Document Detail


Inverse thermodilution with conventional pulmonary artery catheters for the assessment of cerebral, hepatic, renal, and femoral blood flow.
MedLine Citation:
PMID:  19033887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Assessment of regional blood flow changes is difficult in the clinical setting. We tested whether conventional pulmonary artery catheters (PACs) can be used to measure regional venous blood flows by inverse thermodilution (ITD). Inverse thermodilution was tested in vitro and in vivo using perivascular ultrasound Doppler (USD) flow probes as a reference. In anesthetized pigs, PACs were inserted in jugular, hepatic, renal, and femoral veins, and their measurements were compared with simultaneous USD flow measurements from carotid, hepatic, renal, and femoral arteries and from portal vein. Fluid boluses were injected through the PAC's distal port, and temperature changes were recorded from the proximally located thermistor. Injectates of 2 and 5 mL at 22 degrees C and 4 degrees C were used. Flows were altered by using a roller pump (in vitro), and infusion of dobutamine and induction of cardiac tamponade, respectively. In vitro: At blood flows between 400 mL . min-1 and 700 mL . min-1 (n = 50), ITD and USD correlated well (r = 0.86, P < 0.0001), with bias and limits of agreement of 3 +/- 101 mL . min-1. In vivo: 514 pairs of measurements had to be excluded from analysis for technical reasons, and 976 were analyzed. Best correlations were r = 0.87 (P < 0.0001) for renal flow and r = 0.46 (P < 0.0001) for hepatic flow. No significant correlation was found for cerebral and femoral flows. Inverse thermodilution using conventional PAC compared moderately well with USD for renal but not for other flows despite good in vitro correlation in various conditions. In addition, this method has significant technical limitations.
Authors:
Christoph C Ganter; Christof Buser; Matthias Haenggi; Hanswilly Mattes; Jukka Takala; Stephan M Jakob
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  32     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-16     Completed Date:  2009-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  194-200     Citation Subset:  IM    
Affiliation:
Department of Intensive Care Medicine, Bern University Hospital and University of Bern, Inselspital, Bern, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Flow Velocity / drug effects
Cardiac Tamponade / chemically induced,  physiopathology
Cardiotonic Agents / adverse effects,  pharmacology
Catheterization
Catheterization, Swan-Ganz / instrumentation*,  methods*
Cerebrovascular Circulation*
Dobutamine / adverse effects,  pharmacology
Female
Femoral Vein / physiopathology*
Kidney / blood supply*
Liver / blood supply*
Male
Pulmonary Artery / physiopathology*
Swine
Thermodilution / instrumentation,  methods
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine

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


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