Acute and Critical Care

Original Articles

Surgery
Performance evaluation of non-invasive cardiac output monitoring device (HemoVista) based on multi-channel thoracic impedance plethysmography technology: Jaehee Park, Byung-Moon Choi; Acute Crit Care. 2024;39(4):565-572. Published online November 18, 2024; DOI: https://doi.org/10.4266/acc.2024.00731

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Abstract PDF: Background
A non-invasive method of measuring cardiac output (CO) can be beneficial in the care of critically ill patients. HemoVista (BiLab Co., Ltd.) is a medical device that measures CO non-invasively using multi-channel impedance plethysmography technology. The purpose of this study was to exploratively evaluate the performance of HemoVista in critically ill patients undergoing CO monitoring with the FloTrac (Edwards Lifesciences).
Methods
After non-invasively installing the HemoVista sensor in critically ill patients whose CO was monitored with the FloTrac, CO values measured by both devices were collected for 30 minutes. Cardiac output measured by both devices was selected every 10 seconds, creating approximately 360 data pairs per patient. Linear correlation analysis with Pearson correlation coefficients, Bland-Altman analysis, and four-quadrant plot analysis were performed to evaluate the performance of HemoVista.
Results
A total of 7,138 pairs of CO data from the 20 patients were included in the analysis. A significant correlation was observed between the two methods of measuring CO (Pearson's r=0.489, P<0.001). The mean bias was 1.03 L/min, the 95% CI for the limit of agreement was –1.83 L/min to 3.93 L/min and the percentage error was 55.8%. The concordance rate of time-dependent CO between the two devices was 14.6%.
Conclusions
It was observed that the current version of HemoVista has unsuitable performance for use in intensive care units. To be used for critically ill patients, the algorithm must be improved and reevaluated with an enhanced version.

Epidemiology
Perioperative hemodynamic protective assessment of adaptive support ventilation usage in pediatric surgical patients: Dmytro Dmytriiev, Mykola Melnychenko, Oleksandr Dobrovanov, Oleksandr Nazarchuk, Marian Vidiscak; Acute Crit Care. 2022;37(4):636-643. Published online October 19, 2022; DOI: https://doi.org/10.4266/acc.2022.00297

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1 Web of Science
3 Crossref

Background
The aim of this study was to evaluate the hemodynamic protective effects of perioperative ventilation in pressure-controlled ventilation (PCV) and adaptive support ventilation (ASV) modes based on non-invasive hemodynamic monitoring indicators.
Methods
The study included 32 patients who were scheduled for planned open abdominal surgery. Depending on the chosen ventilation strategy, patients were included in two groups of PCV mode ventilation (n=14) and ASV mode ventilation (n=18). The hemodynamic effects of the ventilation strategies were assessed by estimated continuous cardiac output (esCCO) and cardiac index (esCCI).
Results
Preoperative cardiac output (CO) was 6.1±1.3 L/min in group 1 patients and 6.3±0.8 L/min in group 2 patients, and preoperative cardiac index (CI) was 3.9±0.4 L/min/m2 in group 1 patients and 3.8±0.8 L/min/m2 in group 2 patients. The ejection fraction (EF) in group 1 subjects was 55.4%±0.3%; this rate was 56.5%±0.5% in group 2 subjects. Group 1 patients experienced a 14.7% CO decrease to 5.2±0.7 L/min, a 17.9% CI decrease to 3.2±0.6 L/min/m2 , and a 12.8% mean arterial pressure decrease to 82.3±9.4 mm Hg 30 minutes after the start of surgery. One hour after the start of surgery, the CO mean values of group 2 patients were lower than baseline by 7.9% and differed from the dynamics of patients in group 1, in whom CO was lower than baseline by 13.1%. At the end of the operation, the CO values were lower than baseline by 11.5% and 6.3% in patients of groups 1 and 2, respectively. Our data showed that the changes in EF during and after surgery correlated with CO indicators determined by the esCCO.
Conclusions
In our study, perioperative ventilation in ASV mode was more protective than PCV mode and was characterized by lower tidal volume (16.2%) and driving pressure (12.1%). Hemodynamically-controlled mechanical ventilation reduces the negative impact of cardiopulmonary interactions,

Citations

Citations to this article as recorded by

Trends in the dynamics of morbidity and mortality from hypertension in the Republic of Kazakhstan from 2010 to 2019
Yeldos Makhambetchin, Aigerim Yessembekova, Ardak Nurbakyttana, Aza Galayeva, Saparkul Arinova
Polski Merkuriusz Lekarski.2024; 52(1): 95. CrossRef
The effect of Sclerosing drugs on the Tunica albuginea (Experimental study)
Kozhakhmet Kuneshov, Shora Seidinov, Nurpeis Tulezhanov, Fazladin Tеmurov, Shkurulla Massadikov
Research Journal of Pharmacy and Technology.2024; : 2846. CrossRef
Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure
Jun-Jun Wang, Zhong Zhou, Li-Ying Zhang
World Journal of Clinical Cases.2023; 11(26): 6040. CrossRef

Comparison of Impedance Cardiography with Thermodilution of Hemodynamic Parameters in Critically Ill Patients: Hyung Goo Kang, Sang Won Chung, Ki Hyun Byun, In Byung Kim; Korean J Crit Care Med. 2006;21(2):77-82.

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Abstract PDF: BACKGROUND
To evaluate the feasibility of noninvasive hemodynamic monitoring (impedance cardiography, ICG) in critically ill patients, we compared this technique with simultaneous invasive monitoring with a pulmonary artery thermodilution catheter.
METHODS
A prospective observational study was done comparing invasive monitoring and noninvasive monitoring in 12 critically ill patients. The cardiac output (CO), the stroke volume (SV) and the systemic vascular resistance (SVR) measured by using a standard thermodilution pulmonary artery catheter technique were compared with the corresponding measurements simultaneously using an ICG.
RESULTS
The value of CO, SV and SVR measured by ICG were closely correlated to those by the thermodilution methods [r: 0.659 (p<0.01), 0.536 (p<0.01), 0.738 (p<0.01)].
CONCLUSIONS
ICG can provide hemodynamic information previously available only by invasive monitoring with a thermodilution catheter.

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