tailieunhanh - Báo cáo y học: "Transpulmonary thermodilution using femoral indicator injection: a prospective trial in patients with a femoral and a jugular central venous catheter"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Transpulmonary thermodilution using femoral indicator injection: a prospective trial in patients with a femoral and a jugular central venous catheter. | Saugel et al. Critical Care 2010 14 R95 http content 14 3 R95 c CRITICAL CARE RESEARCH Open Access Transpulmonary thermodilution using femoral indicator injection a prospective trial in patients with a femoral and a jugular central venous catheter 1 1 2 1 1 1 Bernd Saugel Andreas Umgelter Tibor Schuster Veit Phillip Roland M Schmid Wolfgang Huber Abstract Introduction Advanced hemodynamic monitoring using transpulmonary thermodilution TPTD is established for measurement of cardiac index CI global end-diastolic volume index GEDVI and extra-vascular lung water index EVLWI . TPTD requires indicator injection via a central venous catheter usually placed via the jugular or subclavian vein . However superior vena cava access is often not feasible due to the clinical situation. This study investigates the conformity of TPTD using femoral access. Methods This prospective study involved an 18-month trial at a medical intensive care unit at a university hospital. Twenty-four patients with both a superior and an inferior vena cava catheter at the same time were enrolled in the study. Results TPTD-variables were calculated from TPTD curves after injection of the indicator bolus via jugular access TPTDjug and femoral access TPTDfem . GEDVIfem and GEDVIjug were significantly correlated rm P but significantly different 1 034 275 vs. 793 180 mL m2 P . Bland-Altman analysis demonstrated a bias of 241 mL m2 limits of agreement -9 and 491 mL m2 . GEDVIfem CIfem and ideal body weight were independently associated with the bias GEDVIfem-GEDVIjug . A correction formula of GEDVIjug after femoral TPTD was calculated. EVLWIfem and EVLWIjug were significantly correlated rm P . Bland-Altman analysis revealed a bias of mL kg limits of agreement and mL kg . Furthermore CIfem and Cljug were significantly correlated rm P . Bland-Altman analysis demonstrated a bias of L min m2 limits of agreement and L min m2 .