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.
KeywordsPermeability Catheter Respiration Dobutamine
- 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
- 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.PubMedCrossRefGoogle 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.PubMedCrossRefGoogle Scholar