Retia Medical, LLC articles

Background

Esophagectomy for cancer involves two- or three-phase procedures, such as abdominal, chest and/or neck incisions, is more invasive than other types of gastrointestinal surgery, and is associated with high risk for postoperative morbidity. Because of this risk, perioperative management of circulatory conditions such as hypovolemic hypotension is especially important to avoid postoperative heart complications, anastomotic leak, and conduit necrosis. The addit

MAP and HR was maintained within normal threshold throughout most of the case. The patient had a SVR >1200 dynes for more than 88% of the case indicating physiological or drug-induced vasoconstriction. Argos provided data that consistently showed the subtle changes in hemodynamics helping to inform decisions for a more targeted therapy.

Protamine is a standard therapy during CABG surgery and hemodynamic responses (i.e., small decreases in systemic blood pressure) to protamine are common. Argos followed a change in HR from 90 to 70, which coincided with an increase in SVR following protamine administration. To maintain a low MAP per the surgeon`s request, Argos shows a trend of decreasing SVR coincident with a decreasing MAP, following the administration of IV nitroglycerin which is used primarily as a vasodilator.

In response to a below-threshold MAP, two vasopressor boluses were administered. The first dose (not shown) was administered 4 minutes prior to the second bolus. Argos shows the dose response (vasoconstriction) through an increased SVR.  Coinciding with an increased SVR, Argos shows a similar trend of increasing MAP.

A head-to-head comparison shows that the Retia Argos Monitor accurately tracks changes in CO as the vena cava is clamped and unclamped during liver surgery, while the leading competitor monitor fails. As shown, the Argos Monitor tracks with the reference standard, while the competitor monitor shows increasing CO when the vena cava is clamped and CO is actually decreasing (205 – 210 minutes), and shows decreasing CO when the vena cava is unclamped and CO is actually increasing (250 &ndas