Monitoring Complete Cardiac Function at the Bedside
June 25, 2012
Cardiac function and fluid volume status are essential components in the care and management of critically ill patients. A new device is allowing surgeons at Thomas Jefferson University Hospital to monitor patients’ complete cardiac function at the bedside for the first time.
The new tool, a first-of-its-kind medical device allows physicians to view in real time the movement of blood and the amount of pressure in the veins, arteries and chambers of the heart and react quickly to any hemodynamic instabilities (compromised blood movement).
“Patients post open heart surgery, heart transplant, LVAD (left ventricular assist device) implant, or coming off ECMO (extracorporeal membrane oxygenation) may require multiple cardiac support medications,” says Nicholas Cavarocchi, MD, Professor of Surgery at Jefferson Medical College and Critical Care Director, Surgical Intensive Care Unit at Thomas Jefferson University Hospital.
“Weaning them off these medications can be a delicate dance in simultaneously assessing cardiac function, post-anesthesia recovery and managing pain levels. Currently, with standard monitoring devices, we are able to measure the filling pressure and implied function of the heart, but not its actual function in minute-to-minute real time. This new device helps us make better, more informed decisions and is a safer, more effective means of assessment,” says Dr. Cavarocchi.
The specialized probe, a hemodynamic transesophageal echocardiography (hTEE™) device, is inserted into the patient’s esophagus to visualize the cardiac chambers and allow for hemodynamic management—the continuous monitoring of the movement of blood and pressure in the veins, arteries and chambers of heart—for up to 72 hours. The probe captures images and sends them to a screen in the patient’s room to monitor his or her response to fluid interventions and to help determine or re-direct the best course of treatment over an extended period of time.
Dr. Cavarocchi and the Surgical Coronary Care Unit team at Jefferson are some of the most prolific users of the hTEE device. They recently presented research at both the International Society of Heart and Lung Transplant in Prague and the American Society for Artificial Internal Organs in San Francisco on the use of the device in a large series of post open heart, heart transplant, ECMO and ventricular assist device patients. Their retrospective review of mechanical circulatory support (MCS) patients and post heart transplant patients who received hTEE monitoring found the device to be “an invaluable new adjunct in the ICU by allowing previously unobtainable continuous real time monitoring of MCS /ECMO/ heart transplant hemodynamics.
The technology provides accurate data in an easy and rapid manner and allows physicians to safely and easily visualize cardiac size and function of high-risk patients and integrate ultrasound capabilities into the critical care setting. “It is an improvement in patient care that is truly changing how we practice,” adds Dr. Cavarocchi.
Media Only Contact:
Jefferson University Hospitals