Document Detail


Therapeutic optimization of atrioventricular delay in cardiosurgical ICU patients by noninvasive cardiac output measurements versus pulse contour analysis.
MedLine Citation:
PMID:  18615372     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Optimizing atrioventricular (AV) delay improves cardiac output and postoperative outcome. Impedance cardiography (ICG) is a non-invasive method for CO measurement. This study evaluates the ability of two ICG methods to determine the optimal AV delay (OAVD) and to compare ICG with invasive PICCO measurements. METHODS: In 14 cardiosurgical ICU patients (age 70.4 +/- 12.0 yrs) with temporary pacing wires, OAVD was determined by pulse contour analysis (PICCO) and ICG (conventional ICG [CI] and electrical velocimetry [EV] ICG monitors). Cardiac output (CO) and stroke volume (SV) were measured during DDD pacing with AVD varying from 70 to 270 ms in 20-ms increments. RESULTS: Measured OAV showed a linear correlation between PICCO and ICG: CI (r = 0.82, P < 0.0002) and EV (r = 0.84, P < 0.0002). The mean OAVD deviation between PICCO and ICG was 15.7 +/- 21.0 ms (CI) and 17.1 +/- 20.5 ms (EV). Hemodynamic parameters (SV increase OAVD against worst case) improved significantly (+ 11.7 +/- 7.2 %, P < 0.0001). CONCLUSION: Inappropriate selection of AVD can compromise the hemodynamic situation of cardiosurgical patients. As it is totally noninvasive, ICG is a reliable and effective tool for tailoring AVD. Both systems (CI and EV) offer valid OAV determination.
Authors:
F Mellert; P Lindner; W Schiller; E Gersing; I Heinze; J Kreuz; A Welz; C J Preusse
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Thoracic and cardiovascular surgeon     Volume:  56     ISSN:  0171-6425     ISO Abbreviation:  Thorac Cardiovasc Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903387     Medline TA:  Thorac Cardiovasc Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  269-73     Citation Subset:  IM    
Affiliation:
Klinik und Poliklinik für Herzchirurgie, Universität Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany. fritz.mellert@uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Algorithms
Atrioventricular Block / physiopathology*
Blood Pressure*
Cardiac Output*
Cardiac Pacing, Artificial*
Cardiac Surgical Procedures*
Cardiography, Impedance / instrumentation,  methods*
Equipment Design
Female
Humans
Intensive Care Units*
Male
Middle Aged
Predictive Value of Tests
Reproducibility of Results

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


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