tailieunhanh - Báo cáo y học: "Effect of norepinephrine dosage and calibration frequency on accuracy of pulse contour-derived cardiac output"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Effect of norepinephrine dosage and calibration frequency on accuracy of pulse contour-derived cardiac output. | Gruenewald et al. Critical Care 2011 15 R22 http content 15 1 R22 KS CRITICAL CARE RESEARCH Open Access Effect of norepinephrine dosage and calibration frequency on accuracy of pulse contour-derived cardiac output 1 1 11 2 1 Matthias Gruenewald Patrick Meybohm Jochen Renner Ole Broch Amke Caliebe Norbert Weiler Markus Steinfath1 Jens Scholz1 Berthold Bein1 Abstract Introduction Continuous cardiac output monitoring is used for early detection of hemodynamic instability and guidance of therapy in critically ill patients. Recently the accuracy of pulse contour-derived cardiac output PCCO has been questioned in different clinical situations. In this study we examined agreement between PCCO and transcardiopulmonary thermodilution cardiac output COTCP in critically ill patients with special emphasis on norepinephrine NE administration and the time interval between calibrations. Methods This prospective observational study was performed with a sample of 73 patients mean age 63 13 years requiring invasive hemodynamic monitoring on a non-cardiac surgery intensive care unit. PCCO was recorded immediately before calibration by COTCP. Bland-Altman analysis was performed on data subsets comparing agreement between PCCO and COTCP according to NE dosage and the time interval between calibrations up to 24 hours. Further central artery stiffness was calculated on the basis of the pulse pressure to stroke volume relationship. Results A total of 330 data pairs were analyzed. For all data pairs the mean COTCP SD was L min. PCCO had a mean bias of L min with limits of agreement to L min percentage error 38 when compared to COTCP. Whereas the bias between PCCO and COTCP was not significantly different between NE dosage categories or categories of time elapsed between calibrations interchangeability percentage error 30 between methods was present only in the high NE dosage subgroup pg kg min as the percentage errors were 40 47 and 28 in the no NE