期刊
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
卷 35, 期 5, 页码 1509-1515出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.jvca.2021.01.040
关键词
carotid Doppler; volume responsiveness; functional hemodynamic monitoring; corrected flow time; velocity time integral; wearable technology
A novel wireless wearable Doppler ultrasound patch is introduced as a tool for resuscitation and functional hemodynamic monitoring, providing accurate and timely tracking of changes in stroke volume by sampling more cardiac cycles to smooth physiological variations.
In this Emerging Technology Review, a novel, wireless, wearable Doppler ultrasound patch is described as a tool for resuscitation. The device is designed, foremost, as a functional hemodynamic monitor-a simple, fast, and consistent method for measuring hemodynamic change with pre-load variation. More generally, functional hemodynamic monitoring is a paradigm that helps predict stroke volume response to additional intravenous volume. Because Doppler ultrasound of the left ventricular outflow tract noninvasively measures stroke volume in realtime, it increasingly is deployed for this purpose. Nevertheless, Doppler ultrasound in this manner is cumbersome, especially when repeat assessments are needed. Accordingly, peripheral arteries have been studied and various measures from the common carotid artery Doppler signal act as windows to the left ventricle. Yet, handheld Doppler ultrasound of a peripheral artery is susceptible to human measurement error and statistical limitations from inadequate beat sample size. Therefore, a wearable Doppler ultrasound capable of continuous assessment minimizes measurement inconsistencies and smooths inherent physiologic variation by sampling many more cardiac cycles. Reaffirming clinical studies, the ultrasound patch tracks immediate SV change with excellent accuracy in healthy volunteers when cardiac preload is altered by various maneuvers. The wearable ultrasound also follows jugular venous Doppler, which qualitatively trends right atrial pressure. With further clinical research and the application of artificial intelligence, the monitoring modalities with this new technology are manifold. (C) 2021 The Authors. Published by Elsevier Inc.
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