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Transpulmonary Thermodilution

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Monitoring Technologies in Acute Care Environments

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Abstract

Transpulmonary thermodilution monitors have emerged during the past decade to replace the pulmonary artery catheter. The advantages of these devices are to be less invasive and to provide the critical care physician with numerous hemodynamic variables that give relevant information on cardiac output, on cardiac preload and systolic function, and on the degree and nature of lung edema. Knowledge of transpulmonary thermodilution variables and of those obtained with the pulse contour analysis (a technology also included in the same monitor) can help in the decision-making process in patients with acute circulatory failure and especially those with cardiac dysfunction and/or lung injury. This chapter describes the main transpulmonary thermodilution variables (i.e., cardiac output, global end-diastolic volume, cardiac function index, extravascular lung water) and emphasizes on their clinical utility and main limitations.

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References

  1. Wiener RS, Welch HG. Trends in the use of the pulmonary artery catheter in the United States, 1993–2004. JAMA. 2007;298:423–9.

    Google Scholar 

  2. Shah MR, Hasselblad V, Stevenson LW, Binanay C, O’Connor CM, Sopko G, et al. Impact of the pulmonary artery catheter in critically ill patients: meta-analysis of randomized clinical trials. JAMA. 2005;294:1664–70.

    Article  PubMed  CAS  Google Scholar 

  3. Eichhorn V, Goepfert MS, Eulenburg C, Malbrain ML, Reuter DA. Comparison of values in critically ill patients for global end diastolic volume and extravascular lung water measured by transcardiopulmonary thermodilution: a metaanalysis of the literature. Med Intensiva. 2012;36:467–74.

    Article  PubMed  CAS  Google Scholar 

  4. Belda FJ, Aguilar G, Teboul JL, Pestana D, Redondo FJ, Malbrain M, et al. Complications related to less-invasive haemodynamic monitoring. Br J Anaesth. 2011;106:482–6.

    Article  PubMed  CAS  Google Scholar 

  5. Bendjelid K, Giraud R, Siegenthaler N, Michard F. Validation of a new transpulmonary thermodilution system to assess global end-diastolic volume and extravascular lung water. Crit Care. 2010;14:R209.

    Article  PubMed  Google Scholar 

  6. Kiefer N, Hofer CK, Marx G, Geisen M, Giraud R, Siegenthaler N, et al. Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters. Crit Care. 2012;16:R98.

    Article  PubMed  Google Scholar 

  7. Sakka SG, Reinhart K, Meier-Hellmann A. Comparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients. Intensive Care Med. 1999;25:843–6.

    Article  PubMed  CAS  Google Scholar 

  8. Goedje O, Hoeke K, Lichtwarck-Aschoff M, Faltchauser A, Lamm P, Reichart B. Continuous cardiac output by femoral arterial thermodilution calibrated pulse contour analysis: comparison with pulmonary arterial thermodilution. Crit Care Med. 1999;27:2407–12.

    Article  PubMed  CAS  Google Scholar 

  9. Michard F, Teboul JL. Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation. Crit Care. 2000;4:282–9.

    Article  PubMed  CAS  Google Scholar 

  10. Monnet X, Persichini R, Ktari M, Jozwiak M, Richard C, Teboul JL. Precision of the transpulmonary thermodilution measurements. Crit Care. 2011;15:R204.

    Article  PubMed  Google Scholar 

  11. Tibby SM, Hatherill M, Marsh MJ, Morrison G, Anderson D, Murdoch IA. Clinical validation of cardiac output measurements using femoral artery thermodilution with direct Fick in ventilated children and infants. Intensive Care Med. 1997;23:987–91.

    Article  PubMed  CAS  Google Scholar 

  12. Dufour N, Delville M, Teboul JL, Camous L, Favier du Noyer A, Richard C, et al. Transpulmonary thermodilution measurements are not affected by continuous veno-venous hemofiltration at high blood pump flow. Intensive Care Med. 2012;38:1162–8.

    Article  PubMed  Google Scholar 

  13. Tagami T, Kushimoto S, Tosa R, Omura M, Hagiwara J, Hirama H, et al. The precision of PiCCO® measurements in hypothermic post-cardiac arrest patients. Anaesthesia. 2012;67:236–43.

    Article  PubMed  CAS  Google Scholar 

  14. Trepte C, Haas S, Meyer N, Gebhardt M, Goepfert MS, Goetz AE, et al. Effects of one-lung ventilation on thermodilution-derived assessment of cardiac output. Br J Anaesth. 2012;108:922–8.

    Article  PubMed  CAS  Google Scholar 

  15. Brücken U, Grensemann J, Wappler F, Sakka SG. Influence of prone positioning on the measurement of transpulmonary thermodilution-derived variables in critically ill patients. Acta Anaesthesiol Scand. 2011;55:1061–7.

    Article  PubMed  Google Scholar 

  16. Faybik P, Hetz H, Baker A, Yankovskaya E, Krenn CG, Steltzer H. Iced versus room temperature injectate for assessment of cardiac output, intrathoracic blood volume, and extravascular lung water by single transpulmonary thermodilution. J Crit Care. 2004;19:103–7.

