USCOM 1A

We have over 460 publications proving the USCOM 1A is useful, accurate and the new clinical Gold Standard. Read some of our recent Evidence and Validation.

Evolution of hemodynamics and outcome of fluid-refractory septic shock in children

Both community-acquired septic shock (cold) and hospital-acquired septic shock (warm) evolved in a heterogeneous manner requiring frequent revision of cardiovascular support therapy. Repeated hemodynamic measurements using non-invasive ultrasound helped in fine tuning cardiovascular therapies.

Deep A, Goonasekera CD, Wang Y, Brierley J

Intensive Care Med. 2013 Sep;39(9):1602-9. doi: 10.1007/s00134-013-3003-z. Epub 2013 Jun 28
Efficacy of non-invasive cardiac monitoring (Ultrasonic Cardiac Output Monitor) guide in management of fluid refractory pediatric septic shock

The study, of 6 month to 14 year olds with severe infections, found USCOM 1A aided treatment in 71% of patients, reduced total fluid loading, and reduced mortality by a relative 46%, from 19% to 10.2%.

Thongnual C, Hantragool S, Samransamruatkit R

Pediatric Respiratory and Critical Care Medicine Association, Annual Scientific Meeting, 2016; proceedings
Mechanical ventilation with positive end-expiratory pressure in critically ill patients: comparison of CW-Doppler ultrasound cardiac output monitoring (USCOM) and thermodilution (PiCCO)

A significant influence of mechanical ventilation with PEEP on hemodynamic parameters was evident both with USCOM 1A and PiCCO. CW-Doppler based USCOM 1A constitutes an important tool for easy, rapid and reliable diagnosis and hemodynamic monitoring of critically ill patients.

Horster S, Stemmler HJ, Sparrer J, Tischer J, Hausmann A, Geiger S

Acta Cardiol. 2012 Apr;67(2):177-85
Non-invasive stroke volume measurement and passive leg raising predict volume responsiveness in medical ICU patients: an observational cohort study

In a broad population of medical ICU patients where less than 50% given fluid boluses were volume responsive, USCOM 1A non-invasive SV measurement and passive leg raising predicted fluid responsiveness with a sensitivity of 81%, specificity of 93%, positive predictive value of 91% and negative predictive value of 85%.

Thiel SW, Kollef MH, Isakow W

Critical Care 2009, 13:R111 doi:10.1186/cc7955
Hemodynamic changes in emergency department patients with poorly controlled hypertension

Antihypertensive drugs prescribed in the emergency department did not correlate with the patient’s primary hemodynamic derangement in 35% of cases. Identifying the hemodynamic profile in emergency patients with poorly controlled hypertension may be valuable in guiding decision-making.

Chan SSW, Tse MM, Chan CPY, Tai MCK, Graham CA, Rainer TH

Hong Kong Med J 2016;22:Epub DOI: 10.12809/hkmj154566
Measuring the cardiac output in acute emergency admissions: use of the non-invasive ultrasonic cardiac output monitor (USCOM) with determination of the learning curve and inter-rater reliability

This learning curve and inter-rater study includes a passive leg raising (PLR) manoeuvre, an intervention that mimics a fluid challenge to the central circulation. Following training and less than fifty scans, Emergency Physicians were reliably able to detect 10% change in SV.

Hodgson LE, Venn R, Forni LG, Samuels TL and Wakeling HG

Journal of the Intensive Care Society May 2016 vol. 17 no. 2 122-128
Assessment of total vascular resistance and total body water in normotensive women during the first trimester of pregnancy. A key for the prevention of preeclampsia

In patients with a high risk of developing hypertensive complications, a high Systemic Vascular Resistance (SVR) measured during the first weeks of gestation may be an early marker of cardiovascular maladaptation, even more than water distribution and a single blood pressure assessment. Lower values of Inotropy Index may be indicative of poor cardiac performance.

