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Impact of changes in systemic vascular resistance on a novel non-invasive continuous cardiac output measurement system based on pulse wave transit time: a report of two cases.

Ishihara H, Tsutsui M - J Clin Monit Comput (2013)

Bottom Line: After a previous multicenter study on esCCO measurement, we retrospectively identified two cases in which apparent changes in SVR developed in a short period during data collection.Recorded data suggest that the time component of PWTT may have a significant impact on the accuracy of estimating stroke volume during changes in SVR.However, further prospective clinical studies are required to test this hypothesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Kuroishi-Kosei Hospital, Kuroishi-Shi, 036-0351, Japan, concerto0328@yahoo.co.jp.

ABSTRACT
The inaccuracy of arterial waveform analysis for measuring continuos cardiac output (CCO) associated with changes in systemic vascular resistance (SVR) has been well documented. A new non-invasive continuous cardiac output monitoring system (esCCO) mainly utilizing pulse wave transit time (PWTT) in place of arterial waveform analysis has been developed. However, the trending ability of esCCO to measure cardiac output during changes in SVR remains unclear. After a previous multicenter study on esCCO measurement, we retrospectively identified two cases in which apparent changes in SVR developed in a short period during data collection. In each case, the trending ability of esCCO to measure cardiac output and time component of PWTT were analyzed. Recorded data suggest that the time component of PWTT may have a significant impact on the accuracy of estimating stroke volume during changes in SVR. However, further prospective clinical studies are required to test this hypothesis.

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Related in: MedlinePlus

Trends of the time-related components associated with SV and MAP from 16:50 to 17:20 in Case 2 (Interval B). Left panel PWTT (PEP + PWTT1 and PWTT2); Middle panel SV; Right panel MAP. Bars in each column show data obtained at 5-min intervals. Red arrows indicate directional changes over time
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Fig5: Trends of the time-related components associated with SV and MAP from 16:50 to 17:20 in Case 2 (Interval B). Left panel PWTT (PEP + PWTT1 and PWTT2); Middle panel SV; Right panel MAP. Bars in each column show data obtained at 5-min intervals. Red arrows indicate directional changes over time

Mentions: When SVR increased in Case 1, PWTT increased in association with the decrease in SV and increase in MAP (Fig. 4). Among the components tested, PEP + PWTT1 remained unchanged, but PWTT2 increased during Interval A. A similar pattern of change was observed during the increase in SVR in Case 2 (Fig. 5, Interval B), even though PEP + PWTT1 tended to be slightly shorter.Fig. 4


Impact of changes in systemic vascular resistance on a novel non-invasive continuous cardiac output measurement system based on pulse wave transit time: a report of two cases.

Ishihara H, Tsutsui M - J Clin Monit Comput (2013)

Trends of the time-related components associated with SV and MAP from 16:50 to 17:20 in Case 2 (Interval B). Left panel PWTT (PEP + PWTT1 and PWTT2); Middle panel SV; Right panel MAP. Bars in each column show data obtained at 5-min intervals. Red arrows indicate directional changes over time
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4119244&req=5

Fig5: Trends of the time-related components associated with SV and MAP from 16:50 to 17:20 in Case 2 (Interval B). Left panel PWTT (PEP + PWTT1 and PWTT2); Middle panel SV; Right panel MAP. Bars in each column show data obtained at 5-min intervals. Red arrows indicate directional changes over time
Mentions: When SVR increased in Case 1, PWTT increased in association with the decrease in SV and increase in MAP (Fig. 4). Among the components tested, PEP + PWTT1 remained unchanged, but PWTT2 increased during Interval A. A similar pattern of change was observed during the increase in SVR in Case 2 (Fig. 5, Interval B), even though PEP + PWTT1 tended to be slightly shorter.Fig. 4

Bottom Line: After a previous multicenter study on esCCO measurement, we retrospectively identified two cases in which apparent changes in SVR developed in a short period during data collection.Recorded data suggest that the time component of PWTT may have a significant impact on the accuracy of estimating stroke volume during changes in SVR.However, further prospective clinical studies are required to test this hypothesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Kuroishi-Kosei Hospital, Kuroishi-Shi, 036-0351, Japan, concerto0328@yahoo.co.jp.

ABSTRACT
The inaccuracy of arterial waveform analysis for measuring continuos cardiac output (CCO) associated with changes in systemic vascular resistance (SVR) has been well documented. A new non-invasive continuous cardiac output monitoring system (esCCO) mainly utilizing pulse wave transit time (PWTT) in place of arterial waveform analysis has been developed. However, the trending ability of esCCO to measure cardiac output during changes in SVR remains unclear. After a previous multicenter study on esCCO measurement, we retrospectively identified two cases in which apparent changes in SVR developed in a short period during data collection. In each case, the trending ability of esCCO to measure cardiac output and time component of PWTT were analyzed. Recorded data suggest that the time component of PWTT may have a significant impact on the accuracy of estimating stroke volume during changes in SVR. However, further prospective clinical studies are required to test this hypothesis.

Show MeSH
Related in: MedlinePlus