Back to Browse Journals » Open Access Journal of Clinical Trials » Volume 2

HeartSmart® for routine optimization of blood flow and facilitation of early goal-directed therapy

Authors Kenneth Warring-Davies, Martin Bland

Published Date August 2010 Volume 2010:2 Pages 115—123

DOI http://dx.doi.org/10.2147/OAJCT.S9843

Published 5 August 2010

Kenneth Warring-Davies1, Martin Bland2
1The Intensive Care Unit, Bradford Royal Infirmary, Bradford, West Yorkshire, UK; 2Department of Health Sciences, University of York, York, North Yorkshire, UK

Abstract: The empirical physiological formulae of the new continuous cardiac dynamic ­monitoring HeartSmart® technology, which involves the use of a new inverse square rule of the heart, were investigated with pulmonary artery catheter (PAC) thermodilution in the ­estimation of CI in diverse patients. Clinical trial data collected from 268 adult surgery or intensive care patients requiring PAC placement were obtained from 7 NHS Trust hospitals, providing 2720 paired sets of CI estimations for comparison between HeartSmart® and PAC thermodilution. For 95% of pairs of measurements, HeartSmart® values were between 57% and 164% of PAC measurements; additionally, the larger limit of agreement between HeartSmart® and PAC thermodilution (1.26 L min-1•m-2) suggests that HeartSmart® agrees with PAC thermodilution as closely as PAC thermodilution agrees with itself. HeartSmart® can also estimate CI in the extreme circumstances of shock/sepsis, as indicated by PAC thermodilution CI values that were hypo- or hyperdynamic based on systemic inflammatory response syndrome criteria. In CI measurements for hypo- or hyperdynamic values that were matched between HeartSmart® and PAC thermodilution, the difference in total volumes and average CI measurements between the two methods was less than 5%. For unmatched hypo- or hyperdynamic values, the difference between total volumes and average CI measurements was less than 33% – an acceptable percentage of difference or error even for normal values of CI. HeartSmart® tracked PAC thermodilution CI hypodynamic values 98.2% of the time and hyperdynamic values 97.6% of the time. These findings show that CI estimations provided by the HeartSmart® empirical physiological formulae are comparable to those obtained using PAC thermodilution. HeartSmart® removes many of the technical barriers that prevent the routine adoption and practice of early goal-directed therapy, and represents a simple, reliable method of estimating CI and other hemodynamic variables at the bedside or in departments other than the Intensive Care Unit.

Keywords: cardiac index, early goal-directed therapy, HeartSmart®, cardiodynamics, blood flow

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite

Takahiro Ueno, Hironori Tsuchiya, Maki Mizogami, Ko Takakura

Journal of Inflammation Research 2008, 1:41-48

Published Date: 13 November 2008

Challenging issues in molecular-targeted therapy

Zoheir Ezziane

Therapeutics and Clinical Risk Management 2009, 5:239-245

Published Date: 3 March 2009

Bone resorption in incompletely impacted mandibular third molars and acute pericoronitis

Minoru Yamaoka, Yusuke Ono, Masahiro Takahashi, Ryosuke Doto, et al.

Clinical, Cosmetic and Investigational Dentistry 2009, 1:7-12

Published Date: 14 April 2009

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors

Eduardo Pimenta, Suzanne Oparil

Vascular Health and Risk Management 2009, 5:453-463

Published Date: 19 May 2009

Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity

Joseph Finkelstein, Eunme Cha, Steven M Scharf

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:337-349

Published Date: 4 September 2009

Clinical evidence supporting the use of an activated clinoptilolite suspension as an agent to increase urinary excretion of toxic heavy metals

James L Flowers, Stewart A Lonky, Erik J Deitsch

Nutrition and Dietary Supplements 2009, 1:11-18

Published Date: 4 November 2009

Early cardiovascular abnormalities in newly diagnosed obstructive sleep apnea

Jean-Philippe Baguet, Marie Nadra, Gilles Barone-Rochette, et al

Vascular Health and Risk Management 2009, 5:1063-1073

Published Date: 11 December 2009