Assessing fluid responses after coronary surgery: role of mathematical coupling of global end-diastolic volume to cardiac output measured by transpulmonary thermodilution
| Autor: | Theo Faes, A.B.J. Groeneveld, Rob B. P. de Wilde, Jos W. R. Twisk, Rose-Marieke B.G.E. Breukers, Paul C. M. Van Den Berg, Jos R. C. Jansen |
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| Přispěvatelé: | Methodology and Applied Biostatistics, Intensive care medicine, Physics and medical technology, ICaR - Ischemia and repair |
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output Central Venous Pressure Hypovolemia Thermodilution Fluid loading Coronary surgery SDG 3 - Good Health and Well-being Internal medicine medicine.artery Humans Medicine Cardiac Output Coronary Artery Bypass skin and connective tissue diseases Aged Aged 80 and over business.industry Stroke Volume Middle Aged Femoral Artery Coupling (electronics) Anesthesiology and Pain Medicine Catheterization Swan-Ganz Anesthesia Pulmonary artery Cardiology Fluid Therapy End-diastolic volume Female sense organs business |
| Zdroj: | European Journal of Anaesthesiology, 26(11), 954-960. Lippincott Williams and Wilkins Breukers, R B G E, Wilde, R B P, Berg, P C M, Jansen, J C, Faes, T J C, Twisk, J W R & Groeneveld, A B J 2009, ' Assessing fluid responses after coronary surgery: role of mathematical coupling of global end-diastolic volume to cardiac output measured by transpulmonary thermodilution ', European Journal of Anaesthesiology, vol. 26, no. 11, pp. 954-960 . https://doi.org/10.1097/EJA.0b013e32833098c6 European Journal of Anaesthesiology, 26(11), 954-960. Wolters Kluwer Health |
| ISSN: | 0265-0215 |
| DOI: | 10.1097/eja.0b013e32833098c6 |
| Popis: | Mathematical coupling may explain in part why cardiac filling volumes obtained by transpulmonary thermodilution may better predict and monitor responses of cardiac output to fluid loading than pressures obtained by pulmonary artery catheters (PACs).Eleven consecutive patients with hypovolaemia after coronary surgery and a PAC, allowing central venous pressure (CVP) and continuous cardiac index (CCIp) measurements, received a femoral artery catheter for transpulmonary thermodilution measurements of global end-diastolic blood volume index (GEDVI) and cardiac index (CItp). One to five colloid fluid-loading steps of 250 ml were done in each patient (n = 48 total).Fluid responses were predicted and monitored similarly by CItp and CCIp, whereas CItp and CCIp correlated at r = 0.70 (P0.001) with a bias of 0.40 l min(-1) m(-2). Changes in volumes (and not in CVP) related to changes in CItp and not in CCIp. Changes in CVP and GEDVI similarly related to changes in CItp, after exclusion of two patients with greatest CItp outliers (as compared to CCIp). Changes in GEDVI correlated better to changes in CItp when derived from the same thermodilution curve than to changes in CItp of unrelated curves and changes in CCIp.After coronary surgery, fluid responses can be similarly assessed by intermittent transpulmonary and continuous pulmonary thermodilution methods, in spite of overestimation of CCIp by CItp. Filling pressures are poor monitors of fluid responses and superiority of GEDVI can be caused, at least in part, by mathematical coupling when cardiac volume and output are derived from the same thermodilution curve. |
| Databáze: | OpenAIRE |
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