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Crimmins-Pierce LD, Bonvillain GP, Henry KR, Hayat MA, Villafranca AA, Stephens SE, Jensen HK, Sanford JA, Wu J, Sexton KW, Jensen MO. Critical Information from High Fidelity Arterial and Venous Pressure Waveforms During Anesthesia and Hemorrhage. Cardiovasc Eng Technol 2022; 13:886-898. [PMID: 35545752 DOI: 10.1007/s13239-022-00624-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/08/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE Peripheral venous pressure (PVP) waveform analysis is a novel, minimally invasive, and inexpensive method of measuring intravascular volume changes. A porcine cohort was studied to determine how venous and arterial pressure waveforms change due to inhaled and infused anesthetics and acute hemorrhage. METHODS Venous and arterial pressure waveforms were continuously collected, while each pig was under general anesthesia, by inserting Millar catheters into a neighboring peripheral artery and vein. The anesthetic was varied from inhaled to infused, then the pig underwent a controlled hemorrhage. Pearson correlation coefficients between the power of the venous and arterial pressure waveforms at each pig's heart rate frequency were calculated for each variation in the anesthetic, as well as before and after hemorrhage. An analysis of variance (ANOVA) test was computed to determine the significance in changes of the venous pressure waveform means caused by each variation. RESULTS The Pearson correlation coefficients between venous and arterial waveforms decreased as anesthetic dosage increased. In an opposing fashion, the correlation coefficients increased as hemorrhage occurred. CONCLUSION Anesthetics and hemorrhage alter venous pressure waveforms in distinctly different ways, making it critical for researchers and clinicians to consider these confounding variables when utilizing pressure waveforms. Further work needs to be done to determine how best to integrate PVP waveforms into clinical decision-making.
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Affiliation(s)
| | - Gabriel P Bonvillain
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Kaylee R Henry
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Md Abul Hayat
- Department of Electrical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Adria Abella Villafranca
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sam E Stephens
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Hanna K Jensen
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joseph A Sanford
- Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Institute for Digital Health and Innovation, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jingxian Wu
- Department of Electrical Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Kevin W Sexton
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Institute for Digital Health and Innovation, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Morten O Jensen
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA.
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Zheng J, Abudayyeh I, Mladenov G, Struppa D, Fu G, Chu H, Rakovski C. An artificial intelligence-based noninvasive solution to estimate pulmonary artery pressure. Front Cardiovasc Med 2022; 9:855356. [PMID: 36093166 PMCID: PMC9448961 DOI: 10.3389/fcvm.2022.855356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Aims Design to develop an artificial intelligence (AI) algorithm to accurately predict the pulmonary artery pressure (PAP) waveform using non-invasive signal inputs. Methods and results We randomly sampled training, validation, and testing datasets from a waveform database containing 180 patients with pulmonary atrial catheters (PACs) placed for PAP waves collection. The waveform database consisted of six hemodynamic parameters from bedside monitoring machines, including PAP, artery blood pressure (ABP), central venous pressure (CVP), respiration waveform (RESP), photoplethysmogram (PPG), and electrocardiogram (ECG). We trained a Residual Convolutional Network using a training dataset containing 144 (80%) patients, tuned learning parameters using a validation set including 18 (10%) patients, and tested the performance of the method using 18 (10%) patients, respectively. After comparing all multi-stage algorithms on the testing cohort, the combination of the residual neural network model and wavelet scattering transform data preprocessing method attained the highest coefficient of determination R2 of 90.78% as well as the following other performance metrics and corresponding 95% confidence intervals (CIs): mean square error of 11.55 (10.22–13.5), mean absolute error of 2.42 (2.06–2.85), mean absolute percentage error of 0.91 (0.76–1.13), and explained variance score of 90.87 (85.32–93.31). Conclusion The proposed analytical approach that combines data preprocessing, sampling method, and AI algorithm can precisely predict PAP waveform using three input signals obtained by noninvasive approaches.
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Affiliation(s)
- Jianwei Zheng
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
- *Correspondence: Jianwei Zheng,
| | - Islam Abudayyeh
- Department of Cardiology, Loma Linda University Health, Loma Linda, CA, United States
| | - Georgi Mladenov
- Department of Cardiology, Loma Linda University Health, Loma Linda, CA, United States
| | - Daniele Struppa
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
| | - Guohua Fu
- Arrhythmia Center, Ningbo First Hospital, Zhejiang University, Ningbo, China
| | - Huimin Chu
- Arrhythmia Center, Ningbo First Hospital, Zhejiang University, Ningbo, China
| | - Cyril Rakovski
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
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Rali AS, Butcher A, Tedford RJ, Sinha SS, Mekki P, Van Spall HGC, Sauer AJ. Contemporary Review of Hemodynamic Monitoring in the Critical Care Setting. US CARDIOLOGY REVIEW 2022. [DOI: 10.15420/usc.2021.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hemodynamic assessment remains the most valuable adjunct to physical examination and laboratory assessment in the diagnosis and management of shock. Through the years, multiple modalities to measure and trend hemodynamic indices have evolved with varying degrees of invasiveness. Pulmonary artery catheter (PAC) has long been considered the gold standard of hemodynamic assessment in critically ill patients and in recent years has been shown to improve clinical outcomes among patients in cardiogenic shock. The invasive nature of PAC is often cited as its major limitation and has encouraged development of less invasive technologies. In this review, the authors summarize the literature on the mechanism and validation of several minimally invasive and noninvasive modalities available in the contemporary intensive care unit. They also provide an update on the use of focused bedside echocardiography.
