medigraphic.com
ISSN 2448-8909 (Print)

2018, Number 4

<< Back Next >>

Med Crit 2018; 32 (4)

Behavior in hemodynamics in patients with ultrasonic monitor controlled hemorrhage (USCOM)

Brito EMA, Cortes SCA, Montelongo FJ, Reyes PMM, Corona MJ

Language: Spanish
References: 35
Page: 174-181
PDF size: 182.97 Kb.


ABSTRACT

Introduction: Hemodynamics is the part of biophysics that is responsible for the anatomical and functional study of the heart, the dynamics of blood inside the blood structures as well as the mechanics of the heart.
Objective: To compare the hemodynamics of our patients with the non-invasive device USCOM, before and after presenting with controlled hemorrhage.
Material and methods: An observational, prospective, longitudinal and comparative study was performed in patients between the ages of 16 and 65 in a period of 6 months as a cutoff date for this academic award. (March 2016-ongoing).
Results: We obtained averages of the different hemodynamic variables, both preload, afterload and inotropism, observing early changes to the exanguination of the patients, being mainly the systemic vascular resistances that are modified.
Discussion: There are early hemodynamic changes to the exanguination of small amounts of blood in the patients, changes determined by the USCOM system, system easy to use, non-invasive and accurate results offered.
Conclusions: In this study we can observe how the variables related to afterload (systemic vascular resistance) are the first variables that are modified, so that with the loss of small amounts of blood we get to observe this.


REFERENCES

  1. Miranda DR, Ryan DW, Schaufeli WB, Fidler V. Organisation and management of intensive care: a prospective study in 12 European countries. Berlin, Alemania: Springer Science & Business Media, 2012.

  2. Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369(18):1726-1734. doi: 10.1056/NEJMra1208943.

  3. Pinsky MR, Payen D. Functional hemodynamic monitoring. United Kingdom: Springer, 2016.

  4. Lee AJ, Cohn JH, Ranasinghe JS. Cardiac output assessed by invasive and minimally invasive techniques. Anesthesiol Res Pract. 2011;2011:475151. doi: 10.1155/2011/475151.

  5. Garcia X, Mateu L, Maynar J, Mercadal J, Ochagavia A, Ferrandiz A. Estimating cardiac output. Utility in the clinical practice. Available invasive and non-invasive monitoring. Med Intensiva. 2011;35(9):552-61. doi: 10.1016/j.medin.2011.01.014.

  6. Prys-Roberts C. The measurement of cardiac output. Brit J Anaesth. 1969;41(9):751-760.

  7. Reuter DA, Huang C, Edrich T, Shernan SK, Eltzschig HK. Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives. Anesth Analg. 2010;110(3):799-811. doi: 10.1213/ANE.0b013e3181cc885a.

  8. Kadota LT. Theory and application of thermodilution cardiac output measurement: a review. Heart Lung. 1985;14(6):605-616.

  9. Stewart GN. Researches on the circulation time and on the influences which affect it. J Physiol. 1897;22(3):159-183.

  10. Nishikawa T, Dohi S. Errors in the measurement of cardiac output by thermodilution. Can J Anaesth. 1993;40(2):142-153.

  11. Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med. 1970;283(9):447-451.

  12. Evans DH, McDicken WN. Doppler ultrasound. 2nd ed. New York: John Wiley and Sons. 2000.

  13. Huntsman LL, Stewart DK, Barnes SR, Franklin SB, Colocousis JS, Hessel EA. Noninvasive Doppler determination of cardiac output in man. Clinical validation. Circulation. 1983;67(3):593-602.

  14. Porter TR, Shillcutt SK, Adams MS, Desjardins G, Glas KE, Olson JJ, et al. Guidelines for the use of echocardiography as a monitor for therapeutic intervention in adults: a report from the American Society of Echocardiography. J Am Soc Echocardiogr. 2015;28(1):40-56. doi: 10.1016/j.echo.2014.09.009.

  15. Beaulieu Y, Marik PE. Bedside ultrasonography in the ICU: part 1. Chest. 2005;128(2):881-895. doi: 10.1378/chest.128.2.881.

  16. Hodgson LE, Forni LG, Venn R, Samuels TL, Wakeling GH. A comparison of the non-invasiveultrasonic cardiac output monitor (USCOM) with the oesophageal Doppler monitor during majorabdominal surgery. J Intensive Care Soc. 2016;17(2):103-110. doi: 10.1177/1751143715610785.

  17. Marik PE. Noninvasive cardiac output monitors: a state-of the-art review. J Cardiothorac Vasc Anesth. 2013;27(1):121-134. doi: 10.1053/j.jvca.2012.03.022.

