FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W3180156243> ?p ?o ?g. }

• W3180156243 endingPage "456" @default.
• W3180156243 startingPage "441" @default.
• W3180156243 abstract "•The aim of hemodynamic management is to optimize the amount of oxygen delivered to tissues.•Because direct monitoring of the amount of oxygen delivered remains difficult, hemodynamic variables are monitored instead.•Hemodynamic monitoring itself does not improve patient outcomes and needs to be combined with treatment protocols.•Pressures, from arterial blood pressure through pulmonary artery occlusion pressure, can be measured using invasive catheters, but are subject to artifacts (e.g. over- and underdamping, patient movements) and should be zeroed correctly before adequate measurements can be obtained.•Flow, that is cardiac output, is mostly obtained by indicator dilution techniques or pulse wave analysis. The evidence for using other noninvasive techniques, for example pulse wave transit time, bioimpedance and bioreactance, is limited. •The aim of hemodynamic management is to optimize the amount of oxygen delivered to tissues.•Because direct monitoring of the amount of oxygen delivered remains difficult, hemodynamic variables are monitored instead.•Hemodynamic monitoring itself does not improve patient outcomes and needs to be combined with treatment protocols.•Pressures, from arterial blood pressure through pulmonary artery occlusion pressure, can be measured using invasive catheters, but are subject to artifacts (e.g. over- and underdamping, patient movements) and should be zeroed correctly before adequate measurements can be obtained.•Flow, that is cardiac output, is mostly obtained by indicator dilution techniques or pulse wave analysis. The evidence for using other noninvasive techniques, for example pulse wave transit time, bioimpedance and bioreactance, is limited. The word “hemodynamic” is derived from the Greek words haima and dunamikós. Hemodynamic monitoring, therefore, freely translates into observing the motion of blood. As the word itself, hemodynamic monitoring originates from ancient times: Feeling the pulse was first described in 2600 BCE in the myth of a Mesopotamian king whose friend had died, and by “touching” his heart, he realized that it did not beat any more,1Dalley S. Myths from Mesopotamia: creation, the flood, Gilgamesh and others. Oxford University Press, Oxford (England, UK)1989Google Scholar demonstrating that at that time mankind understood the heart was beating and that its pulsations could be felt. Two thousand years later, Hippocrates described pulse characteristics during different states of disease, while Praxagoras (born around 340 BCE) was the first one to use the pulse for indication of disease.2Ghasemzadeh N. Zafari A.M. A brief journey into the history of the arterial pulse.Cardiol Res Pract. 2011; 2011: 164832Crossref PubMed Scopus (42) Google Scholar The actual circulation was first described by William Harvey in the seventeenth century, and this was considered one of the greatest contributions to the field of cardiovascular science.3Bolli R. William Harvey and the Discovery of the Circulation of the Blood.Circ Res. 2019; 124: 1169-1171Crossref PubMed Scopus (2) Google Scholar Further development of measuring hemodynamic variables took until 1733, when Stephen Hales pioneered measuring intra-arterial pressure in horses4Esunge P.M. From blood pressure to hypertension: the history of research.J R Soc Med. 1991; 84: 621PubMed Google Scholar and this discovery was followed by the development of the “Stromuhr” in 1867 by Carl Ludwig, a device able to quantify blood flow through perfused organs.5Neil E. Carl Ludwig and His Pupils.Circ Res. 1961; IX: 971-978Crossref Google Scholar From there on forward, important discoveries followed more rapidly, including the first noninvasive systolic blood pressure measuring device using a cuff-based version of the mercury sphygmograph by Riva Rocci in 1896.6Roguin A. Scipione Riva-Rocci and the men behind the mercury sphygmomanometer.Int J Clin Pract. 