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Affiliation(s)
- Aniket S Rali
- Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Amy Butcher
- Department of Cardiovascular Anesthesia and Critical Care, Baylor College of Medicine, Houston, TX
| | - Ryan J Tedford
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Shashank S Sinha
- Division of Cardiology, Inova Heart and Vascular Institute, Inova Fairfax Medical Campus, Falls Church, VA
| | - Pakinam Mekki
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Harriette GC Van Spall
- Department of Medicine, Department of Health Research Methods, Evidence, and Impact, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Andrew J Sauer
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS
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Polcz M, Huston J, Breed M, Case M, Leisy P, Schmeckpeper J, Vaughn L, Sobey JH, Brophy C, Lindenfeld J, Hocking K, Alvis B. Comparison of clinical symptoms and bioimpedance to pulmonary capillary wedge pressure in heart failure. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 15:100133. [PMID: 35600671 PMCID: PMC9119644 DOI: 10.1016/j.ahjo.2022.100133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/03/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022]
Abstract
Introduction Clinical symptoms of heart failure commonly include fatigue, edema, and shortness of breath. Unfortunately, clinical monitoring has proven unreliable in predicting congestion and the need for hospitalization. Biosensing wearables have been developed as a potential adjunct to clinical signs and symptoms to detect congestion before it becomes severe thus preventing a heart failure hospitalization. Hypothesis Clinical signs and symptoms of heart failure will correlate with thoracic bioimpedance measurements (ZOE®) and pulmonary capillary wedge pressure (PCWP). Methods One hundred and fifty-five subjects undergoing right heart catheterization (RHC) were prospectively enrolled. A Zo value (ohms) was obtained, jugular venous pressure (JVP) was estimated, edema graded, and shortness of breath (SOB) assessed in all subjects. RHC was performed by a scheduled cardiologist per routine. One-way ANOVA was performed to assess the relationship between variables. A Pearson correlation coefficient was used to compare the Zo value and PCWP. Results Neither estimated JVP (cmH2O) (p = 0.65, n = 110) nor edema scores (p = 0.12, n = 110) demonstrated a significant relationship to PCWP. The presence of subjective SOB also did not demonstrate a significant association with PCWP (p = 0.99, n = 110). There was no correlation between ZOE® and PCWP (r = -0.08, p = 0.56, n = 56). Conclusions These findings support the idea that traditional measures for monitoring heart failure patients are limited.
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Affiliation(s)
- Monica Polcz
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jessica Huston
- Department of Medicine, Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Meghan Breed
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marisa Case
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Philip Leisy
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeffrey Schmeckpeper
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lexie Vaughn
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jenna Helmer Sobey
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colleen Brophy
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - JoAnn Lindenfeld
- Department of Medicine, Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Bret Alvis
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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Respiratory Non-Invasive Venous Waveform Analysis for Assessment of Respiratory Distress in Coronavirus Disease 2019 Patients: An Observational Study. Crit Care Explor 2021; 3:e0539. [PMID: 34617035 PMCID: PMC8489896 DOI: 10.1097/cce.0000000000000539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is available in the text. Due to the rapid rate of severe acute respiratory syndrome coronavirus 2 transmission and the heterogeneity of symptoms of coronavirus disease 2019, expeditious and effective triage is critical for early treatment and effective allocation of hospital resources.
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Chang D, Leisy PJ, Sobey JH, Reddy SK, Brophy C, Alvis BD, Hocking K, Polcz M. Physiology and clinical utility of the peripheral venous waveform. JRSM Cardiovasc Dis 2020; 9:2048004020970038. [PMID: 33194174 PMCID: PMC7605016 DOI: 10.1177/2048004020970038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 12/19/2022] Open
Abstract
The peripheral venous system serves as a volume reservoir due to its high compliance and can yield information on intravascular volume status. Peripheral venous waveforms can be captured by direct transduction through a peripheral catheter, non-invasive piezoelectric transduction, or gleaned from other waveforms such as the plethysmograph. Older analysis techniques relied upon pressure waveforms such as peripheral venous pressure and central venous pressure as a means of evaluating fluid responsiveness. Newer peripheral venous waveform analysis techniques exist in both the time and frequency domains, and have been applied to various clinical scenarios including hypovolemia (i.e. hemorrhage, dehydration) and volume overload.
