Abstract
The measurement of cardiac output (CO) is often done when the patient is in need of advanced haemodynamic monitoring. The current method for measurement of cardiac output is by thermodilution and necessitates the insertion of a pulmonary artery catheter (PAC), a procedure which is associated with a number of known complications, including a possible increase in mortality in critically ill patients. In addition, the CO that is derived from the PAC is influenced by the significant respiratory variations, and hence from the phase of the mechanical breath in which the injection is made. Mechanical ventilation was also shown to cause a high incidence of significant tricuspid insufficiency and mild to severe vena caval backward flow, which, like other valvular regurgitations, may reduce the accuracy of CO measured by PAC thermodilution (TD) [1].
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References
Jullien T et al (1995) Incidence of tricuspid regurgitation and in mechanically ventilated patients. A color Doppler and contrast echocardiographic study. Chest 107:488–493
Bek JC et al (1989) Cardiac output measurement using femoral artery thermodilution in patients. J Crit Care 4:105–111
McLuckie A et al (1996) Comparison of pulmonary and femoral artery thermodilution cardiac indices in paediatric intensive care patients. Acta Paediatr 85:336–338
Weyland A et al (1994) Application of a transpulmonary double indicator dilution method for postoperative assessment of cardiac index, pulmonary vascular resistance index, and extravascular lung water in children undergoing total cavo-pulmonary anastomosis: Preliminary results in six patients. J Cardiothorac Vase Anesth 8:636–641
Lewis FR et al (1982) The measurement of extravascular lung water by the thermal-green dye indicator dilution. Ann NY Acad Sci, pp 394–410
Wickerts et al (1990) Measurement of extravascular lung water by the thermal-dye dilution technique: Mechanisms of cardiac output dependence. Intensive Care Med 10:115–120
Hoeft A (1995) Transpulmonary indicator dilution: An alternative approach for hemo-dynamic monitoring. In: Yearbook of Intensive Care and Emergency Medicine, Springer, pp 594–605
von Spiegel T et al (1996) Cardiac output evaluation by means of transpulmonary thermodilution. An alternative to the pulmonary artery catheter? Anaesthesist 45:1045–1050
Godje O et al (1998) Reproducibility of double indicator dilution measurements of intrathoracic blood volume compartments, extravascular lung water, and liver function. Chest 113: 1070–1077
Tibby SM et al (1997) Clinical validation of cardiac output measurements using femoral artery thermodilution with direct Fick in ventilated children and infants. Intensive Care Med 23:987–991
Perel et al (1987) The systolic pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 67:498–502
Pizov et al (1989) The arterial pressure waveform during acute ventricular failure and synchronized external chest compression. Anesth Analg 68:150–157
Coriat et al (1994) A comparison of systolic blood pressure and echocardiographic estimates of end-diastolic left ventricular size in patients following aortic surgery. Anesth Analg 78: 46–53
Preisman et al (1997) New monitors of intravascular volume: A comparison of arterial pressure waveform analysis and intrathoracic blood volume. Intensive Care Med 23:651–657
Beaussier et al (1995) Determinants of systolic pressure variation in patients ventilated after vascular surgery. J Cardiothoracic Vase Anesth 9:547–551
Hedenstierna G (1992) What value does the recording of intrathoracic blood volume have in clinical practice? Intensive Care Med 18:137–138
Hoeft A et al (1994) Bedside assessment of intravascular volume status in patients undergoing coronary bypass surgery. Anesthesiology 81:76–86
Lichtwarck-Aschoff M et al (1996) Central venous pressure, pulmonary artery occlusion pressure, intrathoracic blood volume, and right ventricular end-diastolic volume as indicators of cardiac preload. J Crit Care 11:180–189
Lichtwarck-Aschoff M et al (1992) Intrathoracic blood volume accurately reflects circulatory volume status in critically ill patients with mechanical ventilation. Intensive Care Med 18: 142–147
Huttermann E et al (1996) Intrathoracic blood volume versus echocardiographic parameters in surgical patients. Clin Intens Care Med [Suppl]7:20
Pfeiffer UJ et al (1990) Sensitivity of central venous pressure, pulmonary capillary wedge pressure, and intrathoracic blood volume as indicators for acute and chronic hypovolemia. In: Lewis FR, Pfeiffer UJ (eds) Practical applications of fiberoptics in critical care monitoring. Springer, pp 25–31
Eisenberg et al (1987) A prospective study of lung water measurement during patient management in the intensive care unit. Am Rev Respir Dis 136:662–668
Mitchell JP et al (1992) Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization. Am Rev Resp Dis 145:990–998
Schuster DP (1993) The case for and against fluid restriction and occlusion pressure reduction in adult respiratory distress syndrome. New Horizons 1:478–488
Sturm JA (1990) Development and significance of lung water measurement in clinical and experimental practice. In: Lewis FR, Pfeiffer UJ (eds) Practical applications of fiberoptics in critical care monitoring, pp 129–139
Zeravik et al (1989) Efficacy of high frequency ventilation combined with volume controlled ventilation in dependency of extravascular lung water. Acta Anaesthesiol Scand 33:568–574
Zeravik et al (1990) Efficacy of pressure support ventilation is dependent on extravascular lung water. Chest 97:1412–1499
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© 1999 Springer-Verlag Italia
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Perel, A., Berkenstadt, H., Segal, E. (1999). New Insights into Cardiovascular Monitoring: Continuous Arterial Thermodilution and Intrathoracic Blood Volume. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2145-7_45
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DOI: https://doi.org/10.1007/978-88-470-2145-7_45
Publisher Name: Springer, Milano
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