    Article  PubMed  Google Scholar 

  17. Segal E, Katzenelson R, Berkenstadt H, Perel A. Transpulmonary thermodilution cardiac output measurement using the axillary artery in critically ill patients. J Clin Anesth. 2002;14:210–3.

    Article  PubMed  Google Scholar 

  18. Michard F, Alaya S, Zarka V, Bahloul M, Richard C, Teboul JL. Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock. Chest. 2003;124:1900–8.

    Article  PubMed  Google Scholar 

  19. Hofer CK, Furrer L, Matter-Ensner S, Maloigne M, Klaghofer R, Genoni M, et al. Volumetric preload measurement by thermodilution: a comparison with transoesophageal echocardiography. Br J Anaesth. 2005;94:748–55.

    Article  PubMed  CAS  Google Scholar 

  20. Schmidt S, Westhoff TH, Hofmann C, et al. Effect of the venous catheter site on transpulmonary thermodilution measurement variables. Crit Care Med. 2007;35:783–6.

    Article  PubMed  Google Scholar 

  21. Jabot J, Monnet X, Bouchra L, Chemla D, Richard C, Teboul JL. Cardiac function index provided by transpulmonary thermodilution behaves as an indicator of left ventricular systolic function. Crit Care Med. 2009;37:2913–8.

    Article  PubMed  Google Scholar 

  22. Combes A, Berneau JB, Luyt CE, Trouillet JL. Estimation of left ventricular systolic function by single transpulmonary thermodilution. Intensive Care Med. 2004;30:1377–83.

    PubMed  Google Scholar 

  23. Katzenelson R, Perel A, Berkenstadt H, Preisman S, Kogan S, Sternik L, et al. Accuracy of transpulmonary thermodilution versus gravimetric measurement of extravascular lung water. Crit Care Med. 2004;32:1550–4.

    Article  PubMed  Google Scholar 

  24. Tagami T, Kushimoto S, Yamamoto Y, Atsumi T, Tosa R, Matsuda K, et al. Validation of extravascular lung water measurement by single transpulmonary thermodilution: human autopsy study. Crit Care. 2010;14:R162.

    Article  PubMed  Google Scholar 

  25. Jozwiak M, Silva S, Persichini R, Anguel N, Osman D, Richard C, et al. Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med. 2013;41:472–80.

    Article  PubMed  Google Scholar 

  26. Roch A, Michelet P, Lambert D, Delliaux S, Saby C, Perrin G, et al. Accuracy of the double indicator method for measurement of extravascular lung water depends on the type of acute lung injury. Crit Care Med. 2004;32:811–7.

    Article  PubMed  Google Scholar 

  27. Patroniti N, Bellani G, Maggioni E, Manfio A, Marcora B, Pesenti A. Measurement of pulmonary edema in patients with acute respiratory distress syndrome. Crit Care Med. 2005;33:2547–54.

    Article  PubMed  Google Scholar 

  28. Kushimoto S, Taira Y, Kitazawa Y, Okuchi K, Sakamoto T, Ishikura H, et al. The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome. Crit Care. 2012;16:R232.

    Article  PubMed  Google Scholar 

  29. Monnet X, Anguel N, Osman D, Hamzaoui O, Richard C, Teboul JL. Assessing pulmonary permeability by transpulmonary thermodilution allows differentiation of hydrostatic pulmonary edema from ALI/ARDS. Intensive Care Med. 2007;33:448–53.

    Article  PubMed  Google Scholar 

  30. Michard F, Alaya S, Medkour F. Monitoring right-to-left intracardiac shunt in acute respiratory distress syndrome. Crit Care Med. 2004;32:308–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Intensive Care Unit, Antoine Beclere Hospital, Clamart, 92140, France

    Olfa Hamzaoui MD

  2. Medical Intensive Care Unit, Bicetre Hospital, 78 rue du General Leclerc, Le Kremlin-Bicetre, 94270, France

    Xavier Monnet MD, PhD

  3. Medical Intensive Care Unit, Bicetre Hospital, University of Paris South, 78 rue du General Leclerc, Le Kremlin-Bicetre, 94270, France

    Jean-Louis Teboul MD, PhD

Authors
  1. Olfa Hamzaoui MD
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  2. Xavier Monnet MD, PhD
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  3. Jean-Louis Teboul MD, PhD
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Corresponding author

Correspondence to Jean-Louis Teboul MD, PhD .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology, Surgery, and Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Jesse M. Ehrenfeld

  2. Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, California, USA

    Maxime Cannesson

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Hamzaoui, O., Monnet, X., Teboul, JL. (2014). Transpulmonary Thermodilution. In: Ehrenfeld, J., Cannesson, M. (eds) Monitoring Technologies in Acute Care Environments. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8557-5_10

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  • DOI: https://doi.org/10.1007/978-1-4614-8557-5_10

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8556-8

  • Online ISBN: 978-1-4614-8557-5

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