Determination of cardiac output during mechanical ventilation by electrical bioimpedance or thermodilution in patients with acute lung injury: effects of positive end-expiratory pressure

Critical Care Medicine
M GenoniR Malacrida

Abstract

To evaluate the usefulness of transthoracic electrical bioimpedance in sedated and paralyzed patients with acute lung injury during mechanical ventilation with and without early application of positive end-expiratory pressure (PEEP). Prospective, repeated-measures study. University-affiliated intensive care center. Ten patients with acute lung injury. Simultaneous, three-paired cardiac output (CO) measurements by transthoracic electrical bioimpedance (TEB) and thermodilution (TD) were made at 0 and 15 cm H2O of PEEP. The average of the TD-CO measurements was 7.22 +/- 2.12 (SD) L/min during 0 cm H2O of positive end-expiratory pressure (ZEEP), and 6.91 +/- 1.72 L/min during PEEP (NS). The average of the TEB-CO measurements was 4.48 +/- 1.37 L/min during ZEEP, and 6.03 +/- 2.03 L/min during PEEP (p < .05). For each level of PEEP, bias and precision between methods were calculated. Bias calculations between TD-CO and TEB-CO ranged from -1.54 +/- 7.02 L/min at ZEEP to -2.52 +/- 4.28 L/ min at PEEP, and -2.47 +/- 6.09 L/min for mixed data at ZEEP and PEEP. There was no significant correlation between the percent change with PEEP in TEB-CO and TD-CO (r2 =.05, NS). In patients with acute lung injury: a) the agreement between TEB-CO and...Continue Reading

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Nov 1, 2005·Medical & Biological Engineering & Computing·D P Bernstein, H J M Lemmens
Sep 2, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Jean-Luc FellahiJean-Luc Hanouz
Jan 11, 2000·Critical Care Medicine·W S Sageman
Jun 15, 2005·Emergency Medicine Australasia : EMA·Ogilvie Thom, David Taylor

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