Vigilance 2

Manufactured by Edwards Lifesciences

Sourced in United States, Japan

The Vigilance II is a continuous cardiac output and mixed venous oxygen saturation monitoring system. It provides healthcare professionals with real-time data on a patient's hemodynamic status.

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Lab products found in correlation

Truwave, by Edwards Lifesciences (3 mentions) Monitor life scope tr, by Nihon Kohden (3 mentions) Invos, by Medtronic (2 mentions) Swan ganz ccombov, by Edwards Lifesciences (2 mentions) Gem premier 3000, by Werfen (1 mentions) 7.5 fr swan ganz thermodilution catheter, by Edwards Lifesciences (1 mentions) Invos cerebral somatic oximeter, by Medtronic (1 mentions) Dhf 105cx, by Hitachi (1 mentions) Sc9000, by Siemens (1 mentions)

18 protocols using vigilance 2

NIRS and Cardiac Output Monitoring

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NIRS probes (Foresight Elite Tissue Oximetry, Edwards Lifesciences, Irvine, CA) were placed on the skin overlying distal left thoracic limb muscle compartment prior to start of experimentation and confirmed to be reading a signal prior to initiation of experimentation. NIRS data were recorded at a frequency of 0.5 Hz (CAS Medical System, Branford, CT).
An 8-Fr 110-cm Swan-Ganz CCOmbo catheter (Edwards Lifesciences, Irvine, CA) was advanced via the right 9-Fr external jugular sheath and was confirmed to be positioned appropriately based on distal pressure interpretation. Continuous cardiac output (CCO), continuous mixed central venous oxygen saturation (Svo₂), and signal quality index (SQI) were recorded at a frequency of 0.5 Hz (Vigilance II, Edwards Lifesciences, Irvine, CA). An SQI of 1 or 2 was required for inclusion into analysis.

Patel N.T., Templeton T.W., Lane M.R., Williams T.K., Neff L.P, & Goenaga-Diaz E.J. (2022). Near-Infrared Spectroscopy for Determination of Cardiac Output Augmentation in a Swine Model of Ischemia-Reperfusion Injury. Critical Care Explorations, 4(8), e0749.

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Invasive Hemodynamic Monitoring in Animals

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Arterial pressure was measured using standard invasive methods with fluid-filled pressure transducers (Truwave, Edwards Lifesciences LLC, USA) through a pigtail catheter inserted into the aortic arch. A Swan-Ganz catheter was inserted via the femoral vein into the pulmonary artery. Electrocardiographic parameters, HR, invasive blood pressures (aortic arch and central vein), pulse oximetry, capnometry, and invasive central venous SpO₂ were continuously monitored in all animals (Monitor Life Scope TR, Nihon Kohden, Japan; and Vigilance II, Edwards Lifesciences, USA). Four-channel NIRS oximetry (brain, upper [front] limb, body, lower [hind] limb; INVOS, Medtronic, USA) was used to monitor tissue perfusion; the threshold for the detection of hypoperfusion was 40%.

Ostadal P., Mlcek M., Gorhan H., Simundic I., Strunina S., Hrachovina M., Krüger A., Vondrakova D., Janotka M., Hala P., Mates M., Ostadal M., Leiter J.C., Kittnar O, & Neuzil P. (2018). Electrocardiogram-synchronized pulsatile extracorporeal life support preserves left ventricular function and coronary flow in a porcine model of cardiogenic shock. PLoS ONE, 13(4), e0196321.

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Cardiac Output Measurement by Thermodilution

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Cardiac output by TD was measured in triplicate by cold saline injection (Vigilance II, Edwards Lifesciences, Irvine, CA, USA) (3 (link), 13 (link), 14 (link)). At each time point, two to three measurements were performed. Measurements were excluded if they varied >10% from each other, and the mean value was calculated using the remaining measurements.

Duknic M., Lichtblau M., Saxer S., Berlier C., Schneider S.R., Schwarz E.I., Carta A.F., Furian M., Bloch K.E, & Ulrich S. (2021). Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension. Frontiers in Medicine, 8, 776956.

