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  • Transesophageal echocardiography  (3)
  • Cerebral perfusion pressure  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Transgastric, pulsed doppler echocardiographic determination of cardiac output (1996)
    Springer
    Intensive care medicine 22 (1996), S. 34-38 
    Details
    ISSN: 1432-1238
    Keywords: Cardiac output ; Transesophageal echocardiography ; Doppler ultrasonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The aim of this study was to evaluate the accuracy of cardiac output measurement with transesophageal echocardiography (TEE) using a transgastric, pulsed Doppler method in acutely ill patients. Design Cardiac output was simultaneously measured by thermodilution (TD) and a transgastric, pulsed Doppler method. Setting The study was carried out in a surgical intensive care unit as part of the management protocol of the patients. Patients Thirty consecutive acutely ill patients with a Swan-Ganz catheter, mechanically ventilated, sedated and with a stable hemodynamic condition were included. Measurements Pulsed Doppler TEE was performed using a transgastric approach in order to obtain a long axis view of the left ventricle. Cardiac output was calculated from the left ventricular outflow tract diameter, the velocity time integral of the blood flow profile and heart rate. Results One patient was excluded because of the presence of aortic regurgitation and another, because of the impossibility of obtaining a transgastric view. Twenty-eight simultaneous measurements were performed in 28 patients. A clinically acceptable correlation and agreement were found between the two methods (Doppler cardiac output=0.889 thermodilution cardiac output +0.74l/min,r=0.975,p〈0.0001). Conclusion Transgastric pulsed Doppler measurement across the left ventricular outflow tract with TEE is a very feasible and clinically acceptable method for cardiac output measurement in acutely ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728328
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate cardiac function at the early phase of severe trauma. Design Prospective, clinical study. Setting Anesthesiological Intensive Care Unit. Patients 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%,p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg,p=0.02). Conclusion The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Left ventricular function after severe trauma (1996)
    Springer
    Intensive care medicine 22 (1996), S. 439-442 
    Details
    ISSN: 1432-1238
    Keywords: Key words Severe trauma ; Myocardial dysfunction ; Fractional area changes ; Transesophageal echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective:To evaluate cardiac function at the early phase of severe trauma. Design: Prospective, clinical study. Setting: Anesthesiological Intensive Care Unit. Patients: 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results: All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%, p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg, p=0.02). Conclusion: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712161
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Early SjvO2 monitoring in patients with severe brain trauma (1999)
    Springer
    Intensive care medicine 25 (1999), S. 445-451 
    Details
    ISSN: 1432-1238
    Keywords: Key words SjvO2 ; Cerebral perfusion pressure ; Intracranial pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate early cerebral variables after minimal resuscitation and to compare the adequacy of a cerebral perfusion pressure (CPP) guideline above 70 mmHg, with jugular bulb venous oxygen saturation (SjvO2) monitoring in a patient with traumatic brain injury (TBI). Design: Prospective, observational study. Setting: Anesthesiological intensive care unit. Patients: 27 TBI patients with a postresuscitation Glasgow Coma Scale score less than 8. Intervention: After initial resuscitation, cerebral monitoring was performed and CPP increased to 70 mmHg by an increase in mean arterial pressure (MAP) with volume expansion and vasopressors as needed. Measurements and results: MAP, intracranial pressure (ICP), CPP, and simultaneous arterial and venous blood gases were measured at baseline and after treatment. Before treatment, 37 % of patients had an SjvO2 below 55 %, and SjvO2 was significantly correlated with CPP (r = 0.73, p 〈 0.0001). After treatment, we observed a significant increase (p 〈 0,0001) in CPP (78 ± 10 vs 53 ± 15 mmHg), MAP (103 ± 10 vs 79 ± 9 mmHg) and SvjO2 (72 ± 7 vs 56 ± 12), without a significant change in ICP (25 ± 14 vs 25 ± 11 mmHg). Conclusion: The present study shows that early cerebral monitoring with SjvO2 is critical to assess cerebral ischemic risk and that MAP monitoring alone is not sensitive enough to determine the state of oxygenation of the brain. SjvO2 monitoring permits the early identification of patients with low CPP and high risk of cerebral ischemia. In emergency situations it can be used alone when ICP monitoring is contraindicated or not readily available. However, ICP monitoring gives complementary information necessary to adapt treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050878
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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