| Thoracic electrical bioimpedance: a tool to determine cardiac versus non-cardiac causes of acute dyspnoea in the emergency department. | |
| | |
MedLine Citation:
|
PMID: 20442164 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
OBJECTIVES: To determine whether cardiohaemodynamic parameters, using non-invasive thoracic electrical bioimpedance (TEB), can differentiate between cardiac and non-cardiac causes of acute breathlessness in adult emergency department (ED) patients. METHODS: A prospective cohort study of adult patients who presented with acute breathlessness to the ED of a large urban teaching hospital. Study patients had their cardiohaemodynamic parameters measured, using a TEB device. The patient's hospital discharge diagnosis was used as the definitive diagnosis to determine whether the underlying cause of acute dyspnoea was cardiac or non-cardiac related. The definitive diagnosis was compared with the TEB data and the ED physician's diagnosis. RESULTS: 52 patients were recruited into the study, of whom 51 had complete TEB data and were included in the analysis. There were statistically significant differences in cardiac output (6.2 vs 7.9, p<0.001), cardiac index (CI; 3.1 vs 4.4, p<0.001), systemic vascular resistance (1227 vs 933, p=0.002) and systemic vascular resistance index (2403 vs 1681, p<0.001) between the cardiac and non-cardiac cohort. CI was found to be an excellent discriminator (receiver operating characteristics area under the curve 0.906). The optimal diagnostic criterion for CI to distinguish between cardiac and non-cardiac dyspnoea was 3.2 l/min per square metre or less (positive likelihood ratio 7.9; negative likelihood ratio 0.14). CONCLUSION: This study demonstrated that non-invasive TEB cardiohaemodynamic parameters can differentiate between cardiac and non-cardiac-related causes of dyspnoea in ED patients presenting with acute breathlessness. A large-scale trial is required to determine if TEB-derived cardiohaemodynamic information can aid ED clinicians in their early clinical decision-making and improve the care and outcome of patients with dyspnoea. |
| | |
Authors:
|
Christiane Vorwerk; Hanusha Jeyanithi; Timothy J Coats |
Related Documents
:
|
22338304 - Left atrial compression caused by hiatus hernia: a rare cause of syncope. 22197304 - Rare case of an unroofed coronary sinus. 22728484 - Intramyocardial calcification in a patient with apical hypertrophic cardiomyopathy. 19895104 - Virtual histology of the human heart using optical coherence tomography. 630974 - Coexistent wenckebach phenomenon in the distal branches of the specialized conduction s... 11090784 - Usefulness of brachial artery reactivity to isometric handgrip exercise in identifying ... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Emergency medicine journal : EMJ Volume: 27 ISSN: 1472-0213 ISO Abbreviation: Emerg Med J Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-05-05 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: England |
Other Details:
|
Languages: eng Pagination: 359-63 Citation Subset: IM |
Affiliation:
|
Academic Unit of Emergency Medicine, University of Leicester, Leicester, UK. cv28@le.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Early goal-directed therapy: can the emergency department deliver?
Next Document: Emergency department or general practitioner following transient ischaemic attack? A comparison of p...