2006; 60: 73-79Crossref PubMed Scopus (39) Google Scholar In 1905, Nicolai Korotkoff described the sounds auscultating the brachial artery while deflating the cuff.7Wesseling K. A century of non-invasive arterial pressure measurement: form Marey to Peñáz and Finapres.Homeost Heal Dis. 1995; 36: 50-66Google Scholar This way, it became possible to also determine diastolic blood pressure. Around the same time, in 1901, Willem Einthoven invented the electrocardiograph for which he later (1924) received the Nobel Prize.8Einthoven W. Un nouveau galvanomètre.Arch Neerl Sc Ex Nat. 1901; 6: 625-633Google Scholar,9Burnett J. The origins of the electrocardiograph as a clinical instrument.Med Hist. 1985; : 53-76Crossref Scopus (9) Google Scholar The foundation for modern hemodynamic monitoring was laid. Arterial blood pressure was one of the first hemodynamic variables that could be measured.7Wesseling K. A century of non-invasive arterial pressure measurement: form Marey to Peñáz and Finapres.Homeost Heal Dis. 1995; 36: 50-66Google Scholar Currently, different techniques are available for continuous and intermittent arterial blood pressure monitoring in the perioperative period. Arterial catheterization is the gold standard for measuring blood pressure continuously.10Saugel B. Sessler D.I. Perioperative Blood Pressure Management.Anesthesiology. 2021; 134: 250-261Crossref PubMed Scopus (7) Google Scholar A catheter is placed into a superficial artery (mostly radial artery) and is connected via a fluid filled tube to a pressure transducer and a pressurized bag of fluids which creates counterpressure for the arterial pressure.11Saugel B. Kouz K. Meidert A.S. et al.How to measure blood pressure using an arterial catheter: a systematic 5-step approach.Crit Care. 2020; 24: 172Crossref PubMed Scopus (20) Google Scholar The pressure transducer transforms mechanical pressure into an electrical signal, which is used to depict the arterial pressure waveform on a monitor. The arterial pressure waveform is the result of the interaction between the left ventricle and the systemic arteries. The pressure sensor should be placed at right atrium level and zeroed against atmospheric pressure to obtain reliable measurements. Over- and underdamping can underestimate or overestimate arterial blood pressure.11Saugel B. Kouz K. Meidert A.S. et al.How to measure blood pressure using an arterial catheter: a systematic 5-step approach.Crit Care. 2020; 24: 172Crossref PubMed Scopus (20) Google Scholar Additionally, blood pressure measurements can be influenced by movement of the patient’s arm or a kink in the pressure system.10Saugel B. Sessler D.I. Perioperative Blood Pressure Management.Anesthesiology. 2021; 134: 250-261Crossref PubMed Scopus (7) Google Scholar,11Saugel B. Kouz K. Meidert A.S. et al.How to measure blood pressure using an arterial catheter: a systematic 5-step approach.Crit Care. 2020; 24: 172Crossref PubMed Scopus (20) Google Scholar The use of invasive blood pressure monitoring is limited owing to the risk of complications and costs associated with arterial catheterization.12Handlogten K.S. Wilson G.A. Clifford L. et al.Brachial artery catheterization: an assessment of use patterns and associated complications.Anesth Analg. 2014; 118: 288-295Crossref PubMed Scopus (18) Google Scholar,13Scheer B.V. Perel A. Pfeiffer U.J. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine.Crit Care. 2002; 6: 198-204Crossref Google Scholar Frequently used alternative techniques for invasive blood pressure monitoring are noninvasive intermittent oscillometry and the continuous volume clamp method.14Roach J.K. Thiele R.H. Perioperative blood pressure monitoring.Best Pract Res Clin Anaesthesiol. 2019; 33: 127-138Crossref PubMed Scopus (2) Google Scholar The most widely used method of measuring arterial blood pressure noninvasively is oscillometry. Usually, a brachial cuff is inflated and instead of Korotkoff sounds, oscillations of the blood pressure signal are detected.15Forouzanfar M. Dajani H. Groza V. et al.Oscillometric blood pressure estimation: past, present, and future.IEEE Rev Biomed Eng. 2015; 8: 44-63Crossref PubMed Scopus (96) Google Scholar The pressure which causes maximum oscillations is closest to the mean arterial pressure (MAP), and systolic and diastolic blood pressures are mathematically derived from this mean value.16Yelderman M. Ream A. Indirect measurement of mean blood pressure in the anesthetized patient.Anesthesiology. 