PMID- 23508657
OWN - NLM
STAT- MEDLINE
DCOM- 20130423
LR  - 20191210
IS  - 1833-3516 (Print)
IS  - 1833-3516 (Linking)
VI  - 43
IP  - 1
DP  - 2013 Mar
TI  - Monitoring cardiac output during hyperbaric oxygen treatment of haemodynamically 
      unstable patients.
PG  - 3-8
AB  - INTRODUCTION: Patients suffering from necrotizing fasciitis (NF) are often 
      haemodynamically unstable and require extended monitoring of cardiovascular 
      parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We 
      aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring 
      of cardiac output (CO) under hyperbaric conditions in haemodynamically unstable 
      patients diagnosed with NF and sepsis or septic shock. METHODS: Cardiac output 
      was measured prior to, during and after HBOT with the use of TED in seven 
      consecutive patients diagnosed with NF and sepsis or septic shock. The HBOT 
      followed our standard protocol for NF patients, consisting of 90 minutes' 
      exposure to 100% oxygen at 284 kPa. The difference between mean CO just prior to 
      HBOT initiation and at near-maximum treatment duration was assessed using the 
      Student's paired t-test. RESULTS: TED was feasible and easy to use under 
      hyperbaric conditions. We experienced no problems with the measurement of CO or 
      with equipment-related safety during HBOT. Five patients had an increase in CO 
      from initiation of HBOT to near-maximum treatment duration, one patient had a 
      stable CO, while one patient experienced a slight decrease in CO. Overall, there 
      was an increase in mean CO of 1.7 L min-1 (95% CI 0.02 to 3.34 L min-1, P = 
      0.048) from initiation of HBOT to near-maximum treatment duration. CONCLUSION: 
      This is, to the best of our knowledge, the first study to document that TED can 
      provide a minimally-invasive estimate of CO in haemodynamically unstable patients 
      with NF and sepsis or septic shock during HBOT.
FAU - Hansen, Marco Bo
AU  - Hansen MB
AD  - HBO Unit and Laboratory for Hyperbaric Medicine, Department of Anesthesia, 
      Blegdamsvej 9 DK-2100 Copenhagen, Denmark. marco.bo.hansen@rh.regionh.dk
FAU - Treschow, Frederik
AU  - Treschow F
FAU - Skielboe, Martin
AU  - Skielboe M
FAU - Hyldegaard, Ole
AU  - Hyldegaard O
FAU - Jansen, Erik Christian
AU  - Jansen EC
FAU - Nielsen, Jonas Bille
AU  - Nielsen JB
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Output/*physiology
MH  - *Echocardiography, Transesophageal
MH  - Fasciitis, Necrotizing/*physiopathology
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - *Hyperbaric Oxygenation
MH  - Male
MH  - Middle Aged
MH  - Sepsis/*physiopathology
MH  - Shock, Septic/physiopathology
OTO - NOTNLM
OT  - Doppler
OT  - cardiovascular
OT  - hyperbaric oxygen therapy
OT  - necrotising infections
OT  - patient monitoring
OT  - physiology
EDAT- 2013/03/20 06:00
MHDA- 2013/04/24 06:00
CRDT- 2013/03/20 06:00
PHST- 2012/08/11 00:00 [received]
PHST- 2012/12/28 00:00 [accepted]
PHST- 2013/03/20 06:00 [entrez]
PHST- 2013/03/20 06:00 [pubmed]
PHST- 2013/04/24 06:00 [medline]
PST - ppublish
SO  - Diving Hyperb Med. 2013 Mar;43(1):3-8.