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Abstract Introduction The evaluation of stroke volume (SV) is useful in research and patient care. To accomplish this, an ideal device should be noninvasive, continuous, reliable, and reproducible. The Mobil-O-Graph (MOG) is a noninvasive oscillometric matrix validated for measuring aortic and peripheral blood pressure, which through conversion algorithms can estimate hemodynamic parameters. Objectives To compare the MOG measurement of stroke volume, cardiac output, and cardiac index with the transthoracic echocardiogram (TTE). Methods Healthy volunteers aged 18 years or older were included. Two-dimensional TTEs were performed by a single operator. Subsequently, the measurement of noninvasive hemodynamics with MOG was performed with the operator blind to the results of the echocardiogram. Correlation analyses between stroke volume, cardiac output, and cardiac index parameters were performed. The degree of agreement between the methods was verified using the Bland-Altman method. Results A total of 38 volunteers were enrolled with a mean age of 27.6 ± 3.8 years; 21 (55%) were male The SV by TTE was 76.8 ± 19.5 mL and 75.7 ± 19.3 mL by MOG, Rho = 0.726, p< 0.0001. The CO by TTE was 5.04 ± 0.8 mL.min-1 and 5.1 ± 0.8 mL.min-1 by MOG Rho = 0.510, p= 0.001. Bland-Altman plots showed a good concordance between the two techniques. Conclusions Our study shows that the measurement of SV and CO by noninvasive hemodynamics with the MOG device offers a good concordance with the TTE with very few values beyond the confidence limits.
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Humans , Male , Female , Adult , Echocardiography/methods , Hemodynamics/physiology , Stroke Volume/physiology , Blood Pressure , Cardiac Output/physiologyABSTRACT
Objective To evaluate the application value of bedside noninvasive hemodynamic monitoring in the diagnosis and treatment of neonatal septic shock.Methods The purchase time and use of Ultrasound Cardiac Output Monitor (USCOM) to monitor hemodynamic status were taken as the grouping condition,and the infants admitted to Department of Neonatology in Shanghai Children's Hospital from March 2014 to December 2016 were divided into 3 groups,16 of USCOM's pre-purchased septic shock infants were taken as non-USCOM monitoring group,20 patients with septic shock received USCOM monitoring as USCOM monitoring group,the other 20 non-septic shock neonates were assigned as a control group,whose primary diseases were premature,neonatal jaundice or neonatal pneumonia.Systolic volume (SV),cardiac output (CO),heart rate (HR),cardiac index (CI) and systemic vascular resistance index (SVRI) in USCOM monitoring group and control group were recorded.The doses of dopamine,dobutamine,epinephrine or norepinephrine and the time of vasoactive drug administration were compared between the USCOM monitoring group and non-USCOM monitoring group.The data of 3 groups were analyzed statistically.Results Compared with the control group,the hemodynamic parameters of the USCOM monitoring group before treatment such as CO [(0.68 ± 0.44)L/min vs.(0.44 ± 0.17) L/min,t =3.306,P =0.004],CI [(4.40 ± 1.88) L/(min · m2) vs.(3.00 ±0.40) L/(min · m2),t =3.328,P =0.004],SV [(3.90 ±2.39) cm3 vs.(3.08 ±0.31) cm3,t =2.227,P =0.038]and HR [(166.09 ± 26.20) times/min vs.(145.35 ± 16.16) times/min,t =2.750,P =0.013] were increased,while the SVRI showed an obvious decline [(795.88 ± 450.19) d · s/(cm5 · m2) vs.(1 160.61 ± 49.59)d · s/(cm5 · m2),t =-2.898,P =0.009],and the differences were statistically significant.While in the USCOM monitoring group after treatment,the CO [(0.56 ± 0.28) L/min vs.(0.68 ± 0.44) L/min,t =2.456,P =0.024] and CI [(3.65 ± 1.10) L/ (min · m2) vs.(4.40 ± 1.88) L/ (min · m2),t =2.614,P =0.017] were decreased significantly compared with those in USCOM monitoring group before treatment.Compared with non-USCOM monitoring group,the doses of dopamine [(45.72 ± 28.80) mg/kg vs.(85.83 ± 69.33) mg/kg,t =2.352,P =0.005],dobutamine [(12.81 ±26.18) mg/kg vs.(85.83 ±69.33) mg/kg,t =4.351,P =0.002],epinephrine [(0.11 ±0.33) mg/kg vs.(0.90± 1.75) mg/kg,t=1.986,P =0.014],and the time of vasoactive drug use [(68.10 ±34.37) h vs.(167.75 ± 117.14) h,t =3.626,P =0.001] were decreased significantly in USCOM monitoring group.The doses of norepinephrine [(1.91 ± 3.79) mg/kg vs.(0.47 ± 0.90) mg/kg,t =-1.481,P =0.046] were increased significantly in USCOM monitoring group.Conclusion The noninvasive hemodynamic monitoring plays an important role in the diagnosis and treatment of septic shock in neonates by clarifying the hemodynamic status of shock and guiding the rational use of vasoactive drugs so as to improve the successful rescue rate.