Tiralongo GM, Lo Presti D, Pisani I, Gagliardi G, Scala RL, Novelli GP, Vasapollo B, Andreoli A, Valensise H

Pregnancy Hypertens. 2015 Apr;5(2):193-7. doi: 10.1016/j.preghy.2015.02.001. Epub 2015 Feb 26
Foetal heart rate deceleration with combined spinal-epidural analgesia during labour: a maternal haemodynamic cardiac study

Fetal heart rate (FHR) deceleration seems to occur in women without the ability to upregulate stroke volume (SV) and cardiac output (CO) in response to the initial effects of analgesia. The level of TVR (SVR) before combined epidural analgesia in labour may predict post-procedural FHR abnormalities a symptom of fetal hypoxia. SVR <1000 d.s.cm-5 showed a reduced risk of FHR abnormalities.

Valensise H, Lo Presti D, Tiralongo GT, Pisani I, Gagliardi G, Vasapollo B, Frigo MG

J Matern Fetal Neonatal Med. 2016;29(12):1980-6. doi: 10.3109/14767058.2015.1072156
Time for spontaneous closure of ductus arteriosus and dynamic changes with cardiac index, peripheral vascular resistance, blood pressure of different gestational age neonates

Increased gestational age increases the likelihood of early and natural ductus arteriosus closure. For preterm babies, especially very low birth weight preterm babies, USCOM 1A can detect and guide treatment of patent ductus arteriosus.

Dong H, He S, Zheng M, Zhong J, Chen X, Liu Y, Liang S

Journal of Applied Clinical Pediatrics Year 2015, Issue 14, Page 1060-1063
The clinical value of dynamic measurement of cardiac output in early shock neonates

The left ventricular cardiac output and stroke volume in shock neonates were significantly lower than those in normal neonates and improved significantly after volume expansion and dopamine treatment. Fluid resuscitation in early shock neonates may benefit from monitoring cardiac output.

YU Z, LIU X

Journal of Clinical Pediatrics 2010; (1) : 21-23,46
A comparison of the non-invasive ultrasonic cardiac output monitor (USCOM) with the oesophageal Doppler monitor during major abdominal surgery

During major surgery, where 24% of patients studied were elderly and although more difficult, high-quality images were achieved, the USCOM 1A accurately discriminated significant changes in SV as measured by the oesophageal Doppler monitor (ODM) and showed good concordance.

Hodgson LE, Forni LG, Venn R, Samuels TL, Wakeling HG

J Int Care Soc 2015, DOI:10.1177/1751143715619186
Corrected flow time is a good indicator for preload responsiveness during living donor liver donation

Accurate estimation of preload status during living donor liver donation (LDLD) is important due to fluid restriction. Flow Time corrected (FTc) is a non-invasive, easily obtainable, and essentially good preload indicator during LDLD.

Su BC, Luo CF, Chang WY, Lee WC, Lin CC

Transplant Proc. 2014 Apr;46(3):672-4. doi: 10.1016/j.transproceed.2013.11.021
Cardiac output measurements in septic patients: Comparing the accuracy of USCOM to PiCCO

The USCOM 1A is a feasible and rapid method to evaluate cardiac output (CO) in septic patients. It reliably represents CO values as compared to the reference technique based on thermodilution (PiCCO) and would be appropriate when CO measurements are pertinent to patient management.

Horster S, Stemmler HJ, Strecker N, Brettner F, Hausmann A, Jitske Cnossen J, Klaus G, Parhofer KG, Nickel T, Geiger S

Critical Care Research and Practice Volume 2012, Article ID 270631, 5 pages doi:10.1155/2012/270631
Validation of an ultrasound cardiac output monitor as a bedside tool for pediatric patients

The estimation of cardiac output and by extension systemic vascular resistance with USCOM 1A is reliable against pulmonary artery catheter thermodilution in children with normal cardiac anatomy. Given the non-invasive nature of USCOM 1A, speed of measurement, and relative ease of use, it may be useful as a bedside tool for pediatric patients.

Beltramo F, Menteer J, Razavi A, Khemani RG, Szmuszkovicz J, Newth CJL, Ross PA

Pediatr Cardiol. 2016 Jan;37(1):177-83. doi: 10.1007/s00246-015-1261-y

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