| Physical examination, central venous pressure, and chest radiography for the prediction of transpulmonary thermodilution-derived hemodynamic parameters in critically ill patients: A prospective trial. | |
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MedLine Citation:
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PMID: 21273034 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Physical examination, assessment of central venous pressure (CVP) and chest radiography are diagnostic tools for estimation of volume status in intensive care unit (ICU) patients. Passive leg raising (PLR) is a test to estimate fluid responsiveness. Transpulmonary thermodilution (TPTD) is established for measurement of cardiac index (CI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI). This study compares the estimation of volume status using physical examination, CVP, chest radiography, PLR, and TPTD. MATERIALS AND METHODS: This study was a prospective trial. Seventy-one patients in a medical ICU were studied. Interventions were as follows: physical examination by 2 independent examiners. CVP was measured. TPTD was performed. In 2 patient subgroups PLR and chest radiography was performed. Comparison of clinical and x-ray-based estimation of volume status, CVP, PLR, and TPTD variables was performed. RESULTS: Estimation of volume status based on physical examination showed a poor interobserver agreement between the examiners. There was no significant correlation between physical examination-based estimation of volume status and CVP or TPTD-derived GEDVI. There was no significant correlation between CVP and GEDVI, EVLWI or CI. PLR did not indicate fluid responsiveness. Radiographically estimated and TPTD-GEDVI/EVLWI values were significantly different. CONCLUSIONS: In ICU patients, assessment of volume status remains difficult. Physical examination, CVP, and portable radiography do not correlate with TPTD assessment of volume status, preload, or pulmonary hydration. |
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Authors:
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Bernd Saugel; Stephan Ringmaier; Konstantin Holzapfel; Tibor Schuster; Veit Phillip; Roland M Schmid; Wolfgang Huber |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-25 |
Journal Detail:
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Title: Journal of critical care Volume: - ISSN: 1557-8615 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, D-81675 München, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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