Biomaterial Database

Multicomponent noninvasive physiologic monitoring of circulatory function. 1988

W C Shoemaker, and P L Appel, and H B Kram, and R C Nathan, and J L Thompson

Department of Surgery, King-Drew Medical Center, Los Angeles, CA.

A multicomponent noninvasive monitoring system for high-risk critically ill patients was developed and tested in a series of 58 high-risk surgical patients. The system was comprised of a thoracic electric bioimpedance (TEB) method for cardiac output estimation, laser-Doppler velocimeter for small vessel flow, transcutaneous oxygen (PtcO2) sensor for tissue oxygenation, pulse oximeter for arterial hemoglobin saturation (SaO2) and finger pressor sensor for arterial pressure. In a series of critically ill patients, this noninvasive system was compared with the widely used invasive monitoring system with systemic and pulmonary artery catheters. Despite theoretical limitations of TEB as a measure of cardiac output, there was a satisfactory correlation (r = .83) of cardiac output measured by thermodilution (TD) and TEB throughout a wide range of severe illnesses. Moreover, changes in TEB cardiac output satisfactorily tracked changes in TD cardiac output (r = .91). There was poor correlation between TD cardiac output and BP or heart rate. The incidence of abruptly changing physiologic patterns was observed with simultaneously monitored invasive and noninvasive systems. Descriptions were made of the central circulation, peripheral perfusion, and pulmonary function; common interactive responses of these circulations were also evaluated. Monitored events defined as abrupt reductions in these variables often occurred from reduced cardiac output, PtcO2 or PtcO2/PaO2 index, and infrequently from unanticipated reductions in SaO2. Recovery from the nadir of the monitored event was associated usually with improvements in flow, PtcO2, or both. Hemodynamic and oxygen transport patterns of a few commonly encountered patterns are described.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008838	Microcomputers	Small computers using LSI (large-scale integration) microprocessor chips as the CPU (central processing unit) and semiconductor memories for compact, inexpensive storage of program instructions and data. They are smaller and less expensive than minicomputers and are usually built into a dedicated system where they are optimized for a particular application. "Microprocessor" may refer to just the CPU or the entire microcomputer.	Computers, Personal,Microprocessors,Computer, Personal,Microcomputer,Microprocessor,Personal Computer,Personal Computers
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D008991	Monitoring, Physiologic	The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.	Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D009026	Mortality	All deaths reported in a given population.	CFR Case Fatality Rate,Crude Death Rate,Crude Mortality Rate,Death Rate,Age Specific Death Rate,Age-Specific Death Rate,Case Fatality Rate,Decline, Mortality,Determinants, Mortality,Differential Mortality,Excess Mortality,Mortality Decline,Mortality Determinants,Mortality Rate,Mortality, Differential,Mortality, Excess,Age-Specific Death Rates,Case Fatality Rates,Crude Death Rates,Crude Mortality Rates,Death Rate, Age-Specific,Death Rate, Crude,Death Rates,Determinant, Mortality,Differential Mortalities,Excess Mortalities,Mortalities,Mortality Declines,Mortality Determinant,Mortality Rate, Crude,Mortality Rates,Rate, Age-Specific Death,Rate, Case Fatality,Rate, Crude Death,Rate, Crude Mortality,Rate, Death,Rate, Mortality,Rates, Case Fatality
D010092	Oximetry	The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry.	Pulse Oximetry,Oximetry, Pulse,Oximetries,Oximetries, Pulse,Pulse Oximetries
D002302	Cardiac Output	The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).	Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D003422	Critical Care	Health care provided to a critically ill patient during a medical emergency or crisis.	Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005069	Evaluation Studies as Topic	Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies.	Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D005260	Female		Females