Hemodynamic testing described

A report from the Mayo Clinic has described 27 elderly patients (mean age 71 years) with aortic stenosis in whom dobutamine stress hemodynamic testing was used to assess the severity of the stenosis (12). There were no severe adverse effects, but relatively minor problems occurred in 16 patients, including chest pain and ventricular extra beats (n = 9 each) and atrial dysrhythmias (n — 4). The authors concluded that the procedure appears to be safe in these high-risk patients, although its diagnostic value may be limited. 

CRITICAL ASSESSMENT OF THE METHOD Breddin (1989) described the Wessler model because of its static character as the retransformation of an in vitro experiment into a very artificial test situation. One of the major drawbacks is the relative independence of platelet function and hemodynamic changes that largely influence thrombus formation in vivo. However, the model has been shown to be very useful for evaluation of the antithrombotic effect of compounds like heparin and hirudin. 

System improvements may improve the quality of prescribing by standardizing to an expert level. Morris (51) described the development, testing, and use of computerized protocols for management of intravenous fluid and hemodynamic factors in patients with acute respiratory distress syndrome. Evans et al. (52) used a computerized anti-infectives management... 

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