  18. Walker A, Olsson E, Wranne B, Ringqvist I, Ask P. Accuracy of spectral Doppler flow and tissue velocity measurements in ultrasound systems. Ultrasound Med Biol. 2004;30(1):127-132. doi: 10.1016/j.ultrasmedbio.2003.08.020.

  19. USCOM Ltd. Available in: [http://www.uscom.com.au/]. Australia: The Association; c2000-2009 [Updated 2009; cited 2016 Nov 24]. USCOM Ltd; [About 55 screens]. Available in: http://www.talentmed.com.tw/download/UscomBasics.pdf

  20. Soni NJ, Arntfield R, Kory P. Point-of-care ultrasound. Philadelphia: Elsevier Saunders, 2015.

  21. Crossingham IR Nethercott DR, Columb MO. Comparing cardiac output monitors and defining agreement: a systematic review and meta-analysis. J Intensive Care Soc. 2016;17(4):302-313. doi:10.1177/1751143716644457.

  22. Eriksen M, Walloe L. Improved method for cardiac output determination in man using ultrasound Doppler technique. Med Biol Eng Comput. 1990;28(6):555-560.

  23. Ihlen H, Amlie JP, Dale J, Forfang K, Nitter-Hauge S, Otterstad JE, et al. Determination of cardiac output by Doppler echocardiography. Br Heart J. 1984;51(1):54-60.

  24. Sjöberg BJ1, Wranne B. Cardiac output determined by ultrasound-Doppler: clinical applications. Clin Physiol. 1990;10(5):463-473.

  25. Rowland T, Obert P. Doppler echocardiography for the estimation of cardiac output with exercise. Sports Med. 2002;32(15):973-986.

  26. Lopes PC, Sousa MG, Camacho AA, Carareto R, Nishimori CT, Santos PS, et al. Comparison between two methods for cardiac output measurement in propofol anesthetized dogs: thermodilution and Doppler. Vet Anaesth Analg. 2010;37(5):401-408. doi: 10.1111/j.1467-2995.2010.00552.x.

  27. Haites NE, McLennan FM, Mowat DH, Rawles JM. Assessment of cardiac output by the Doppler ultrasound technique alone. Br Heart J. 1985;53(2):123-129.

  28. McLean AS, Needham A, Stewart D, Parkin R. Estimation of cardiac output by noninvasive echocardiographic techniques in the critically ill subject. Anaesth Intensive Care. 1997;25(3):250-254.

  29. Levitov A, Frankel HL, Blaivas M, Kirkpatrick AW, Su E, Evans D, et al. Guidelines for the appropriate use of bedside general and cardiac ultrasonography in the evaluation of critically ill patients-part II: cardiac ultrasonography. Crit Care Med. 2016;44(6):1206-1227. doi: 10.1097/CCM.0000000000001847.

  30. Nidorf SM, Picard MH, Triulzi MO, Thomas JD, Newell J, King ME, Weyman AE. New perspectives in the assessment of cardiac chamber dimensions during development and adulthood. J Am Coll Cardiol. 1992;19(5):983-938.

  31. Critchley LA, Peng ZY, Fok BS, Lee A, Phillips RA. Testing the reliability of a new ultrasonic cardiac output monitor, the USCOM, by using aortic flowprobes in anesthetized dogs. Anesth Analg. 2005;100(3):748-753. doi: 10.1213/01.ANE.0000144774.42408.05.

  32. Phillips RA, Hood SG, Jacobson BM, West MJ, Wan L, May CN. Pulmonary artery catheter (PAC) accuracy and efficacy compared with flow probe and transcutaneous Doppler (USCOM): an ovine cardiac output validation. Crit Care Res Pract. 2012;2012:621496. doi: 10.1155/2012/621496.

  33. Phillips R, Lichtenthal P, Sloniger J, Burstow D, West M, Copeland J. Noninvasive cardiac output measurement in heart failure subjects on circulatory support. Anesth Analg. 2009;108(3):881-886. doi: 10.1213/ane.0b013e318193174b.

  34. Zhang J, Critchley LA, Huang L. Five algorithms that calculate cardiac output from the arterial waveform: a comparison with Doppler ultrasound. Br J Anaesth. 2015;115(3):392-402. doi: 10.1093/bja/aev254.

  35. Huang L, Critchley LA. An assessment of two Doppler-based monitors to track cardiac output changes in anaesthetised patients undergoing major surgery. Anaesth Intensive Care. 2014;42(5):631-639.




2020     |     www.medigraphic.com