Influence of different infracardial positions of central venous catheters in hemodynamic monitoring using the transpulmonal thermodilution method

Journal of Clinical Monitoring and Computing
Patrick KellnerJens Soukup

Abstract

Hemodynamic measurements are often conducted by the transpulmonary thermodilution (TPTD)-based PiCCO(®)-system. This requires a central-venous (CVC) and a thermistor-tipped arterial catheter, usually placed in the femoral artery. In certain clinical situations, CVC devices have to be placed in the inferior vena cava. However, little is known about the influence of different CVC positions (i.e. ipsi- vs. contra-lateral to the arterial catheter) on the accuracy of the TPTD measurement results. In this prospective observational study surgical intensive care unit patients who had been inserted with CVCs either into the superior (CVCVCS) or the inferior vena cava (CVCinf) in addition to an arterial PiCCO(®)-catheter, were enrolled. Patients were then divided into two groups: Group I was provided with a CVC in the contralateral (CVCcontra) and Group II in the ipsilateral (CVCipsi) inferior vena cava. Thermodilution via injection of ice-cold saline was then performed via CVCsup and CVCinf. Bland-Altman analysis for cardiac index (CI), extra-vascular lung water index (EVLWI) and global end-diastolic volume index (GEDVI) were employed. Additional correction formulas for femorally assed parameters were determined. In a total of 28 patien...Continue Reading

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Citations

Aug 14, 2020·Deutsche medizinische Wochenschrift·Veit-Simon EckleHolger Müller-Redetzky
Jan 9, 2017·Journal of Clinical Monitoring and Computing·Bernd SaugelThomas W L Scheeren

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