1979; 50: 253-256Crossref PubMed Scopus (126) Google Scholar The noninvasive volume clamp method uses a plethysmograph and an inflatable finger cuff. The plethysmograph detects the blood volume in the digital arteries and subsequently the pressure from the inflatable finger cuff is adjusted with high frequency to keep the blood volume in the digital arteries constant (volume clamp). Subsequently, the arterial pressure waveform can be constructed from the amount of pressure in the finger cuff needed to ensure constant volume.17Kouz K. Scheeren T.W.L. de Backer D. et al.Pulse Wave Analysis to Estimate Cardiac Output.Anesthesiology. 2020; 134: 119-126Crossref Scopus (12) Google Scholar, 18Saugel B. Hoppe P. Nicklas J.Y. et al.Continuous noninvasive pulse wave analysis using finger cuff technologies for arterial blood pressure and cardiac output monitoring in perioperative and intensive care medicine: a systematic review and meta-analysis.Br J Anaesth. 2020; 125: 25-37Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar, 19Saugel B. Kouz K. Scheeren T.W.L. et al.Cardiac output estimation using pulse wave analysis-physiology, algorithms, and technologies: a narrative review.Br J Anaesth. 2021; 126: 67-76Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Calibration is periodically performed by applying a constant pressure, to determine MAP and subsequently calibrate the plethysmography signal.14Roach J.K. Thiele R.H. Perioperative blood pressure monitoring.Best Pract Res Clin Anaesthesiol. 2019; 33: 127-138Crossref PubMed Scopus (2) Google Scholar The use of the volume clamp method has also been validated in obese patients20Rogge D.E. Nicklas J.Y. Schön G. et al.Continuous noninvasive arterial pressure monitoring in obese patients during bariatric surgery: an evaluation of the vascular unloading technique.Anesth Analg. 2019; 128: 477-483Crossref PubMed Scopus (22) Google Scholar and in patients with atrial fibrillation21Berkelmans G.F.N. Kuipers S. Westerhof B.E. et al.Comparing volume-clamp method and intra-arterial blood pressure measurements in patients with atrial fibrillation admitted to the intensive or medium care unit.J Clin Monit Comput. 2018; 32: 439-446Crossref PubMed Scopus (17) Google Scholar; however, the use is limited in patients with impaired peripheral perfusion, for example in patients receiving high doses of vasopressors or during peripheral hypothermia or edema.14Roach J.K. Thiele R.H. Perioperative blood pressure monitoring.Best Pract Res Clin Anaesthesiol. 2019; 33: 127-138Crossref PubMed Scopus (2) Google Scholar,21Berkelmans G.F.N. Kuipers S. Westerhof B.E. et al.Comparing volume-clamp method and intra-arterial blood pressure measurements in patients with atrial fibrillation admitted to the intensive or medium care unit.J Clin Monit Comput. 2018; 32: 439-446Crossref PubMed Scopus (17) Google Scholar Other methods for measuring blood pressure noninvasively include applanation tonometry, hydraulic coupling, pulse wave transit time, and pulse decomposition. The evidence for the accuracy of these methods is limited and therefore these are not (yet) widely used in daily clinical routine.10Saugel B. Sessler D.I. Perioperative Blood Pressure Management.Anesthesiology. 2021; 134: 250-261Crossref PubMed Scopus (7) Google Scholar The central venous pressure (CVP) is the pressure measured in the vena cava near the right atrium, and is commonly obtained by placing a central venous catheter in the superior vena cava via the internal jugular vein or the subclavian vein.22Shah P. Louis M. Physiology, central venous pressure..in: StatPearls [Internet]. 