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Volume assessment in mechanically ventilated critical care patients using bioimpedance vectorial analysis, brain natriuretic Peptide, and central venous pressure.
MedLine Citation:
PMID:  21151535     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Purpose. Strategies for volume assessment of critically ill patients are limited, yet early goal-directed therapy improves outcomes. Central venous pressure (CVP), Bioimpedance Vectorial Analysis (BIVA), and brain natriuretic peptide (BNP) are potentially useful tools. We studied the utility of these measures, alone and in combination, to predict changing oxygenation. Methods. Thirty-four mechanically ventilated patients, 26 of whom had data beyond the first study day, were studied. Relationships were assessed between CVP, BIVA, BNP, and oxygenation index (O(2)I) in a cross-sectional (baseline) and longitudinal fashion using both univariate and multivariable modeling. Results. At baseline, CVP and O(2)I were positively correlated (R = 0.39; P = .021), while CVP and BIVA were weakly correlated (R = -0.38; P = .025). The association between slopes of variables over time was negligible, with the exception of BNP, whose slope was correlated with O(2)I (R = 0.40; P = .044). Comparing tertiles of CVP, BIVA, and BNP slopes with the slope of O(2)I revealed only modest agreement between BNP and O(2)I (kappa = 0.25; P = .067). In a regression model, only BNP was significantly associated with O(2)I; however, this was strengthened by including CVP in the model. Conclusions. BNP seems to be a valuable noninvasive measure of volume status in critical care and should be assessed in a prospective manner.
Authors:
Andrew A House; Mikko Haapio; Paolo Lentini; Ilona Bobek; Massimo de Cal; Dinna N Cruz; Grazia M Virzì; Rizzieri Carraro; Giampiero Gallo; Pasquale Piccinni; Claudio Ronco
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Publication Detail:
Type:  Journal Article     Date:  2010-12-02
Journal Detail:
Title:  International journal of nephrology     Volume:  2011     ISSN:  2090-2158     ISO Abbreviation:  Int J Nephrol     Publication Date:  2011  
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101546753     Medline TA:  Int J Nephrol     Country:  England    
Other Details:
Languages:  eng     Pagination:  413760     Citation Subset:  -    
Affiliation:
Division of Nephrology, London Health Sciences Center, London, Canada N6A 5A5.
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