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Comparison of clinical results between transpulmonary thermodilution monitoring and conventional methods in cardiac surgery: An observational study.
Medicine (Baltimore)
December 2024
Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Turkey.
The Pulse Index Contour Continuous Cardiac Output (PICCO) module provides advanced and continuous monitoring of cardiac output through the use of arterial pulse contour analysis and transpulmonary thermodilution. The objective of this study was to compare the early postoperative outcomes of patients who were monitored using the conventional method and the pulse contour analysis method. A prospective observational study was conducted involving 45 patients who underwent cardiac surgery between 2020 and 2022.
View Article and Find Full Text PDFPiCCO or Cardiac Ultrasound? Which Is Better for Hemodynamic Monitoring in ICU?
Medicina (Kaunas)
November 2024
Department of Cardiology, Emergency County Hospital of Craiova, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Advanced hemodynamic monitoring is fundamental in the management of the critically ill. Blood pressure and cardiac function are key markers of cardiovascular system function;, thus, having accurate measurements of these parameters in critically ill patients is essential. Currently, there are various methods available to choose from, as well as a greater understanding of the methods and criteria to be able to compare devices and select the best option for our patients' needs.
View Article and Find Full Text PDFQuantification of pulmonary edema using automated lung segmentation on computed tomography in mechanically ventilated patients with acute respiratory distress syndrome.
Intensive Care Med Exp
November 2024
Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, University Hospital Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68165, Mannheim, Germany.
Background: Quantification of pulmonary edema in patients with acute respiratory distress syndrome (ARDS) by chest computed tomography (CT) scan has not been validated in routine diagnostics due to its complexity and time-consuming nature. Therefore, the single-indicator transpulmonary thermodilution (TPTD) technique to measure extravascular lung water (EVLW) has been used in the clinical setting. Advances in artificial intelligence (AI) have now enabled CT images of inhomogeneous lungs to be segmented automatically by an intensive care physician with no prior radiology training within a relatively short time.
View Article and Find Full Text PDFDeep phenotyping of pulmonary edema and pulmonary vascular permeability in COVID-19 ARDS.
Am J Physiol Lung Cell Mol Physiol
January 2025
Department of Pulmonary Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Clinical monitoring of pulmonary edema due to vascular hyperpermeability in acute respiratory distress syndrome (ARDS) poses significant clinical challenges. Presently, no biological or radiological markers are available for quantifying pulmonary edema. Our aim was to phenotype pulmonary edema and pulmonary vascular permeability in patients with coronavirus disease 2019 (COVID-19) ARDS.
View Article and Find Full Text PDFFluid balance neutralization secured by hemodynamic monitoring versus protocolized standard of care in patients with acute circulatory failure requiring continuous renal replacement therapy: results of the GO NEUTRAL randomized controlled trial.
Intensive Care Med
December 2024
Service de Médecine Intensive-Réanimation, Hôpital de La Croix Rousse, Hospices Civils de Lyon, Lyon, France.
Purpose: Net ultrafiltration (UF) during continuous renal replacement therapy (CRRT) can control fluid balance (FB), but is usually 0 ml·h in patients with vasopressors due to the risk of hemodynamic instability associated with CRRT (HIRRT). We evaluated a UF strategy adjusted by functional hemodynamics to control the FB of patients with vasopressors, compared to the standard of care.
Methods: In this randomized, controlled, open-label, parallel-group, multicenter, proof-of-concept trial, adults receiving vasopressors, CRRT since ≤ 24 h and cardiac output monitoring were randomized (ratio 1:1) to receive during 72 h a UF ≥ 100 ml·h, adjusted using a functional hemodynamic protocol (intervention), or a UF ≤ 25 ml·h (control).
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