2020https://www.ncbi.nlm.nih.gov/books/NBK519493/Google Scholar The catheter is then connected to a pressure transducer via a fluid filled line. The CVP is determined by cardiac function and venous return to the heart,23Magder S. How to use central venous pressure measurements.Curr Opin Crit Care. 2005; 11: 264-270Crossref PubMed Scopus (74) Google Scholar,24Guyton A. Determination of cardiac output by equating venous return curves with cardiac response curves.Physiol Rev. 1955; 35: 123-129Crossref PubMed Scopus (331) Google Scholar and has traditionally been used to estimate preload and volume status,23Magder S. How to use central venous pressure measurements.Curr Opin Crit Care. 2005; 11: 264-270Crossref PubMed Scopus (74) Google Scholar,25Kumar A. Anel R. Bunnell E. et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects.Crit Care Med. 2004; 32: 691-699Crossref PubMed Scopus (602) Google Scholar and also to guide fluid therapy.26Boldt J. Lenz M. Kumle B. et al.Volume replacement strategies on intensive care units: results from a postal survey.Intensive Care Med. 1998; 24: 147-151Crossref PubMed Scopus (117) Google Scholar It was assumed that, because obtaining ventricular end-diastolic volume was not suitable in many clinical settings, the CVP would be a surrogate measure of preload.25Kumar A. Anel R. Bunnell E. et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects.Crit Care Med. 2004; 32: 691-699Crossref PubMed Scopus (602) Google Scholar However the use of the CVP as a surrogate for end-diastolic volume was questioned owing to the poor correlation with the volume status of the patient25Kumar A. Anel R. Bunnell E. et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects.Crit Care Med. 2004; 32: 691-699Crossref PubMed Scopus (602) Google Scholar,27Michard F. Alaya S. Zarka V. et al.Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock.Chest. 2003; 124: 1900-1908Abstract Full Text Full Text PDF PubMed Scopus (261) Google Scholar, 28Hofer C.K. Furrer L. Matter-Ensner S. et al.Volumetric preload measurement by thermodilution: a comparison with transoesophageal echocardiography.Br J Anaesth. 2005; 94: 748-755Abstract Full Text Full Text PDF PubMed Scopus (114) Google Scholar, 29Marik P.E. Baram M. Vahid B. Does central venous pressure predict fluid responsiveness? A Systematic Review of the Literature and the Tale of Seven Mares.Chest. 2008; 134: 172-178Abstract Full Text Full Text PDF PubMed Scopus (1043) Google Scholar and should no longer be used to assess fluid responsiveness.29Marik P.E. Baram M. Vahid B. Does central venous pressure predict fluid responsiveness? A Systematic Review of the Literature and the Tale of Seven Mares.Chest. 2008; 134: 172-178Abstract Full Text Full Text PDF PubMed Scopus (1043) Google Scholar,30Marik P.E. Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense.Crit Care Med. 2013; 41: 1774-1781Crossref PubMed Scopus (470) Google Scholar Nonetheless, the CVP is still measured frequently and might be used instead as an indication to stop fluid resuscitation.31Pinsky M. Kellum J. Bellomo R. Central venous pressure is a stopping rule, not a target of fluid resuscitation.Crit Care Resusc. 2015; 17: 56PubMed Google Scholar Although the CVP is not able to predict fluid responsiveness, it can be used to assess right ventricular function, for example, in pulmonary embolism, right ventricular failure, or after heart transplantation.29Marik P.E. Baram M. Vahid B. Does central venous pressure predict fluid responsiveness? A Systematic Review of the Literature and the Tale of Seven Mares.Chest. 2008; 134: 172-178Abstract Full Text Full Text PDF PubMed Scopus (1043) Google Scholar Another advantage from using a central venous catheter is the possibility of taking blood gas samples for measuring the central venous oxygen saturation.32Van Beest P. Wietasch G. Scheeren T. et al.Clinical review: use of venous oxygen saturations as a goal - a yet unfinished puzzle.Crit Care. 2011; 15: 232Crossref PubMed Scopus (74) Google Scholar Pulmonary artery pressures include the systolic and diastolic pressures and the pulmonary artery occlusion pressure (PAOP) and can be assessed by a pulmonary artery catheter (PAC).33Vincent J.L. The pulmonary artery catheter.J Clin Monit Comput. 2012; 26: 341-345Crossref PubMed Scopus (23) Google Scholar,34Bootsma I. Boerma E. de Lange F. et al.The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis.J Clin Monit Comput. 2021; https://doi.org/10.1007/s10877-021-00662-8Crossref Scopus (5) Google Scholar A PAC is inserted via the internal jugular vein, subclavian vein, or femoral vein through the right atrium and right ventricle until its tip is positioned in the pulmonary artery.34Bootsma I. Boerma E. de Lange F. et al.The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis.J Clin Monit Comput. 