Comparison of cardiac output measured by oesophageal Doppler ultrasonography or pulse pressure contour wave analysis.

BACKGROUND: Maintaining adequate organ perfusion during high-risk surgery requires continuous monitoring of cardiac output to optimise haemodynamics. Oesophageal Doppler Cardiac Output monitoring (DCO) is commonly used in this context, but has some limitations. Recently, the cardiac output estimated by pulse pressure analysis- (PPCO) was developed. This study evaluated the agreement of cardiac output variations estimated with 9 non-commercial algorithms of PPCO compared with those obtained with DCO. METHODS: High-risk patients undergoing neurosurgery were monitored with invasive blood pressure and DCO. For each patient, 9 PPCO algorithms and DCO were recorded before and at the peak effect for every haemodynamic challenge. RESULTS: Sixty-two subjects were enrolled; 284 events were recorded, including 134 volume expansions and 150 vasopressor boluses. Among the 9 algorithms tested, the Liljestrand-Zander model led to the smallest bias (0.03 litre min(-1) [-1.31, +1.38] (0.21 litre min(-1) [-1.13; 1.54] after volume expansion and -0.13 litre min(-1) [-1.41, 1.15] after vasopressor use). The corresponding percentage of the concordance was 91% (86% after volume expansion and 94% after vasopressor use). The other algorithms, especially those using the Winkessel concept and the area under the pressure wave, were profoundly affected by the vasopressor. CONCLUSIONS: Among the 9 PPCO algorithms examined, the Liljestrand-Zander model demonstrated the least bias and best limits of agreement, especially after vasopressor use. Using this particular algorithm in association with DCO calibration could represent a valuable option for continuous cardiac output monitoring of high risk patients. CLINICAL TRIAL REGISTRATION: Comité d'éthique de la Société de Réanimation de Langue Française No. 11-356.

Binary and ternary Pt-based clusters grown in a plasma multimagnetron-based gas aggregation source: electrocatalytic evaluation towards glycerol oxidation.

Platinum (Pt), platinum-bismuth (PtBi), platinum-copper (PtCu) and platinum-bismuth-copper (PtCuBi) clusters were grown in a gas aggregation source (GAS) equipped with three in-plane plasma magnetrons located in a single region of the gas aggregation zone. The X-ray diffraction results have shown that PtCu clusters form alloys as the decrease of the lattice parameter occurs when the Cu atomic content increases. PtBi clusters do not form alloys, but the presence of secondary Bi oxide phases was detected. Scanning transmission electron microscope mapping images revealed that simultaneously adding Bi and Cu to Pt leads to PtCu alloyed clusters decorated with Bi or CuBi species on the surface. The electrochemical results indicated that the shell might be composed of a metastable CuBi phase. Electrochemical measurements have shown that the addition of Bi or Cu to the Pt clusters enhances the catalytic activity for glycerol oxidation by decreasing the oxidation onset potential.