| Therapeutic optimization of atrioventricular delay in cardiosurgical ICU patients by noninvasive cardiac output measurements versus pulse contour analysis. | |
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MedLine Citation:
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PMID: 18615372 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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F Mellert; P Lindner; W Schiller; E Gersing; I Heinze; J Kreuz; A Welz; C J Preusse |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: The Thoracic and cardiovascular surgeon Volume: 56 ISSN: 0171-6425 ISO Abbreviation: Thorac Cardiovasc Surg Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-10 Completed Date: 2008-12-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903387 Medline TA: Thorac Cardiovasc Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 269-73 Citation Subset: IM |
Affiliation:
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Klinik und Poliklinik für Herzchirurgie, Universität Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany. fritz.mellert@uni-bonn.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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