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Objective To observe the changes in noninvasive hemodynamic parameters in patients with chronic heart failure (CHF) at different stages of development,and to explore the clinical significance of related parameters.Methods A total of 119 patients who had been hospitalized in the Heart Center of our hospital between March 2014 and Orctober 2016 were divided into phases A,B,and C according to the ACC/AHA Progression Criteria for Chronic Heart failure.Phase A was pre heart failure group A,phase B was pre clinical heart failure stage group B,and phase C was the clinical stage of heart failure group C.Meanwhile,39 healthy people in our hospital were chosen as group O.Their clinical data,serum BNP levels and LVEF values were collected,the noninvasive hemodynamic indexes of heart function were recorded by the noninvasive cardiac function detection system,including stroke volume (SV),cardiac output (CO),cardiac index (CI),systolic C wave amplitude,cardiac contractility index (HI),systolic function of heart contractility index (Q-B/B-X),pulmonary artery wedge pressure (PCWP),left ventricular end diastolic pressure (LVEDP),aortic compliance (AC) and total peripheral resistance (TPR).Comparative analysis of noninvasive hemodynamic indexes and changes in BNP and LVEF in different stages of CHF was conducted.Results The levels of C,SV,CO,CI,AC and HI in groups A,B and C were lower than those in control group (P ＜0.05),while Q-B/B-X,PCWP,LVEDP,and TPR were higher than those in the control group (P ＜ 0.05).C,CI,and HI decreased more significantly,but Q-B/B-X,PCWP,and LVEDP increased with the development of heart failure (P ＜ 0.05).BNP was significantly higher in group C than in normal control group (P ＜ 0.05),but there was no significant difference between group A and B.LVEF in group C was significantly lower than that in group O (P ＜ 0.05).There were negative correlations between SV,CO,CI,C,HI,AC and LVEF at different stages of heart failure,but there were positive correlations between Q-B/B-B,PCWP,LVEDP,TPR,and BNP.Receiver operating characteristics curve analysis further indicated the value of the noninvasive hemodynamic parameters C,CI,HI and Q-B/B-X in evaluation of cardiac function in the early stage of heart failure.Conclusion The changes in noninvasive hemodynamic parameters are consistent with the different stages of heart failure,which can provide an objective reference for early evaluation of cardiac function.
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Purpose: To assess the effectiveness of the Pritikin diet and exercise program on cardiovascular hemodynamics using the noninvasive technique of Thoracic Electrical Bioimpedance (TEB). Material and Methods: Twenty subjects divided in two groups, according to their body habitus and hemodynamic disturbances. These data were compared to a group of 10 healthy individuals not involved in the program. Hemodynamic parameters were collected at admission and at the end of the intensive 26-day program of exercise and nutrition. Results: In obese and hypertensive subjects not on medication we observed that cardiac index increased from 3.27 ± 0.4 to 3.58 ± 0.5 L/min/m2; mean arterial pressure decreased from 100 ± 8.5 to 94.8 ± 7.9 mmHg while systemic vascular resistance index decreased from 2362 ± 391 to 1934 ± 357 dynes. sec. cm-5/m2; p < 0.05 (Data obtained in supine position)...
Objetivo: Avaliar a eficácia da dicta de Pritikin e programa de condicionamento físico pela análise de parâmetros hemodinâmicos obtidos com a técnica não invasiva de Bioimpedância Torácica (BIT). Pacientes e Métodos: Vinte hipertensos obesos foram divididos em dois grupos de acordo com o uso ou não de drogas para coronariopatia e hipertensão arterial. Os dados hemodinâmicos foram obtidos no início e no fim de um programa intensivo de condicionamento (exercício e dieta) com duração de 26 dias. Estes dados foram comparados com os de outro grupo e dez indivíduos normais. Resultados: No grupo de obesos hipertensos não medicados, foi documentuao aumento do índice cardíaco de 3,27 ± 0,4 para 3,58 ± 0,5 L/min/m2, diminuição da pressão arterial média de 100 ± 8,5 para 94,8 ± 7,9 mmHg e queda do índice de resistência vascular periférica de 2362 ± 391 para 1934 ± 357 dyne. seg. cm-5/m2...