2021; https://doi.org/10.1007/s10877-021-00662-8Crossref Scopus (5) Google Scholar The catheter is then connected via a tubing to a pressure transducer to obtain pressure measurements. These pressure measurements can be used during insertion to assess the position of the tip. The catheter contains 2 or more ports; the distal port is located at the tip and the other port is located more proximal and can be used to measure the CVP.34Bootsma I. Boerma E. de Lange F. et al.The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis.J Clin Monit Comput. 2021; https://doi.org/10.1007/s10877-021-00662-8Crossref Scopus (5) Google Scholar A PAC contains a balloon close to the tip, which can be inflated to float the catheter into the pulmonary artery and to determine PAOP.33Vincent J.L. The pulmonary artery catheter.J Clin Monit Comput. 2012; 26: 341-345Crossref PubMed Scopus (23) Google Scholar The PAOP reflects the pressure in the pulmonary veins and left atrium.33Vincent J.L. The pulmonary artery catheter.J Clin Monit Comput. 2012; 26: 341-345Crossref PubMed Scopus (23) Google Scholar,35O’Quin R. Marini J. Pulmonary artery occlusion pressure: clinical physiology, measurement, and interpretation.Br J Psychother. 1983; 128: 319-326Google Scholar In analogy to the CVP for the right ventricle, the PAOP was used as a predictor of left ventricular preload, but turned out to be unreliable for this purpose as well.25Kumar A. Anel R. Bunnell E. et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects.Crit Care Med. 2004; 32: 691-699Crossref PubMed Scopus (602) Google Scholar The use of a PAC can be associated with several (severe) complications,33Vincent J.L. The pulmonary artery catheter.J Clin Monit Comput. 2012; 26: 341-345Crossref PubMed Scopus (23) Google Scholar and treatment benefits of using a PAC have not been clearly established in critically ill patients.36Shah M. Hasselblad V. Stevenson L. et al.Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials.JAMA. 2005; 294: 1664-1670Crossref PubMed Scopus (515) Google Scholar,37Rajaram S. Desai N. Kalra A. et al.Pulmonary artery catheters for adult patients in intensive care (Review).Cochrane Database Syst Rev. 2013; 2: CD003408Crossref PubMed Scopus (166) Google Scholar Therefore, the evidence for using a PAC has been questioned. The use of a PAC should always be combined with a specific treatment protocol to improve patient outcomes.38Harvey S. Harrison D.A. Singer M. et al.Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial.Lancet. 2005; 366: 472-477Abstract Full Text Full Text PDF PubMed Scopus (754) Google Scholar The PAC is still frequently used worldwide, particularly in cardiac surgery, in patients with pulmonary arterial hypertension (suspected or known), severe cardiogenic shock, unknown volume status in shock, or other severe cardiopulmonary disease.39Cohen M.G. Kelly R.V. Kong D.F. et al.Pulmonary artery catheterization in acute coronary syndromes: insights from the GUSTO IIb and GUSTO III trials.Am J Med. 2005; 118: 482-488Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar, 40Rapoport J. Teres D. Steingrub J. et al.Patient characteristics and ICU organizational factors that influence frequency of pulmonary artery catheterization.J Am Med Assoc. 2000; 283: 2559-2567Crossref PubMed Scopus (94) Google Scholar, 41Koo K.K.Y. Sun J.C.J. Zhou Q. et al.Pulmonary artery catheters: evolving rates and reasons for use.Crit Care Med. 2011; 39: 1613-1618Crossref PubMed Scopus (70) Google Scholar It has been suggested that clinicians use the PAC to gain a clear understanding of the pathophysiology.42Ospina-Tascón G.A. Cordioli R.L. Vincent J.L. What type of monitoring has been shown to improve outcomes in acutely ill patients?.Intensive Care Med. 2008; 34: 800-820Crossref PubMed Scopus (78) Google Scholar Similar to the central venous catheter, a PAC can be used to obtain blood samples for measuring mixed venous oxygen saturation, a marker of the global relation between oxygen delivery and consumption or the ability of the tissues to extract oxygen from the blood. The mean systemic filling pressure (Pmsf) is the pressure that equilibrates in the systemic circulation when the heart stops pumping and all blood is distributed equally throughout the systemic circulation.43Rothe C.F. Mean circulatory filling pressure: its meaning and measurement.J Appl Physiol. 