Articles: monitoring.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Observational StudyIntroduction of a Vendor-Independent Application for Clinical Generation of Pressure-Volume Loops from Routine Hemodynamic Data: A Methodological Exploration.
In the dynamic perioperative setting, changing fluid states complicate determination of ventricular function. This study evaluated the feasibility of clinical ventricular pressure-volume loop (PVL) construction using routine monitoring (echocardiography and invasive pressure monitoring). An application was developed and tested with biventricular simulated data and right ventricular (RV) clinical data. ⋯ This study introduces a vendor-independent application to generate PVLs from routinely available clinical data. The results highlight the potential application of the pressure-volume framework in cardiovascular research and patient care. A lack of external validation must be taken into account. Further research is warranted to validate the application. The app can be accessed at https://michael-vandenheuvel.shinyapps.io/eMv_Looper/.
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Observational Study
Mitochondrial oxygenation monitoring and acute kidney injury risk in cardiac surgery: A prospective cohort study.
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication of cardiac surgery and is associated with increased morbidity and mortality. Recent guidelines emphasize the need for new monitoring methods to facilitate targeted CSA-AKI prevention and treatment strategies. In vivo real-time measurement of mitochondrial oxygen tension (mitoPO2), could potentially fulfil this role during cardiac surgery, as suggested in our previous pilot study. ⋯ This study highlighted the association between mitoPO2 and the onset of CSA-AKI. Extended durations below the mitoPO2 threshold of 25 mmHg significantly correlate with an elevated CSA-AKI risk. Using mitoPO2 as a monitoring tool shows promise in potentially predicting and possibly preventing CSA-AKI when used as a treatment trigger in cardiac surgery patients.
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Accurate assessment of kidney function is essential for diagnosing and managing chronic kidney disease (CKD) and acute kidney injury (AKI), adjusting drug dosages, and predicting clinical outcomes. Despite its ubiquitous use, serum creatinine has significant limitations, necessitating the exploration of alternative and complementary biomarkers and technologies. ⋯ Furthermore, it highlights innovations in real-time glomerular filtration rate (GFR) measurement, such as transdermal monitoring using MB-102 and dual fluorescent tracers. We conclude with a discussion on the development, validation, and clinical integration of these advancements, which may redefine renal function assessment in the years to come.