Extravascular lung water measurements and hemodynamic monitoring in the critically ill: bedside alternatives to the pulmonary artery catheter
Autor: | Warren Isakow, Daniel P. Schuster |
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Rok vydání: | 2006 |
Předmět: |
Pulmonary and Respiratory Medicine
Cardiac output Physiology Critical Illness Point-of-Care Systems medicine.medical_treatment Thermodilution Hemodynamics Pulmonary Artery Lung injury Body Water Physiology (medical) medicine.artery medicine Intravascular volume status Humans Cardiac Output Lung Monitoring Physiologic business.industry Pulmonary artery catheter Cell Biology Pulmonary edema medicine.disease Respiratory Function Tests Radiography Catheter Anesthesia Pulmonary artery business Blood Flow Velocity |
Zdroj: | American Journal of Physiology-Lung Cellular and Molecular Physiology. 291:L1118-L1131 |
ISSN: | 1522-1504 1040-0605 |
Popis: | The recently completed Fluid and Catheter Treatment Trial conducted by the National Institutes of Health ARDSNetwork casts doubt on the value of routine pulmonary artery catheterization for hemodynamic management of the critically ill. Several alternatives are available, and, in this review, we evaluate the theoretical, validation, and empirical databases for two of these: transpulmonary thermodilution measurements (yielding estimates of cardiac output, intrathoracic blood volume, and extravascular lung water) that do not require a pulmonary artery catheter, and hemodynamic measurements (including estimates of cardiac output and ejection time, a variable sensitive to intravascular volume) obtained by esophageal Doppler analysis of blood flow through the descending aorta. We conclude that both deserve serious consideration as a means of acquiring useful hemodynamic data for managing shock and fluid resuscitation in the critically ill, especially in those with acute lung injury and pulmonary edema, but that additional study, including carefully performed, prospective clinical trials demonstrating outcome benefit, is needed. |
Databáze: | OpenAIRE |
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