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General Principles for Measuring Arterial Waves
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Esophageal Doppler ultrasound monitoring is a widely used technique of minimally invasive CO monitoring performed currently in critically ill patients (Bein et al., 2004; Dark and Singh, 2004; Koliopanos et al., 2005; Chen et al., 2009; Atlas et al., 2012; Sangkum et al., 2016; De Pascale et al., 2017; Muñoz et al., 2017). It is based on measurement of blood flow velocity in the descending thoracic aorta by means of a Doppler transducer and either an estimated aortic cross-sectional area close to the mean value during systole (derived from a nomogram stored in the computer based on age, sex, height and weight) or a measured cross-sectional area using an M-mode echo-transducer incorporated into the probe. This provides immediate, comprehensive, beat-to-beat and continuous SV. The Doppler probe is inserted into the esophagus to an approximate depth of 35 cm from the incisors in an intubated patient. The probe is then rotated so that the transducer faces the aorta, and a characteristic aortic blood flow velocity signal is obtained (Figure 6.17).
Critical care
Published in Sam Mehta, Andrew Hindmarsh, Leila Rees, Handbook of General Surgical Emergencies, 2018
Sam Mehta, Andrew Hindmarsh, Leila Rees
Cardiac output can also be measured using oesophageal Doppler. A probe is placed in the mid-oesophagus which measures the velocity of blood in the descending aorta. This method is poorly tolerated in awake patients.
Intensive care
Published in Daryl Dob, Griselda Cooper, Anita Holdcroft, Philip Steer, Gwyneth Lewis, Crises in Childbirth Why Mothers Survive, 2018
The measurement of cardiac output is another procedure that is usually confined to the intensive-care unit, thermodilution using a pulmonary artery catheter still being considered by most to be the current gold standard. More recently, other dye dilution techniques using either cold injectates and arterial thermistors or lithium ion-selective electrodes have been introduced into clinical practice. Trans-oesophageal Doppler measurements have also enjoyed an increase in popularity. All of these techniques still remain better suited to the intensive-care environment. There are two new techniques for estimating cardiac output which have a much wider applicability. Both of them are based on modifications of much older methods.
Dexmedetomidine versus propofol or midazolam in patients with abdominal sepsis regarding inflammatory response and capillary leak
Published in Egyptian Journal of Anaesthesia, 2022
Seham M. Moeen, Essam E. Abdelhakeem, Esam M. Abdalla, Ibraheem Embaby, Hebatallah M. Hassan, Eman A. Ismail
This study investigated serum IL-6 and IL-1β concentrations only as markers for inflammatory response. Evaluation of more sepsis biomarkers as TNF-α and procalcitonin as well as anti-inflammatory cytokines as IL-10 and IL-13 may be helpful in upcoming studies. Additionally, this study did not use the advanced dynamic modalities used in monitoring shocked patients and determining fluid responsiveness as trans-esophageal Doppler and arterial blood pressure waveform analysis due to unavailability. Finally, the wide variety of causes of abdominal sepsis with varying degrees of severity could attribute to the variability in serum baseline measurements of IL-6 and IL-1β among the studied patients.
The efficacy of enhanced recovery protocol from anesthesia in diabetic patients undergoing radical cystectomy
Published in Alexandria Journal of Medicine, 2021
Ramadan Abd El Azim Ammar, Emad El Din Abd El Menem Areda, Ahmed Abd El Aziz El Abbady, Mina Wadieh Halim
Waldron et al. [19] conducted a study on 100 adult patients undergoing elective colorectal surgery. The intraoperative GDFT was guided by the esophageal Doppler monitor EDM and the noninvasive cardiac output monitor NICOM. The EDM had significantly more missing data than the NICOM. The NICOM works similarly to the EDM in assessing GDFT, with no clinically significant differences in results, and offers more easy practice as well as fewer missing data points.
Goal-directed fluid therapy compared to liberal fluid therapy in patients subjected to colorectal surgery
Published in Egyptian Journal of Anaesthesia, 2023
Mona Gad Mostafa Elebieby, Mohamed Abdelkhalek, Zenat Eldadamony Mohamed Eldadamony, Mohammed Nashaat Mohammed
Several published meta-analyses have compared GDFT with other fluid treatment strategies in colorectal surgery. The investigations included in these meta-analyses, however, only employed esophageal Doppler monitor in the GDFT group, and they were published in the past with a limited number of RCTs [15].