HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy
Kenneth Warring-Davies1, Martin Bland21The Intensive Care Unit, Bradford Royal Infirmary, Bradford, West Yorkshire, UK; 2Department of Health Sciences, University of York, York, North Yorkshire, UKAbstract: The empirical physiological formulae of the new continuous cardiac dynamic ­monit...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2010-08-01
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| Series: | Open Access Journal of Clinical Trials |
| Online Access: | http://www.dovepress.com/heartsmartreg-for-routine-optimization-of-blood-flow-and-facilitation--a4988 |
| _version_ | 1828918110608949248 |
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| author | Kenneth Warring-Davies Martin Bland |
| author_facet | Kenneth Warring-Davies Martin Bland |
| author_sort | Kenneth Warring-Davies |
| collection | DOAJ |
| description | Kenneth Warring-Davies1, Martin Bland21The Intensive Care Unit, Bradford Royal Infirmary, Bradford, West Yorkshire, UK; 2Department of Health Sciences, University of York, York, North Yorkshire, UKAbstract: The empirical physiological formulae of the new continuous cardiac dynamic ­monitoring HeartSmart® technology, which involves the use of a new inverse square rule of the heart, were investigated with pulmonary artery catheter (PAC) thermodilution in the ­estimation of CI in diverse patients. Clinical trial data collected from 268 adult surgery or intensive care patients requiring PAC placement were obtained from 7 NHS Trust hospitals, providing 2720 paired sets of CI estimations for comparison between HeartSmart® and PAC thermodilution. For 95% of pairs of measurements, HeartSmart® values were between 57% and 164% of PAC measurements; additionally, the larger limit of agreement between HeartSmart® and PAC thermodilution (1.26 L min-1•m-2) suggests that HeartSmart® agrees with PAC thermodilution as closely as PAC thermodilution agrees with itself. HeartSmart® can also estimate CI in the extreme circumstances of shock/sepsis, as indicated by PAC thermodilution CI values that were hypo- or hyperdynamic based on systemic inflammatory response syndrome criteria. In CI measurements for hypo- or hyperdynamic values that were matched between HeartSmart® and PAC thermodilution, the difference in total volumes and average CI measurements between the two methods was less than 5%. For unmatched hypo- or hyperdynamic values, the difference between total volumes and average CI measurements was less than 33% – an acceptable percentage of difference or error even for normal values of CI. HeartSmart® tracked PAC thermodilution CI hypodynamic values 98.2% of the time and hyperdynamic values 97.6% of the time. These findings show that CI estimations provided by the HeartSmart® empirical physiological formulae are comparable to those obtained using PAC thermodilution. HeartSmart® removes many of the technical barriers that prevent the routine adoption and practice of early goal-directed therapy, and represents a simple, reliable method of estimating CI and other hemodynamic variables at the bedside or in departments other than the Intensive Care Unit.Keywords: cardiac index, early goal-directed therapy, HeartSmart®, cardiodynamics, blood flow |
| first_indexed | 2024-12-13T21:03:40Z |
| format | Article |
| id | doaj.art-6bb3ba358de643d8ad8aa8aa7389fa24 |
| institution | Directory Open Access Journal |
| issn | 1179-1519 |
| language | English |
| last_indexed | 2024-12-13T21:03:40Z |
| publishDate | 2010-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Journal of Clinical Trials |
| spelling | doaj.art-6bb3ba358de643d8ad8aa8aa7389fa242022-12-21T23:31:31ZengDove Medical PressOpen Access Journal of Clinical Trials1179-15192010-08-012010default115123HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapyKenneth Warring-DaviesMartin BlandKenneth Warring-Davies1, Martin Bland21The Intensive Care Unit, Bradford Royal Infirmary, Bradford, West Yorkshire, UK; 2Department of Health Sciences, University of York, York, North Yorkshire, UKAbstract: The empirical physiological formulae of the new continuous cardiac dynamic ­monitoring HeartSmart® technology, which involves the use of a new inverse square rule of the heart, were investigated with pulmonary artery catheter (PAC) thermodilution in the ­estimation of CI in diverse patients. Clinical trial data collected from 268 adult surgery or intensive care patients requiring PAC placement were obtained from 7 NHS Trust hospitals, providing 2720 paired sets of CI estimations for comparison between HeartSmart® and PAC thermodilution. For 95% of pairs of measurements, HeartSmart® values were between 57% and 164% of PAC measurements; additionally, the larger limit of agreement between HeartSmart® and PAC thermodilution (1.26 L min-1•m-2) suggests that HeartSmart® agrees with PAC thermodilution as closely as PAC thermodilution agrees with itself. HeartSmart® can also estimate CI in the extreme circumstances of shock/sepsis, as indicated by PAC thermodilution CI values that were hypo- or hyperdynamic based on systemic inflammatory response syndrome criteria. In CI measurements for hypo- or hyperdynamic values that were matched between HeartSmart® and PAC thermodilution, the difference in total volumes and average CI measurements between the two methods was less than 5%. For unmatched hypo- or hyperdynamic values, the difference between total volumes and average CI measurements was less than 33% – an acceptable percentage of difference or error even for normal values of CI. HeartSmart® tracked PAC thermodilution CI hypodynamic values 98.2% of the time and hyperdynamic values 97.6% of the time. These findings show that CI estimations provided by the HeartSmart® empirical physiological formulae are comparable to those obtained using PAC thermodilution. HeartSmart® removes many of the technical barriers that prevent the routine adoption and practice of early goal-directed therapy, and represents a simple, reliable method of estimating CI and other hemodynamic variables at the bedside or in departments other than the Intensive Care Unit.Keywords: cardiac index, early goal-directed therapy, HeartSmart®, cardiodynamics, blood flowhttp://www.dovepress.com/heartsmartreg-for-routine-optimization-of-blood-flow-and-facilitation--a4988 |
| spellingShingle | Kenneth Warring-Davies Martin Bland HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy Open Access Journal of Clinical Trials |
| title | HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy |
| title_full | HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy |
| title_fullStr | HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy |
| title_full_unstemmed | HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy |
| title_short | HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy |
| title_sort | heartsmart amp reg for routine optimization of blood flow and facilitation of early goal directed therapy |
| url | http://www.dovepress.com/heartsmartreg-for-routine-optimization-of-blood-flow-and-facilitation--a4988 |
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