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Affiliation(s)
- Devin Chang
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Philip J Leisy
- Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, Nashville TN, USA
| | - Jenna H Sobey
- Department of Anesthesiology, Division of Pediatric Anesthesiology, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville TN, USA
| | - Srijaya K Reddy
- Department of Anesthesiology, Division of Pediatric Anesthesiology, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville TN, USA
| | - Colleen Brophy
- Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville TN, USA
| | - Bret D Alvis
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Monica Polcz
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Polcz M, Hocking KM, Chang D, Leisy P, Sobey JH, Huston J, Eagle S, Brophy C, Alvis BD. A brief report on the effects of vasoactive agents on peripheral venous waveforms in a porcine model. JRSM Cardiovasc Dis 2020; 9:2048004020940857. [PMID: 32864123 PMCID: PMC7430072 DOI: 10.1177/2048004020940857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/05/2020] [Accepted: 06/17/2020] [Indexed: 01/04/2023] Open
Abstract
Objectives Non-invasive venous waveform analysis (NIVA) is a recently described, novel technique to assess intravascular volume status. Waveforms are captured with a piezoelectric sensor; analysis in the frequency domain allows for calculation of a “NIVA value” that represents volume status. The aim of this report was to determine the effects of vasoactive agents on the venous waveform and calculated NIVA values. Design Porcine experimental model. Setting Operating theatre. Participants A piezoelectric sensor was secured over the surgically exposed saphenous vein in eight anesthetized pigs. Main outcome measures NIVA value, pulmonary capillary wedge pressure (PCWP), and mean arterial pressure prior to and post intravenous administration of 150–180 µg of phenylephrine or 100 µg of sodium nitroprusside. Results Phenylephrine led to a decrease in NIVA value (mean 9.2 vs. 4.6, p < 0.05), while sodium nitroprusside led to an increase in NIVA value (mean 9.5 vs. 11.9, p < 0.05). Mean arterial pressure increased after phenylephrine (p < 0.05) and decreased after sodium nitroprusside (p < 0.05). PCWP did not change significantly after phenylephrine (p = 0.25) or sodium nitroprusside (p = 0.06). Conclusions Vasoactive agents lead to changes in non-invasively obtained venous waveforms in euvolemic pigs, highlighting a potential limitation in the ability to NIVA to estimate static volume in this setting. Further studies are indicated to understand the effects of vasoactive agents in the setting of hypovolemia and hypervolemia.
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Affiliation(s)
- Monica Polcz
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle M Hocking
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Devin Chang
- Department of Bioengineering, Vanderbilt University, Nashville, TN, USA
| | - Philip Leisy
- Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jenna H Sobey
- Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jessica Huston
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Susan Eagle
- Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colleen Brophy
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bret D Alvis
- Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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Non-Invasive Venous waveform Analysis (NIVA) for volume assessment during complex cranial vault reconstruction: A proof-of-concept study in children. PLoS One 2020; 15:e0235933. [PMID: 32640004 PMCID: PMC7343152 DOI: 10.1371/journal.pone.0235933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/24/2020] [Indexed: 12/27/2022] Open
Abstract
Background Non-Invasive Venous waveform Analysis (NIVA) is novel technology that captures and analyzes changes in venous waveforms from a piezoelectric sensor on the wrist for hemodynamic volume assessment. Complex cranial vault reconstruction is performed in children with craniosynostosis and is associated with extensive blood loss, potential life-threatening risks, and significant morbidity. In this preliminary study, we hypothesized that NIVA will provide a reliable, non-invasive, quantitative assessment of intravascular volume changes in children undergoing complex cranial vault reconstruction. Objective To present proof-of-concept results of a novel technology in the pediatric population. Methods The NIVA prototype was placed on each subject’s wrist, and venous waveforms were collected intraoperatively. Estimated blood loss and fluid/blood product administration were recorded in real time. Venous waveforms were analyzed into a NIVA value and then correlated, along with mean arterial pressure (MAP), to volume changes. Concordance was quantified to determine if the direction of change in volume was similar to the direction of change in MAP or change in NIVA. Results Of 18 patients enrolled, 14 had usable venous waveforms, and there was a significant correlation between change in NIVA value and change in volume. Change in MAP did not correlate with change in volume. The concordance between change in MAP and change in volume was less than the concordance between change in NIVA and change in volume. Conclusion NIVA values correlate more closely to intravascular volume changes in pediatric craniofacial patients than MAP. This initial study suggests that NIVA is a potential safe, reliable, non-invasive quantitative method of measuring intravascular volume changes for children undergoing surgery.
