European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive...

41

TAGS:

Transcript of European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive...

Page 1: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 2: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

European Society for Computing and Technologyin Anesthesia and Intensive Care 2010

Non-invasive pulse contour cardiac output by Nexfin technology

Johannes J. van Lieshout, Wilbert A. Wesselink, Berend E. WesterhofSpecial Medical Care, Dpt Internal Medicine

Laboratory for Clinical Cardiovascular Physiology, Center for Heart Failure Research

Academic Medical Center Amsterdam

Page 3: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Casus

Page 4: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Casus

Page 5: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 6: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 7: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 8: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

• Continuous Finger Arterial Pressure

• From Finger Pressure to Flow

Non-invasive pulse contour cardiac output - Outline

Page 9: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 10: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Clinical standard

Page 11: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 12: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

9/00 JJvL05/06 JJvL

late 1970s: Non-Invasive Blood pressure Device (NIBD)

Page 13: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

9/00 JJvL05/06 JJvL

Page 14: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Pressure as Function of Location in Arterial Tree

Nichols & O’Rourke 2005

Page 15: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Finger pressure

Portapres

Finometer

NexFin

Page 16: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Diameter of an artery under a finger cuff is kept constant (clamped) in spite of changes in arterial pressure during each heart beat

Blood Pressure - Volume Clamp

Page 17: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Diameter of an artery under a finger cuff is kept constant (clamped) in spite of changes in arterial pressure during each heart beat

Detection of arterial diameter by an infra-red plethysmograph built in the finger cuff

Blood Pressure - Volume Clamp

Page 18: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Diameter of an artery under a finger cuff is kept constant (clamped) in spite of changes in arterial pressure during each heart beat

Detection of arterial diameter by an infra-red plethysmograph built in the finger cuff

Changes in diameter opposed by a fast pressure servo controller that changes finger cuff pressure

Blood Pressure - Volume Clamp

Page 19: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Bogert LW, Van Lieshout JJ. Exp Physiol 2005;90(4):437-46

Blood Pressure - Volume Clamp

Diameter of an artery under a finger cuff is kept constant (clamped) in spite of changes in arterial pressure during each heart beat

Detection of arterial diameter by an infra-red plethysmograph built in the finger cuff

Changes in diameter opposed by a fast pressure servo controller that changes finger cuff pressure

Expert system (Physiocal ) defines and maintains the correct diameter at which the finger artery is clamped

Page 20: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 21: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Bogert LWJ et al. Anaesthesia, 2010

Page 22: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 23: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 24: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 25: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 26: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Martina J et al. Revision

Page 27: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Martina J et al. Revision

Page 28: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Martina J et al. Revision

Page 29: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

• Continuous Finger Arterial Pressure

• From Finger Pressure to Flow

Non-invasive pulse contour cardiac output - Outline

Page 30: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Windkessel model 1-3

The 3 element Windkessel model is used to determine the afterload (Zin) of the heart for every beat

Page 31: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Windkessel model 2-3

Page 32: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Windkessel model 3-3

Page 33: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Nexfin CO-Trek

age

gender

height

weight

Z0

Cw

stroke volume

cardiac output

heart rate

RpPressure

MAP

Zin

Page 34: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.
Page 35: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

05/06 JJvL

Page 36: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Harms MPM, Wesseling KH, Pott F, Jenstrup M, Van Goudoever J, Secher NH, Van Lieshout JJ. Clin Sci 1999 Jellema WT, Wesseling KH, Groeneveld AB, Stoutenbeek CP, Thijs LG, Van Lieshout JJ. Anesthesiology 1999

Page 37: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Nissen P, Van Lieshout JJ, Novovic S, Bundgaard-Nielsen M, Secher NH. Liver Transplantation 2009

Page 38: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Bogert LW, Wesseling KH, Schraa O, Van Lieshout EJ, De Mol BA, Van GJ, Westerhof BE, Van Lieshout JJ. Anaesthesia 2010

Page 39: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

• Continuous Finger Arterial Pressure

• From Finger Pressure to Flow

Non-invasive pulse contour cardiac output - Outline

Page 40: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

Continuous Cardiac Output

Tissue Perfusion & Oxygenation

Perspective

Page 41: European Society for Computing and Technology in Anesthesia and Intensive Care 2010 Non-invasive pulse contour cardiac output by Nexfin technology Johannes.

GRADE 9 MAPWORK and landforms.pdf · CONTOUR LINES •Contour lines connect places of equal altitude •Contour lines depict various landforms on a map •By “reading” the contour

GRADE 9 MAPWORK and landforms.pdf · CONTOUR LINES •Contour lines connect places of equal altitude •Contour lines depict various landforms on a map •By “reading” the contour

Contour Tbtrans

Contour Tbtrans

January 28 th Why is contour drawing important? What does “blind” add to contour? Draw 1 – Blind contour. Modified Contour of shoe/backpack/bag. Get two.

January 28 th Why is contour drawing important? What does “blind” add to contour? Draw 1 – Blind contour. Modified Contour of shoe/backpack/bag. Get two.

A Neural Model of Visual Contour Integration · A neural model of visual contour integration Zhaoping Li Computer Science, Hong Kong University of Science and Technology Clear Water

A Neural Model of Visual Contour Integration · A neural model of visual contour integration Zhaoping Li Computer Science, Hong Kong University of Science and Technology Clear Water

Contour maps

Contour maps

Contour line

Contour line

52352main contour

52352main contour

Blind Contour

Blind Contour

Topographic Maps Topographic Maps: ____________ ______________________________ Contour Lines:________________ _____________________________ Contour Interval:_______________.

Topographic Maps Topographic Maps: ____________ ______________________________ Contour Lines:________________ _____________________________ Contour Interval:_______________.

Contour Userguide

Contour Userguide

Contour Recognition

Contour Recognition

Simply Silent™ Contour CV and CVLV Superior technology · Simply Silent™ Contour CV and CVLV Superior technology. The . Simply Silent™ Contour CV. ... Sound Pressure Level ...

Simply Silent™ Contour CV and CVLV Superior technology · Simply Silent™ Contour CV and CVLV Superior technology. The . Simply Silent™ Contour CV. ... Sound Pressure Level ...

Balanço: The Contour of Relative Offbeatness · 2014. 1. 26. · Balanço: The Contour of Relative Offbeatness Mehmet Vurkaç Oregon Institute of Technology 3201 Campus Dr Klamath

Balanço: The Contour of Relative Offbeatness · 2014. 1. 26. · Balanço: The Contour of Relative Offbeatness Mehmet Vurkaç Oregon Institute of Technology 3201 Campus Dr Klamath

Intermediate Contour

Intermediate Contour

AN26 Surfer Contour Plots of Measured Data - Z · PDF fileCreating Signal Coverage Contour Plots With Surfer Software from Measured Data Captured with ZTI Drive-Test Systems Z Technology

AN26 Surfer Contour Plots of Measured Data - Z · PDF fileCreating Signal Coverage Contour Plots With Surfer Software from Measured Data Captured with ZTI Drive-Test Systems Z Technology

Contour Drawings and Contour Wire Sculptures

Contour Drawings and Contour Wire Sculptures

99 Contour

99 Contour

Contour Trees

Contour Trees

Contour 2012

Contour 2012

16284 Contour

16284 Contour