Monitor does not reliably reflect absolute CO values as compared with subxiphoidal Doppler flow measurement.

  • Cardiac Output measurement in children comparison of aesculon Cardiac Output Monitor and thermodilution
    BJA: British Journal of Anaesthesia, 2008
    Co-Authors: Maren Tomaske, Walter Knirsch, Oliver Kretschmar, Christian Balmer, A Schmitz, Urs Bauersfeld, Katja Woitzek, M Weiss
    Abstract:

    BACKGROUND: We compared Cardiac Output (CO) measurements by the non-invasive electrical velocimetry (Aesculon) Monitor with the pulmonary artery catheter (PAC) thermodilution method in children. METHODS: CO values using the Aesculon Monitor and PAC thermodilution were simultaneously recorded during Cardiac catheterization in children. Measurements were performed under general anaesthesia. To compare, three consecutive measurements for each patient within 3 min were obtained. The means of the three values were compared using simple regression and Bland-Altman analysis. Data were presented as mean (sd). A mean percentage of <30% was defined to indicate clinical useful reliability of the Aesculon Monitor. RESULTS: A total of 50 patients with a median (range) age of 7.5 (0.5-16.5) yr were enrolled in the study. Mean CO values were 3.7 (1.5) litre min(-1) (PAC thermodilution) and 3.1 (1.7) litre min(-1) (Aesculon) Monitor). Analysis for CO measurement showed a good correlation between the two methods (r=0.894; P<0.0001). The bias between the two methods was 0.66 litre min(-1) with a precision of 1.49 litre min(-1). The mean percentage error for CO measurements was 48.9% for the Aesculon Monitor when compared with PAC thermodilution. CONCLUSIONS: Electrical velocimetry using the Aesculon Monitor did not provide reliable CO values when compared with PAC thermodilution. Whether the Aesculon Monitor can be used as a CO trend Monitor has to be assessed by further investigations in patients with changing haemodynamics.

  • Cardiac Output measurement in children comparison of the ultrasound Cardiac Output Monitor with thermodilution Cardiac Output measurement
    Intensive Care Medicine, 2008
    Co-Authors: Walter Knirsch, Oliver Kretschmar, Maren Tomaske, K Stutz, Nicole Nagdyman, Christian Balmer, A Schmitz, Dominique Bettex, Felix Berger, Urs Bauersfeld
    Abstract:

    Objective To compare the assessment of Cardiac Output (CO) in children using the noninvasive Ultrasound Cardiac Output Monitor (USCOM) with the invasive pulmonary artery catheter (PAC) thermodilution Cardiac Output measurement.

E Mcclean - One of the best experts on this subject based on the ideXlab platform.

Christopher J. L. Newth - One of the best experts on this subject based on the ideXlab platform.

  • validation of an ultrasound Cardiac Output Monitor as a bedside tool for pediatric patients
    Pediatric Cardiology, 2016
    Co-Authors: Fernando Beltramo, Jondavid Menteer, Asma Razavi, Robinder G. Khemani, Jacqueline R. Szmuszkovicz, Christopher J. L. Newth
    Abstract:

    The aim of our study was to determine the validity of Cardiac Output (CO) measurements taken with the ultrasonic Cardiac Output Monitor (USCOM) by comparing to CO measured by pulmonary arterial catheter (PAC) thermodilution during Cardiac catheterization. We enrolled thirty-one children (<18 years) undergoing Cardiac catheterization in this double-blinded, prospective, observational study. The median CO measured by USCOM was 4.37 L/min (IQR 3.73, 5.60 L/min) compared to 4.28 L/min (IQR 3.52, 5.26 L/min) by PAC thermodilution. The bias (mean difference) between the two methods was 0.2 L/min, and the 95 % limits of agreement were −1.2 to 1.6 L/min. The mean percentage error of CO between USCOM and PAC thermodilution was 11 %. When excluding a sole outlier, the bias between the two measures decreased to 0.1 L/min (95 % limits of agreement −0.6 to 0.9 L/min), and the percentage error was reduced to 8 %. The median SVRI measured by USCOM was 22.0 Wood Units (IQR 17.0, 26.8 Wood Units) compared to 22.1 Wood Units (IQR 17.6, 27.4 Wood Units) by PAC thermodilution. Bias (mean difference) between the two methods was −0.6 Wood Units, and the 95 % limits of agreement were −8.2 to 6.9 Wood Units. We found that the estimation of CO and by extension SVRI with USCOM is reliable against pulmonary artery catheter thermodilution in children with normal Cardiac anatomy. Given the noninvasive nature of USCOM, speed of measurement, and relative ease of use, it may be useful as a bedside tool for pediatric patients.