1993; 74: 499-509Crossref PubMed Scopus (167) Google Scholar The value of the Pmsf is therefore between MAP and CVP (closer to the latter owing to the size of the venous blood reservoir). The Pmsf does not include the pressures in the pulmonary circulation and cardiac chambers (mean cardiopulmonary filling pressure). The Pmsf and mean cardiopulmonary filling pressure combined are the mean circulatory filling pressure.43Rothe C.F. Mean circulatory filling pressure: its meaning and measurement.J Appl Physiol. 1993; 74: 499-509Crossref PubMed Scopus (167) Google Scholar The Pmsf resembles the stressed blood volume, that is, the amount of blood that exerts pressure against the vascular walls. The unstressed blood volume in turn is the amount of blood, which can be held within the vascular system without creating pressure.43Rothe C.F. Mean circulatory filling pressure: its meaning and measurement.J Appl Physiol. 1993; 74: 499-509Crossref PubMed Scopus (167) Google Scholar The Pmsf can be measured in different ways: (1) by the inspiratory hold method, (2) by the arm stop-flow method, or (3) through a calculated model.44Maas J.J. Pinsky M.R. Geerts B.F. et al.Estimation of mean systemic filling pressure in postoperative cardiac surgery patients with three methods.Intensive Care Med. 2012; 38: 1452-1460Crossref PubMed Scopus (58) Google Scholar,45Wijnberge M. Sindhunata D.P. Pinsky M.R. et al.Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill.Ann Intensive Care. 2018; 8: 73Crossref PubMed Scopus (20) Google Scholar The inspiratory hold method uses inspiratory holds of several seconds at plateau pressure to briefly increase the CVP. When the CVP increases, the venous return decreases and consequently the cardiac output (CO) decreases as well. Multiple inspiratory hold maneuvers at different plateau pressure levels are performed to derive pairs of CO and CVP measurements, which are then correlated and extrapolated to zero CO (which resembles a no flow state) and the pressure that remains is the estimated Pmsf (Fig. 1). For this method, a central venous catheter and CO monitoring are required.46Maas J.J. Geerts B.F. Van Den Berg P.C.M. et al.Assessment of venous return curve and mean systemic filling pressure in postoperative cardiac surgery patients.Crit Care Med. 2009; 37: 912-918Crossref PubMed Scopus (85) Google Scholar However, the Pmsf might be overestimated by this method because high airway pressures may redistribute blood from the pulmonary to the systemic circulation.47Fessler H.E. Brower R.G. Wise R.A. et al.Effects of positive end-expiratory pressure on the canine venous return curve.Am Rev Respir Dis. 1991; 143: 19-24Crossref PubMed Scopus (104) Google Scholar The arm stop-flow method is performed using a rapidly inflating arm cuff, which occludes the arteries in the arm creating a status of zero flow. The intravascular pressure will equilibrate between the venous and arterial compartment after approximately 30 seconds. The equilibration pressure is an estimation of the Pmsf. For this method, only an arterial catheter is required.44Maas J.J. Pinsky M.R. Geerts B.F. et al.Estimation of mean systemic filling pressure in postoperative cardiac surgery patients with three methods.Intensive Care Med. 2012; 38: 1452-1460Crossref PubMed Scopus (58) Google Scholar The last method uses a mathematical model to estimate the Pmsf. The Pmsf comprises of the arterial and venous compartment and resistance to flow, resulting in the following formula: Pmsf = aRAP + bMAP + cCO, in which RAP is right atrial pressure, MAP is mean arterial pressure, and CO is cardiac output48Parkin W.G. Leaning M.S. Therapeutic control of the circulation.J Clin Monit Comput. 2008; 22: 391-400Crossref PubMed Scopus (43) Google Scholar, a and b are both dimensionless constants (often a = 0.96, b = 0.04), reflecting the contribution of venous and arterial blood, and c is a constant determined by age, height, and weight, resembling resistance.48Parkin W.G. Leaning M.S. Therapeutic control of the circulation.J Clin Monit Comput. 