Document Detail


Assessment of cardiac output, intravascular volume status, and extravascular lung water by transpulmonary indicator dilution in critically ill neonates and infants.
MedLine Citation:
PMID:  12407612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess cardiac output, intrathoracic blood volume, global end-diastolic volume, and extravascular lung water in critically ill neonates and small infants using transpulmonary indicator dilution. DESIGN: Prospective, observational, clinical study. SETTING: Pediatric intensive care unit in a university hospital. PARTICIPANTS: Critically ill neonates and small infants suffering from severe heart failure, respiratory failure, or sepsis (n = 10). INTERVENTIONS: A total of 194 transpulmonary indicator dilution measurements were done. Global end-diastolic volume, intrathoracic blood volume, and stroke volume were measured and compared with standard hemodynamic parameters during the clinical course and before and after volume loading (16 +/- 3.7 mL/kg of 10% albumin solution) in 8 of 10 patients. MEASUREMENTS AND MAIN RESULTS: A positive correlation was found for stroke volume index versus global end-diastolic volume (r = 0.76, p < 0.001) and intrathoracic blood volume (r = 0.56, p < 0.001). In contrast, no correlation was observed for stroke volume index versus central venous pressure. Volume loading resulted in significant increases in stroke volume index (p < 0.01), global end-diastolic volume (p < 0.01), and intrathoracic blood volume (p < 0.01); whereas central venous pressure, heart rate, mean arterial pressure, and extravascular lung water remained unchanged. CONCLUSION: Transpulmonary indicator dilution enables measurement of cardiac output and intravascular volume status in critically ill neonates and infants at the bedside. The effects of volume loading on cardiac preload and effective change in stroke volume can be monitored by this technique, whereas central venous pressure was not indicative of changes in intravascular volume status.
Authors:
Holger Schiffmann; Bernhard Erdlenbruch; Dominique Singer; Sybille Singer; Egbert Herting; Andreas Hoeft; Wolfgang Buhre
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  16     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-10-30     Completed Date:  2003-01-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-7     Citation Subset:  IM    
Copyright Information:
Copyright 2002, Elsevier Science (USA). All rights reserved.
Affiliation:
Department of Pediatrics, University of Göttingen, Göttingen, Germany. schiffi@med.uni-goettingen.de
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MeSH Terms
Descriptor/Qualifier:
Blood Volume
Cardiac Output*
Critical Illness
Diastole
Extravascular Lung Water*
Humans
Indicator Dilution Techniques*
Infant
Prospective Studies
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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