当前位置： SCI文献检索 > JOURNAL OF CLINICAL MONITORING AND COMPUTING期刊下所有文献 > USCOM-window to the circulation: utility of supra-sternal Doppler in an elderly anaesthetized patient for a robotic cystectomy.

USCOM-window to the circulation: utility of supra-sternal Doppler in an elderly anaesthetized patient for a robotic cystectomy.

Abstract：

:Supra-sternal Doppler (USCOM Ltd., Sydney, Australia) can be used during anaesthesia to measure cardiac output (CO) and related flow parameters. However, before the USCOM can be used routinely, its utility and limitations need to be fully understood and critical information about its use disseminated. In "Window to the Circulation" we use the example of an elderly man undergoing major urological robotic surgery to highlight the utility and limitations of intra-operative USCOM use. USCOM readings were verified against oesophageal Doppler. Despite the lack of major blood loss (<500 ml in 8-h), significant changes in haemodynamics were recorded. CO ranged from 3.2 to 8.3 l/min. The quality of USCOM scans and reliability of data was initially poor, but improved as CO increased as surgery progressed. When USCOM scans became acceptable the correlation with oesophageal Doppler was R(2) = 8.0 (p < 0.001). Several characteristic features of the supra-sternal Doppler scans were identified: Aortic and pulmonary flow waves, valve closure, E and A waves, false A-wave and aberrant arterial flow patterns. Their identification helped with identifying the main flow signal across the aortic valve. The USCOM has the potential to monitor changes in CO and related flow parameters intra-operatively and thus help the anaesthetist to more fully understand the patient's haemodynamics. However, achieving a good quality scan is important as it improves the reliability of USCOM data. The supra-sternal route is rich in flow signals and identifying the aortic valve signal is paramount. Recognizing the other characteristic waveforms in the signal helps greatly.

journal_name

J Clin Monit Comput

journal_title

Journal of clinical monitoring and computing

authors

Critchley LA,Huang L

doi

10.1007/s10877-013-9499-5

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

83-93

issue

1

eissn

1387-1307

issn

1573-2614

journal_volume

28

pub_type

杂志文章

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