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Hemodynamic and Respiratory Monitoring in Cardiac Surgery

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Hemodynamic parameters (HR, MAP, CVP, mean pulmonary artery pressure, and pulmonary capillary wedge pressure) were continuously monitored with PiCCO2 (PULSION Medical Systems, Germany) and Vigilance II (Edwards Lifesciences, USA). CI, global end-diastolic volume index (GEDVI), ELWI and PVPI measurements were obtained by triplicate central venous injections of 20 ml of iced (<8°C) 0.9% NaCl (saline) and recorded as the mean of the 3 measurements. These parameters were monitored with thermodilution at the following time points: before skin incision (T(−1)); at sternum closing (T0); and 4 h (T4), 8 h (T8), 12 h (T12), and 24 h (T24) after the operation. Respiratory mechanics parameters, including static lung compliance (Cst), plateau airway pressure (Pplat), and airway resistance (Raw), were recorded using Engstrom Carestation software (GE Healthcare, USA) at T(−1), T0, T4, and T8. Arterial gas was monitored with GEM Premier 3000 (Instrumentation Laboratory, USA), and PaO2/FiO2 was calculated. The CPB time, aortic clamping time, ventilation support time, ICU length of stay, postoperative hospitalization time, thoracic drainage volume, and blood transfusion volume were also recorded.

Li W., Xue Q., Liu K., Hong J., Xu J., Wu L., Ji G., Wang Z, & Zhang Y. (2016). Effects of MIAVS on Early Postoperative ELWI and Respiratory Mechanics. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 22, 1085-1092.

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Pulmonary Hemodynamics Assessment Protocol

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RHC was performed with Swan-Ganz catheter (Edwards 774,7.5F) and monitoring system (Edwards Lifesciences LLC, Vigilance II). All measurements were performed in supine position. Hemodynamic parameters included right atrial pressure (RAP), pulmonary artery pressure (PAP) and pulmonary artery wedge pressure (PAWP). Cardiac output (CO) were assessed using the Fick’s method before TCC or continuous thermodilution method during follow-up. Arterial blood gases and mixed venous oxygen generation (SvO₂) were also measured. Pulmonary to systemic flow ratio (Qp/Qs), PVR and systemic vascular resistance (SVR) were calculated using standard formulas. All measurements were made in a stable baseline condition without oxygen for 2 h at least.
Acute vasodilator testing was then performed with oxygen. Standardized oxygen was provided via standard commercial equipment at a flow rate of 8 L/min, achieving an oxygen saturation of 100% in every patient. Oxygen was applied at least 10 min. Hemodynamic parameters, particularly Qp/Qs, were again recorded. Qp/Qs > 1.5 after inhalation of 100% oxygen was defined as an absolute cutoff value to screen the candidates for our study.

Xu J., Wang L., Shen Y., Geng L, & Chen F. (2020). Transcatheter closure for patent ductus arteriosus in patients with Eisenmenger syndrome: to do or not?. BMC Cardiovascular Disorders, 20, 505.

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Invasive Cardiac Hemodynamic Assessment

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A 7.5‐Fr Swan‐Ganz thermodilution catheter (model 774F75; Edwards Lifesciences) was advanced via the right jugular vein into the pulmonary artery wedge position. Cardiac output was measured using the thermodilution method (Vigilance II; Edwards Lifesciences). In patients with atrial fibrillation, at least five cardiac cycles were used to assess mPAP and mPAWP. Derived hemodynamic variables were calculated by standard formulas.

Yu W., Dujiang X., Yi W., Guanwen D., Mengyu Z., Chang P., Aikai Z., Juan Z., Linlin Z, & Hang Z. (2022). Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure. Pulmonary Circulation, 12(3), e12096.

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Invasive Hemodynamic Monitoring in Anesthesia

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In accordance with standard protocol at our institution,^{[13 (link),14 (link)]} we performed routine monitoring using electrocardiography, noninvasive blood pressure monitoring, pulse oximetry, and end-tidal capnography. Anesthesia was maintained with continuous infusions of fentanyl and vecuronium under 1 to 1.5 vol% sevoflurane in a 50% O₂/air mixture. We monitored direct arterial blood pressure by radial artery catheterization. The pulmonary artery catheterization (7.5 French, Swan-Ganz Ccombo V; Edwards Lifesciences, Irvine, CA) was performed via central venous access (9 French, MAC; Arrow International Inc., Reading, Pennsylvania) and connected to a Vigilance device (Vigilance II; Edwards Lifesciences, Irvine, CA).