2008; 22: 391-400Crossref PubMed Scopus (43) Google Scholar The Pmsf can be used to accurately assess volume status, although it is quite difficult to measure and thus of limited clinical use. Additionally, the Pmsf minus the right atrial pressure is the driving force for venous return.49Guyton A. Lindsey A. Abernathy B. et al.Venous return at various right atrial pressures and the normal venous return curve.Am J Physiol. 1957; 189: 609-615Crossref PubMed Scopus (308) Google Scholar An overview of all pressure monitoring methods can be found in Table 1.Table 1Overview of pressure monitoring methodsArterial Blood PressureCentral Venous PressurePulmonary Artery PressuresPmsfArterial catheterVolume clamp methodIntermittent oscillometryCentral venous catheterPulmonary artery catheterInspiratory hold methodArm stop-flow methodCalculated model Open table in a new tab The CO is the product of stroke volume and heart rate and is the primary determinant of oxygen delivery to organs and peripheral tissues, therefore being one of the most clinically relevant hemodynamic variables. Invasive methods of determining CO include pulmonary artery thermodilution (PATD), transpulmonary thermodilution (TPTD), and lithium dilution.50Saugel B. Vincent J.L. Cardiac output monitoring: how to choose the optimal method for the individual patient.Curr Opin Crit Care. 2018; 24: 165-172Crossref PubMed Scopus (31) Google Scholar All of these techniques use modified versions of the Stewart Hamilton equation to determine CO.51Monnet X. Teboul J.L. Transpulmonary thermodilution: advantages and limits.Crit Care. 2017; 21: 147Crossref PubMed Scopus (91) Google Scholar The Stewart Hamilton equation is based on the fact that, if the volume and temperature or concentration of an injected indicator are known, then the change in temperature or indicator concentration downstream is related to the flow, that is CO, and can be calculated as follows: CO=TemperatureofindicatorAreaunderthetemperaturecurve PATD requires a PAC, through which a cold fluid bolus can be injected to the right atrium and downstream temperature changes can be measured at the tip thermistor. Because the tip of the PAC is located in the pulmonary artery, this method actually measures right ventricular output.50Saugel B. Vincent J.L. Cardiac output monitoring: how to choose the optimal method for the individual patient.Curr Opin Crit Care. 2018; 24: 165-172Crossref PubMed Scopus (31) Google Scholar,51Monnet X. Teboul J.L. Transpulmonary thermodilution: advantages and limits.Crit Care. 2017; 21: 147Crossref PubMed Scopus (91) Google Scholar Newer generation PACs incorporate electric heating elements to continuously assess temperature differences downstream and, thus, CO.52Reuter D.A. Huang C. Edrich T. et al.Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives.Anesth Analg. 2010; 110: 799-811Crossref PubMed Scopus (183) Google Scholar TPTD requires a central venous catheter and an arterial catheter placed in a systemic artery in proximity to the heart.51Monnet X. Teboul J.L. Transpulmonary thermodilution: advantages and limits.Crit Care. 2017; 21: 147Crossref PubMed Scopus (91) Google Scholar Using this technique, a cold fluid bolus is injected in the central venous circulation and the blood temperature difference is measured in the systemic circulation, therefore measuring the global CO. Unlike PATD, TPTD is not influenced by the ventilatory cycle.52Reuter D.A. Huang C. Edrich T. et al.Cardiac out" @default.
• W3180156243 created "2021-07-19" @default.
• W3180156243 creator A5010652400 @default.
• W3180156243 creator A5060788353 @default.
• W3180156243 date "2021-09-01" @default.
• W3180156243 modified "2023-09-26" @default.
• W3180156243 title "Perioperative Hemodynamic Monitoring" @default.
• W3180156243 cites W1445188039 @default.
• W3180156243 cites W1493365134 @default.
• W3180156243 cites W1544828279 @default.
• W3180156243 cites W1761976466 @default.
• W3180156243 cites W1890508282 @default.
• W3180156243 cites W1954157498 @default.
• W3180156243 cites W1963857455 @default.
