Estimation of left ventricular systolic function by single transpulmonary thermodilution View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2004-04-23

AUTHORS

Alain Combes, Jean-Baptiste Berneau, Charles-Edouard Luyt, Jean-Louis Trouillet

ABSTRACT

ObjectiveThe single-indicator transpulmonary thermodilution technique (PiCCO system) provides two derived indices of cardiac systolic function: the cardiac function index and the global ejection fraction. We used transesophageal echocardiography to compare theses indices with left ventricular fractional area of change only for patients with no isolated right ventricular dysfunction. (The global cardiac systolic function may be decreased despite preserved left ventricular function in this situation.)DesignProspective, open, clinical study.SettingIntensive care unit (ICU) in a university hospital.PatientsThirty-three mechanically ventilated patients.InterventionLeft ventricular fractional area of change (LVFAC) was measured using transesophageal echocardiography. The cardiac function index (CFI) and the global ejection fraction (GEF) were determined from transpulmonary thermodilution-derived cardiac output and thoracic volumes.Measurements and main resultsTransesophageal echocardiography identified 3 patients with isolated right ventricular failure (PiCCO underestimated LVFAC in this situation). Significant correlations were established between LVFAC and CFI (r=0.87, n=30, p<0.0001) or GEF (r=0.82, n=30, p<0.0001). The mean differences between measured LVFAC and LVFAC estimated with CFI or GEF were 0.8±8.5% (range: –17 to 14%) and 0.8±9.0% (range: –21 to 19%), respectively. Area under the receiver operating characteristics curves for the estimation of LVFAC ≥40% using CFI or GEF was 0.92. CFI >4 and GEF >18% estimated LVFAC ≥40% with respective sensitivities of 86 and 88% and specificities of 88 and 79%. Significant correlations were established between changes of LVFAC and CFI/GEF over time.ConclusionsIn mechanically ventilated ICU patients, PiCCO-derived cardiac function index and global ejection fraction provide reliable estimations of LV systolic function but may underestimate it in the cases of isolated right ventricular failure. More... »

PAGES

1377-1383

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-004-2289-2

DOI

http://dx.doi.org/10.1007/s00134-004-2289-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029626196

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15105983


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