Kim W.J., Kim J.W., Moon Y.J., Kim S.H., Hwang G.S, & Shin W.J. (2017). The photoplethysmographic amplitude to pulse pressure ratio can track sudden changes in vascular compliance and resistance during liver graft reperfusion: A beat-to-beat analysis. Medicine, 96(22), e7045.

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Invasive Hemodynamic Monitoring Protocol

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Arterial pressure was measured using standard invasive methods with pressure transducers (Truwave, Edwards Lifesciences, LLC, USA) through a pigtail catheter inserted into the aortic arch. A Swan–Ganz catheter was introduced via a femoral vein to the pulmonary artery and pulmonary cardiac output (_PCO) was measured at the end of each level of EBF. Electrocardiography, heart rate (HR), invasive blood pressures (aortic arch and jugular vein), pulse oximetry, capnometry and invasive central venous oxygen saturation were continuously monitored in all animals (Monitor Life Scope TR, Nihon Kohden, Japan; and Vigilance II, Edwards Lifesciences, USA). Brain oxygenation levels were measured using near-infrared spectroscopy (INVOS Cerebral/Somatic Oximeter, Somanetics, USA).

Ostadal P., Mlcek M., Kruger A., Hala P., Lacko S., Mates M., Vondrakova D., Svoboda T., Hrachovina M., Janotka M., Psotova H., Strunina S., Kittnar O, & Neuzil P. (2015). Increasing venoarterial extracorporeal membrane oxygenation flow negatively affects left ventricular performance in a porcine model of cardiogenic shock. Journal of Translational Medicine, 13, 266.

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Comprehensive Cardiovascular Monitoring Protocol

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A non-invasive monitoring of heart rate, blood oxygen saturation, and EKG was continuously performed. Invasive SBP, diastolic blood pressure (DBP), and MBP were monitored by using an arterial catheter. A Swan-Ganz catheter monitored pulmonary artery pressure (systolic pulmonary artery pressure [sPAP]), mean pulmonary artery pressure [mPAP], diastolic pulmonary artery pressure [dPAP], PCWP, and CO using the thermodilution approach (Vigilance II, Edwards®).
Lower limb perfusion was clinically assessed (heat, cutaneous coloration time) and a continuously transcutaneous pressure in oxygen (TcPO₂) monitoring was also used (TCM 400-2, Radiometer SAS®, France) during experiments.
Respiratory (arterial and venous blood gases) and renal (creatinine, kaliemia, natremia, and chloremia) functions, systemic and distal limb perfusion (lactate), and hemostase (TQ, aPTT) were repeatedly monitored by a relocated biology monitor (EPOC, CoagPoc, EDGE®). Other biological samples were frozen to realized specific post-hoc analysis (LDH and troponin).

Delmas C., Porterie J., Jourdan G., Lezoualc'h F., Arnaud R., Brun S., Cavalerie H., Blanc G., Marcheix B., Lairez O., Verwaerde P, & Mialet-Perez J. (2022). Effectiveness and Safety of a Prolonged Hemodynamic Support by the IVAC2L System in Healthy and Cardiogenic Shock Pigs. Frontiers in Cardiovascular Medicine, 9, 809143.

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Continuous Hemodynamic Monitoring Post-Op

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The cardiac output (CO, in liters/minute), the mixed venous saturation (SvO2, in %), the central venous pressure (CVP, in mmHg), and the systolic pulmonal arterial pressure (sysPAP, in mmHg) were obtained from the routinely utilized continuous-cardiac-output (CCO) Swan-Ganz Catheter (Edwards Vigilance II®) during the first 3 postoperative days. The daily maximum values of CO and SvO2 and the daily minimum values of CVP and sysPAP were collected.

Opfermann P., Simader E., Felli A., Bevilacqua M., Holaubek C., Dworschak M., Mouhieddine M., Zimpfer D., Ankersmit J.H, & Steinlechner B. (2020). Early sST2 Liberation after Implantation of a Left Ventricular Assist Device in Patients with Advanced Heart Failure. Journal of Immunology Research, 2020, 5826176.

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