J Clin Monit Comput - Non-invasive cardiac output and oxygen delivery measurement in an infant with critical anemia.

Tópicos

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Resumo

JECTIVE: To assess the combination of a non-invasive blood oxygen content (CaO(2)) monitor and a non-invasive cardiac output (CO) monitor to continuously measure oxygen delivery (DO(2); DO(2) = CaO(2) ? CO).METHODS: DO(2) was assessed during blood transfusions in an infant with acute hemolytic anemia following admission (~48 h). CaO(2) was measured by Pulse Co-Oximetry, which also provides estimates of hemoglobin (Hgb) concentration and percent oxygen saturation. CO was measured by Electrical Velocimetry, which also provides an estimate of stroke volume (SV). Lactate levels, an indirect measure of adequate DO(2), were assessed during the initial 8 h following admission.RESULTS: Incremental blood transfusions during the first 36 h increased Hgb from 2.7 to 9.5 g/dL during which time heart rate (HR) normalized from 156 to 115 beats/min. Lactate levels decreased from 20 to 0.8 mmol/L in the first 7 h. Non-invasive Hgb and CaO(2) measurements were well correlated with invasive Hgb and CaO(2) measures (r (2) = 0.88; P = 0.019; r (2) = 0.86; P = 0.0074, respectively). CO decreased from 2.47 ? 0.06 to 1.28 ? 0.02 L/min and SV decreased from 15.9 ? 0.4 to 11.1 ? 0.2 mL/beat. Mean arterial blood pressure was stable throughout the admission with systemic vascular resistance increasing from 407.6 ? 15.2 to 887.7 ? 30.1 dynes-s/cm(5). DO(2) was estimated to increase from 120.2 ? 18.9 to 182.4 ? 5.6 mL O(2)/min.CONCLUSIONS: Non-invasive continuous CO and CaO(2) monitors are shown in this single case to provide continuous DO(2) measurement. The ability to assess DO(2) may improve hemodynamic monitoring during goal directed therapies.

Resumo Limpo

jectiv assess combin noninvas blood oxygen content cao monitor noninvas cardiac output co monitor continu measur oxygen deliveri cao comethod assess blood transfus infant acut hemolyt anemia follow admiss h cao measur puls cooximetri also provid estim hemoglobin hgb concentr percent oxygen satur co measur electr velocimetri also provid estim stroke volum sv lactat level indirect measur adequ assess initi h follow admissionresult increment blood transfus first h increas hgb gdl time heart rate hr normal beatsmin lactat level decreas mmoll first h noninvas hgb cao measur well correl invas hgb cao measur r p r p respect co decreas lmin sv decreas mlbeat mean arteri blood pressur stabl throughout admiss system vascular resist increas dynesscm estim increas ml ominconclus noninvas continu co cao monitor shown singl case provid continu measur abil assess may improv hemodynam monitor goal direct therapi

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