Document Detail

Effects of cardiac output levels on the measurement of transpulmonary thermodilution cardiac output in patients with acute respiratory distress syndrome.
MedLine Citation:
PMID:  22914086     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transpulmonary thermodilution cardiac output (CO) correlates closely with pulmonary artery (PA) thermodilution CO. Levels of CO may contribute to varying amounts of thermal indicator loss and recirculation during thermodilution CO measurement. This study aimed to investigate the effects of CO levels on the agreement between transpulmonary and PA thermodilution CO in patients with acute respiratory distress syndrome (ARDS).
METHODS: Twenty-two patients with ARDS were prospectively enrolled. Paired bolus transpulmonary thermodilution cardiac index (BCItp) and continuous PA thermodilution cardiac index (CCIpa) data were recorded at baseline and repeated immediately and at 2, 4, and 6 hours after volume expansion with a 500-mL infusion of 10% pentastarch (HES 200/0.5).
RESULTS: One hundred and ten paired cardiac index measurements were recorded and divided into 4 quartiles from the lowest to the highest CCIpa. The mean BCItp was higher than CCIpa, and the Bland and Altman analysis revealed a mean (SD) bias of 0.57 (0.75) L L min(-1) m(-2). The limits of agreement (2SD) were +2.07 to -0.93 L min(-1) m(-2). BCItp correlated closely with CCIpa (R = 0.887). CCIpa negatively correlated with the difference between BCItp and CCIpa (R = -0.26). The bias of quartile 1 with the least CCIpa was significantly greater than those of the three other quartiles.
CONCLUSION: In patients with ARDS, transpulmonary thermodilution is a clinically acceptable and interchangeable alternative to PA thermodilution for CO measurement. Levels of CO weakly and negatively correlate with the difference between BCItp and CCIpa. There is greater overestimation of BCItp over CCIpa in low than in high CO states.
LEVEL OF EVIDENCE: Diagnostic study, level II.
Chung-Chi Huang; Ning-Hung Chen; Li-Fu Li; Cheng-Ta Yang; Hsiu-Feng Hsiao; Yen-Huey Chen; Hui-Ling Lin; Kuo-Chin Kao
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  73     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  2013-02-11     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1236-41     Citation Subset:  AIM; IM    
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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MeSH Terms
Aged, 80 and over
Cardiac Output / physiology*
Catheterization, Central Venous
Catheterization, Swan-Ganz
Femoral Artery
Fluid Therapy
Middle Aged
Pulmonary Artery
Reproducibility of Results
Respiratory Distress Syndrome, Adult / diagnosis*,  physiopathology*,  therapy
Shock / diagnosis,  etiology,  physiopathology
Thermodilution / methods*
Young Adult

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