• W3180156243 cites W1968030064 @default.
• W3180156243 cites W1975711531 @default.
• W3180156243 cites W1976595177 @default.
• W3180156243 cites W1983065488 @default.
• W3180156243 cites W1990532201 @default.
• W3180156243 cites W1996998519 @default.
• W3180156243 cites W2004972077 @default.
• W3180156243 cites W2015964944 @default.
• W3180156243 cites W2021142075 @default.
• W3180156243 cites W2021667729 @default.
• W3180156243 cites W2024377214 @default.
• W3180156243 cites W2032148968 @default.
• W3180156243 cites W2043355214 @default.
• W3180156243 cites W2048249523 @default.
• W3180156243 cites W2052355793 @default.
• W3180156243 cites W2052529172 @default.
• W3180156243 cites W2055904196 @default.
• W3180156243 cites W2059052029 @default.
• W3180156243 cites W2060680577 @default.
• W3180156243 cites W2061076996 @default.
• W3180156243 cites W2063968511 @default.
• W3180156243 cites W2064063818 @default.
• W3180156243 cites W2064831622 @default.
• W3180156243 cites W2067853222 @default.
• W3180156243 cites W2068158817 @default.
• W3180156243 cites W2073525047 @default.
• W3180156243 cites W2073733456 @default.
• W3180156243 cites W2074180533 @default.
• W3180156243 cites W2077571143 @default.
• W3180156243 cites W2091503143 @default.
• W3180156243 cites W2092751843 @default.
• W3180156243 cites W2092839265 @default.
• W3180156243 cites W2092898593 @default.
• W3180156243 cites W2094260981 @default.
• W3180156243 cites W2101006776 @default.
• W3180156243 cites W2102820915 @default.
• W3180156243 cites W2106542431 @default.
• W3180156243 cites W2106721231 @default.
• W3180156243 cites W2107395097 @default.
• W3180156243 cites W2108710261 @default.
• W3180156243 cites W2108712092 @default.
• W3180156243 cites W2124626907 @default.
• W3180156243 cites W2128252369 @default.
• W3180156243 cites W2133742416 @default.
• W3180156243 cites W2137672100 @default.
• W3180156243 cites W2140190634 @default.
• W3180156243 cites W2140537097 @default.
• W3180156243 cites W2141144414 @default.
• W3180156243 cites W2144408525 @default.
• W3180156243 cites W2146351148 @default.
• W3180156243 cites W2147561122 @default.
• W3180156243 cites W2149750434 @default.
• W3180156243 cites W2154390395 @default.
• W3180156243 cites W2156086455 @default.
• W3180156243 cites W2158265212 @default.
• W3180156243 cites W2162516878 @default.
• W3180156243 cites W2181820070 @default.
• W3180156243 cites W2221187342 @default.
• W3180156243 cites W2553821910 @default.
• W3180156243 cites W2625069600 @default.
• W3180156243 cites W2725611898 @default.
• W3180156243 cites W2766682155 @default.
• W3180156243 cites W2795459584 @default.
• W3180156243 cites W2803153385 @default.
• W3180156243 cites W2808757445 @default.
• W3180156243 cites W2909859767 @default.
• W3180156243 cites W2943941017 @default.
• W3180156243 cites W3020347372 @default.
• W3180156243 cites W3029526211 @default.
• W3180156243 cites W3086677680 @default.
• W3180156243 cites W3102510608 @default.
• W3180156243 cites W3108403526 @default.
• W3180156243 cites W4245916755 @default.
• W3180156243 cites W4294916050 @default.
• W3180156243 doi "https://doi.org/10.1016/j.anclin.2021.03.007" @default.
• W3180156243 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/34392878" @default.
• W3180156243 hasPublicationYear "2021" @default.
• W3180156243 type Work @default.
• W3180156243 sameAs 3180156243 @default.
• W3180156243 citedByCount "5" @default.
• W3180156243 countsByYear W31801562432022 @default.
• W3180156243 countsByYear W31801562432023 @default.
• W3180156243 crossrefType "journal-article" @default.
• W3180156243 hasAuthorship W3180156243A5010652400 @default.

• next