caa a22 4500 605510261 CHVBK 20210128100645.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10877-014-9647-6 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9647-6 Hemodynamic volumetry using transpulmonary ultrasound dilution (TPUD) technology in a neonatal animal model [Elektronische Daten] [Sabine Vrancken, Arno van Heijst, Jeroen Hopman, Kian Liem, Johannes van der Hoeven, Willem de Boode] To analyze changes in cardiac output and hemodynamic volumes using transpulmonary ultrasound dilution (TPUD) in a neonatal animal model under different hemodynamic conditions. 7 lambs (3.5-8.3kg) under general anesthesia received arterial and central venous catheters. A Gore-Tex® shunt was surgically inserted between the descending aortaand the left pulmonary artery to mimic a patent ductus arteriosus. After shunt opening and closure, induced hemorrhagic hypotension (by repetitive blood withdrawals) and repetitive volume challenges, the following parameters were assessed using TPUD: cardiac output, active circulating volume index (ACVI), central blood volume index (CBVI) and total end-diastolic volume index (TEDVI). 27 measurement sessions were analyzed. After shunt opening, there was a significant increase in TEDVI and a significant decrease in cardiac output with minimal change in CBVI and ACVI. With shunt closure, these results reversed. After progressive hemorrhage, cardiac output and all volumes decreased significantly, except for ACVI. Following repetitive volume resuscitation, cardiac output increased and all hemodynamic volumes increased significantly. Correlations between changes in COufp and changes in hemodynamic volumes (ACVI 0.83; CBVI 0.84 and TEDVI 0.78 respectively) were (slightly) better than between changes in COufp and changes in heart rate (0.44) and central venous pressure (0.7). Changes in hemodynamic volumes using TPUD were as expected under different conditions. Hemodynamic volumetry using TPUD might be a promising technique that has the potential to improve the assessment and interpretation of the hemodynamic status in critically ill newborns and children. Springer Science+Business Media New York, 2014 Child nationallicence Infant nationallicence Newborn nationallicence Cardiac output nationallicence Transpulmonary ultrasound dilution technique nationallicence Ductus arteriosus nationallicence Hemodynamic volumes nationallicence ACV(I) : Active circulating volume (index) nationallicence AV-loop : Arteriovenous loop nationallicence CBV(I) : Central blood volume (index) nationallicence COtpud : Cardiac output measured by transpulmonary ultrasound dilution nationallicence COufp : Systemic blood flow/cardiac output measured by ultrasonic transit-time flow probe nationallicence CVP : Central venous pressure nationallicence GEDV(I) : Global end-diastolic volume (index) nationallicence ITBV(I) : Intrathoracic blood volume (index) nationallicence MAP : Mean arterial blood pressure nationallicence TEDV(I) : Total end-diastolic volume (index) nationallicence TPUD : Transpulmonary ultrasound dilution nationallicence TPTD : Transpulmonary thermodilution nationallicence QAOpre : Blood flow proximal to the insertion of aortopulmonary shunt nationallicence QAOpost : Blood flow distal to the insertion of aortopulmonary shunt nationallicence Vrancken Sabine Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut van Heijst Arno Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Hopman Jeroen Department of Radiology, Medical Ultrasound Imaging Centre, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut Liem Kian Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut van der Hoeven Johannes Department of Pediatric Intensive Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut de Boode Willem Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/5(2015-10-01), 643-652 1387-1307 29:5<643 2015 29 10877 https://doi.org/10.1007/s10877-014-9647-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9647-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vrancken Sabine Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van Heijst Arno Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Hopman Jeroen Department of Radiology, Medical Ultrasound Imaging Centre, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Liem Kian Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van der Hoeven Johannes Department of Pediatric Intensive Care, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- de Boode Willem Division of Neonatology, Department of Pediatrics, Radboud University Nijmegen Medical Center, Internal Postal Code 804, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/5(2015-10-01), 643-652 1387-1307 29:5<643 2015 29 10877