[Noninvasive hemodynamic monitoring via the integration of data obtained by ECG, aortic flow by Doppler esophageal probe and by finger plethysmography].
The aims of this work are to describe the general and technical characteristics of a new device for the noninvasive monitoring of patients in intensive care and during general anaesthesia, and the results concerning the reliability of this method. An ultrasonic esophageal probe and an echo-Doppler device have been used to obtain continuous data of the aortic diameter and of blood velocity. Aortic output is calculated automatically. This method, together with other non-invasive monitoring techniques (blood pressure, heart rate, rhythm and cardiac conduction), gives on the one hand the data of aortic output, systemic peripheral resistance and stroke volume; on the other, through a computerized elaboration, the systolic time intervals (PEP pre-ejection period, LVET left ventricular ejection time, QS2 electromechanical systole, PEP/LVET ratio of PEP to LVET). The validation of STI data, has been obtained through 125 comparative measurements for each of the three parameters. The data obtained through the aortic velocity waveform in descending aorta (pulsed Doppler) have been compared with those obtained through the aortic pressure waveform (intra aortic catheter). The correlation was: PEP 0.92, LVET 0.95, QS2 0.93. The clinical application of this method supplies data concerning cardiac load, after-load and indirectly cardiac pre-load. This non-invasive procedure gives us a continuous measurement of hemo-dynamic situation, which allows the physician to plan and evaluate the therapeutical efficacy. Finally new pathologic events may be opportunely faced.
Muchada
R
R
Departement d'Anésthesie ed Réanimation, Clinique Mutualiste E. Andrè, Lyon, France.
Rinaldi
A
A
Vernier
F
F
Fady
J F
JF
Lavandier
B
B
Cathignol
D
D
D000768:Anesthesia, General; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000502:physiology; D003422:Critical Care; D004562:Electrocardiography / Q000295:instrumentation; D004947:Esophagus; D005385:Fingers / Q000098:blood supply*; D006439:Hemodynamics; D006801:Humans; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D010991:Plethysmography / Q000295:instrumentation; D014463:Ultrasonography / Q000295:instrumentation
Monitorizzazione emodinamica non invasiva attraverso l'integrazione dei dati ottenuti con l'ECG, con il flusso aortico mediante sonda esofagea Doppler e con la pletismografia digitale.