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Alvis BD, Polcz M, Miles M, Wright D, Shwetar M, Leisy P, Forbes R, Fissell R, Whitfield J, Eagle S, Brophy C, Hocking K. Non-invasive venous waveform analysis (NIVA) for volume assessment in patients undergoing hemodialysis: an observational study. BMC Nephrol 2020; 21:194. [PMID: 32448178 PMCID: PMC7245891 DOI: 10.1186/s12882-020-01845-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 05/08/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Accurate assessment of volume status to direct dialysis remains a clinical challenge. Despite current attempts at volume-directed dialysis, inadequate dialysis and intradialytic hypotension (IDH) are common occurrences. Peripheral venous waveform analysis has recently been developed as a method to accurately determine intravascular volume status through algorithmic quantification of changes in the waveform that occur at different volume states. A noninvasive method to capture peripheral venous signals is described (Non-Invasive Venous waveform Analysis, NIVA). The objective of this proof-of-concept study was to characterize changes in NIVA signal with dialysis. We hypothesized that there would be a change in signal after dialysis and that the rate of intradialytic change in signal would be predictive of IDH. METHODS Fifty subjects undergoing inpatient hemodialysis were enrolled. A 10-mm piezoelectric sensor was secured to the middle volar aspect of the wrist on the extremity opposite to the access site. Signals were obtained fifteen minutes before, throughout, and up to fifteen minutes after hemodialysis. Waveforms were analyzed after a fast Fourier transformation and identification of the frequencies corresponding to the cardiac rate, with a NIVA value generated based on the weighted powers of these frequencies. RESULTS Adequate quality (signal to noise ratio > 20) signals pre- and post- dialysis were obtained in 38 patients (76%). NIVA values were significantly lower at the end of dialysis compared to pre-dialysis levels (1.203 vs 0.868, p < 0.05, n = 38). Only 16 patients had adequate signals for analysis throughout dialysis, but in this small cohort the rate of change in NIVA value was predictive of IDH with a sensitivity of 80% and specificity of 100%. CONCLUSIONS This observational, proof-of-concept study using a NIVA prototype device suggests that NIVA represents a novel and non-invasive technique that with further development and improvements in signal quality may provide static and continuous measures of volume status to assist with volume directed dialysis and prevent intradialytic hypotension.
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Affiliation(s)
- Bret D. Alvis
- Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, 422 MAB, 1211 21st Ave South, Nashville, TN 37212 USA
| | - Monica Polcz
- Vanderbilt University Medical Center, S111 Medical Center North, 21st Ave South, Medical Art Building 422, Nashville, TN 37212 USA
| | - Merrick Miles
- Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, 422 MAB, 1211 21st Ave South, Nashville, TN 37212 USA
| | - Donald Wright
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN 37232 USA
| | - Mohammad Shwetar
- Vanderbilt University School of Medicine, 1161 21st Ave S # D3300, Nashville, TN 37232 USA
| | - Phil Leisy
- Department of Anesthesiology, Division of Critical Care, Vanderbilt University Medical Center, 422 MAB, 1211 21st Ave South, Nashville, TN 37212 USA
| | - Rachel Forbes
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, 1301 Medical Center Drive, Nashville, TN 37232 USA
| | - Rachel Fissell
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, 1161 21st Ave South, MCN S-3223, Nashville, TN 37232 USA
| | - Jon Whitfield
- Volumetrix, LLC, 2126 21st Ave South, Nashville, TN 37212 USA
| | - Susan Eagle
- Vanderbilt University Medical Center, S111 Medical Center North, 21st Ave South, Medical Art Building 422, Nashville, TN 37212 USA
| | - Colleen Brophy
- Vanderbilt University Medical Center, S111 Medical Center North, 21st Ave South, Medical Art Building 422, Nashville, TN 37212 USA
| | - Kyle Hocking
- Vanderbilt University Medical Center, S111 Medical Center North, 21st Ave South, Medical Art Building 422, Nashville, TN 37212 USA
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Imamura T, Narang N. Further Potential of Noninvasive Venous Waveform Analysis to Estimate Intracardiac Filling Pressure. J Card Fail 2020; 26:95. [DOI: 10.1016/j.cardfail.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 11/25/2022]
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Alvis BD, Huston JH, Lindenfeld J, Hocking KM. Author Response to Imamura and Narang. J Card Fail 2019; 26:96. [PMID: 31765693 DOI: 10.1016/j.cardfail.2019.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Bret D Alvis
- Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee 37212.
| | - Jessica H Huston
- Vanderbilt University Medical Center, Department of Medicine, Nashville, Tennessee 37232
| | - Joann Lindenfeld
- Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Kyle M Hocking
- Vanderbilt University Medical Center, Department of Surgery, Nashville, Tennessee 37212
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