  • Validation of an Ultrasound Cardiac Output Monitor as a Bedside Tool for Pediatric Patients
    Pediatric Cardiology, 2015
    Co-Authors: Fernando Beltramo, Jondavid Menteer, Asma Razavi, Robinder G. Khemani, Jacqueline R. Szmuszkovicz, Christopher J. L. Newth, Patrick A. Ross
    Abstract:

    The aim of our study was to determine the validity of Cardiac Output (CO) measurements taken with the ultrasonic Cardiac Output Monitor (USCOM) by comparing to CO measured by pulmonary arterial catheter (PAC) thermodilution during Cardiac catheterization. We enrolled thirty-one children (

  • impact of positive end expiratory pressure on Cardiac index measured by ultrasound Cardiac Output Monitor
    Pediatric Critical Care Medicine, 2014
    Co-Authors: Oscar A Ingaramo, Robinder G. Khemani, Christopher J. L. Newth
    Abstract:

    Objectives:To evaluate the impact of different levels of positive end-expiratory pressure on Cardiac index in children receiving mechanical ventilation. To explore the effect of lung recruitment on the relationship between positive end-expiratory pressure and Cardiac Output.Design:Prospective, singl

Pere Caminal - One of the best experts on this subject based on the ideXlab platform.

  • EMBC - Validation of the qCO Cardiac Output Monitor during Valsalva maneuver
    Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and, 2012
    Co-Authors: Mathieu Jospin, Juan P. Aguilar, Pedro L. Gambús, Erik W. Jensen, Montserrat Vallverdú, Pere Caminal
    Abstract:

    Monitoring Cardiac Output for a variety of patient conditions is essential to ensure tissue perfusion and oxygenation. Cardiac Output can be measured either invasively using a pulmonary artery catheter or non-invasively using impedance cardiography (ICG). The objective of the present study was to validate a Cardiac Output Monitor, the qCO (Quantium Medical, Barcelona, Spain). The qCO is based on the ICG principle. Twenty-five volunteers (18–75 years) were enrolled in the study. The duration of the study was 10 min. The subjects were asked to rest quietly in an armchair for a duration of 5 min. At 5 min they were asked to do a Valsalva maneuver which is known to decrease the Cardiac Output. The baseline value of the normalized Cardiac Output (qCO index) was compared with the minimum value during the Valsalva maneuver. The results showed (t-test, p<0.0005) significant difference between the Cardiac Output estimated at baseline and during the Valsalva maneuver. In conclusion, the qCO was able to indicate trend changes of the Cardiac Output in volunteers.

  • validation of the qco Cardiac Output Monitor during valsalva maneuver
    International Conference of the IEEE Engineering in Medicine and Biology Society, 2012
    Co-Authors: Mathieu Jospin, Juan P. Aguilar, Pedro L. Gambús, Erik W. Jensen, Montserrat Vallverdú, Pere Caminal
    Abstract:

    Monitoring Cardiac Output for a variety of patient conditions is essential to ensure tissue perfusion and oxygenation. Cardiac Output can be measured either invasively using a pulmonary artery catheter or non-invasively using impedance cardiography (ICG). The objective of the present study was to validate a Cardiac Output Monitor, the qCO (Quantium Medical, Barcelona, Spain). The qCO is based on the ICG principle. Twenty-five volunteers (18–75 years) were enrolled in the study. The duration of the study was 10 min. The subjects were asked to rest quietly in an armchair for a duration of 5 min. At 5 min they were asked to do a Valsalva maneuver which is known to decrease the Cardiac Output. The baseline value of the normalized Cardiac Output (qCO index) was compared with the minimum value during the Valsalva maneuver. The results showed (t-test, p<0.0005) significant difference between the Cardiac Output estimated at baseline and during the Valsalva maneuver. In conclusion, the qCO was able to indicate trend changes of the Cardiac Output in volunteers.

  • Validation of the qCO Cardiac Output Monitor during Valsalva maneuver
    2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2012
    Co-Authors: Mathieu Jospin, Juan P. Aguilar, Pedro L. Gambús, Erik W. Jensen, Montserrat Vallverdú, Pere Caminal
    Abstract:

    Monitoring Cardiac Output for a variety of patient conditions is essential to ensure tissue perfusion and oxygenation. Cardiac Output can be measured either invasively using a pulmonary artery catheter or non-invasively using impedance cardiography (ICG). The objective of the present study was to validate a Cardiac Output Monitor, the qCO (Quantium Medical, Barcelona, Spain). The qCO is based on the ICG principle. Twenty-five volunteers (18-75 years) were enrolled in the study. The duration of the study was 10 min. The subjects were asked to rest quietly in an armchair for a duration of 5 min. At 5 min they were asked to do a Valsalva maneuver which is known to decrease the Cardiac Output. The baseline value of the normalized Cardiac Output (qCO index) was compared with the minimum value during the Valsalva maneuver. The results showed (t-test, p