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NICaS parameters

Understanding of NICaS Parameters

 

Common Patient Signs and Symptoms Associated with Abnormal NICaS® Parameters

Parameter
High Low
CO / CI Fever, Diaphoretic, Septic Syndrome Dyspnea (difficulty breathing); decreased exercise tolerance; shock; decreased urine output
SVR / SVRI Cold extremities, High Mean Arterial Pressure (MAP), blue finger and toe nail beds Low MAP, warm extremities
TBW In CHF Patients: Dyspnea, Edema, increased body weight, Paroxysmal Nocturnal Dyspnea (PND), Orthopnea (patient must sit up to breathe) Excessive thirst; dehydration

 

 Commonly Used Cardiovascular Medications

Parameter
Increase Parameter Decrease Parameter
Heart Rate Atropine; pacemaker; positive inotropic agents, Beta Blocker: Carvedilol (COREG), Propranolol (Inderal), Atenolol (Tenormin), Metoprolol Tartrate (Lopressor)
SV / SI Positive Inotropes: Dobutamine (Dobutrex), Milrinone (Primacor), Dopamine (Intropin), Amrinone (Inocor), Digitalis (Digoxin); Vasodilators (ACE Inhibitors) Beta-Blocker: Carvedilol (COREG), Propranolol (Inderal), Atenolol (Tenormin), Metoprolol Tartrate (Lopressor).
CO / CI Positive Inotropes: Dobutamine (Dobutrex), Milrinone (Primacor), Dopamine (Intropin), Amrinone (Inocor), Digitalis (Digoxin) Beta-Blocker: Carvedilol (COREG), Propranolol (Inderal), Atenolol (Tenormin), Metoprolol Tartrate (Lopressor).
CPI CI:  Positive Inotropes: Dobutamine (Dobutrex), Milrinone (Primacor), Dopamine (Intropin), Amrinone (Inocor), Digitalis (Digoxin)MAP:  Positive Inotropes and Vasopressors CI:  Beta-Blocker: Carvedilol (COREG), Propranolol (Inderal), Atenolol (Tenormin), Metoprolol Tartrate (Lopressor).MAP:  ACE Inhibitors, Beta Blockers, Diuretics
TPR / TPRI Vasopressors: Epinephrine, Norepinephrine, Dopamine ACE Inhibitors:  Captopril (Capoten), Enalapril (Vasotec);Calcium Channel Blockers: Nifedipine (Procardia), Diltiazem (Cardizem), Verapamil (Calan), Hydralazine (Apresoline)
TBW Volume expanders:  Blood; Crystolloids (normal saline and lactated Ringer’s solution); and Colloids (albumin, hetastarch) Diuretics: Furosemide (Lasix), Bumentanide (Bumex), Hydrochlorothiazide (Diuril), Spironolactone (Aldactone)

 

NICaS Parameters

Parameter   Definition Normal Range Derivation/Formula
Heart Rate HR Number of heart beats each minute 60 – 90 bpm (beats per minute) Measurement of the R-R interval on the ECG
Stroke Volume SV Amount of blood pumped by the left ventricle each heartbeat 60 – 130 ml  SV ~ ∆R / R
Stroke Index SI Stroke volume normalized for body surface area 35 – 65 ml/m2
Cardiac Output CO Amount of blood pumped by the left ventricle each minute 4.0 – 8.0 l/min
Cardiac Index CI Cardiac Output normalized for body surface area 2.5 – 4.0 l/min/m2  CI = CO / BSA
Cardiac Power Index (1) CPI An indicator of myocardial contractility 0.45 – 0.85 w/m2  CPI = CI x MAP x 0.0022
Granov Goor Index (2) GGI An indicator of Left Ventricular Function, which is strongly related to Ejection Fraction > 10.0 (equals to Ejection Fraction > 55%)  GGI = ∆R/R x α x HR
Total Peripheral Resistance TPR The resistance to the flow of blood in the arterial system (“Afterload”) 770 – 1500 dynes x sec /cm5
Total Peripheral Resistance Index TPRI The resistance to the flow of blood in the arterial system normalized for body surface area 1600 – 3000 dynes x sec /cm5 x m2
Total Body Water (3) TBW The amount of extracellular fluid in % or kilograms Individually calculated (Range 40 – 63%)  TBW ~ Ht2 / R
Respiration Rate RR Number of breaths each minute 8 – 24 breaths / minute

 

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