Use of Non Invasive Hemodynamic Cardiovascular Monitoring to Evaluate Emergency Department Patients

Henry Ford Health

Status: Completed

Conditions: Stroke; Trauma; COPD; Sepsis; Congestive Heart Failure

Treatments: Device: NexfinHD Monitor

Study type: Observational

Funder types: Other

Identifiers

NCT00851214

HFH DEM 001

Details and patient eligibility

About

This study is an observational prospective pilot trial that utilizes finger cuff non invasive hemodynamic monitoring (NexfinHD Monitor) to assess 4 different groups (CHF/COPD, Trauma, Sepsis, Stroke) of patients on arrival to the Emergency Department and to document the changes seen in these hemodynamics with acute therapies.

Full description

There has been little very early (after Emergency Department presentation) hemodynamic monitoring of acutely ill or injured patients secondary to the lack of non invasive technologies that could be reliably applied to this patient population.Thus all assessments of hemodynamics have been made by physicians on clinical information including intermittent pulse and blood pressure measurements. It is not known what the underlying continuous cardiac output, systemic vascular resistance, etc are in these patients and how these change with current Emergency Medicine therapeutic interventions. Currently there is available a finger cuff devise (NexfinHD Monitor, BMEYE, Amsterdam) that can measure these hemodynamics on a beat to beat basis and that can be easily applied to acutely ill individuals. This prospective pilot study of 48 patients (4 groups of 12 each) will document the hemodynamics of patients on arrival and continuously for 2 hours, blinded to the treating physician. Treating physicians will be asked to estimate these hemodynamic parameters at various time points. The study will characterize the hemodynamics of patients, compare them to the estimates of treating physicians and determine whether they predict the need for life saving interventions.

Enrollment: 40 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with acute CHF/COPD (n=12)
• Patients with acute trauma and a trauma ISS>15 (n=12)
• Patients with acute sepsis (n=12)
• Patients with acute stroke (n=12)

Exclusion criteria

• Patients in cardiopulmonary arrest
• patients with STEMI
• Patients with known peripheral vascular disease
• Pregnant patients
• Age<18
• Excessively agitated patients
• Interference with current standard of acre

Trial design

40 participants in 4 patient groups

Acute CHF/COPD

Description:

Patients presenting with shortness of breath secondary to acute exacerbation of CHF/COPD

Treatment:

Device: NexfinHD Monitor

Acute Trauma

Description:

Acute trauma patients with a trauma ISS>15

Treatment:

Device: NexfinHD Monitor

Sepsis

Description:

Patients presenting with a suspicion of acute sepsis (fever, tachycardia, tachypnea)

Treatment:

Device: NexfinHD Monitor

Stroke

Description:

Patients presenting with symptoms and signs of acute stroke (thrombotic or hemorrhagic)

Treatment:

Device: NexfinHD Monitor