PMID- 21880510
OWN - NLM
STAT- MEDLINE
DCOM- 20121123
LR  - 20151119
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 26
IP  - 2
DP  - 2012 Apr
TI  - A comparison of endotracheal bioimpedance cardiography and transpulmonary 
      thermodilution in cardiac surgery patients.
PG  - 217-22
LID - 10.1053/j.jvca.2011.06.023 [doi]
AB  - OBJECTIVES: The authors hypothesized that bioimpedance cardiography measured by 
      the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient 
      and reliable method for both cardiac index (CI) assessment and prediction in 
      fluid responsiveness. DESIGN: A prospective observational study. SETTING: A 
      teaching university hospital. PARTICIPANTS: Twenty-five adult patients. 
      INTERVENTIONS: Admission to the intensive care unit after conventional cardiac 
      surgery and investigation before and after a fluid challenge. MEASUREMENTS AND 
      MAIN RESULTS: Simultaneous comparative CI data points were collected from 
      transpulmonary thermodilution (TD) and ECOM. Correlations were determined by 
      linear regression. Bland-Altman analysis was used to compare the bias, precision, 
      and limits of agreement. The percentage error was calculated. Pulse-pressure 
      variations (PPVs) and stroke-volume variations (SVVs) before fluid challenge were 
      collected to assess their discrimination in predicting fluid responsiveness. A 
      weak but statistically significant relationship was found between CI(TD) and 
      CI(ECOM) (r = 0.31, p = 0.03). Bias, precision, and limits of agreement between 
      CI(TD) and CI(ECOM) were 0.08 L/min/m(2) (95% confidence interval, -0.11 to 
      0.27), 0.68 L/min/m(2), and -1.26 to 1.42 L/min/m(2), respectively. The 
      percentage error was 51%. A nonsignificant positive relationship was found 
      between percent changes in CI(TD) and CI(ECOM) after fluid challenge (r = 0.37, p 
      = 0.06). Areas under the ROC curves for both PPV and SVV to predict fluid 
      responsiveness were 0.86 (95% confidence interval, 0.67-1.06) and 0.89 (95% 
      confidence interval, 0.74-1.04, respectively; p = 0.623). CONCLUSIONS: Continuous 
      measurements of CI under dynamic conditions are consistent and easy to obtain 
      with ECOM although not interchangeable with transpulmonary thermodilution. SVV 
      given by ECOM is a dynamic parameter that predicts fluid responsiveness with good 
      accuracy and discrimination.
CI  - Copyright A(c) 2012 Elsevier Inc. All rights reserved.
FAU - Fellahi, Jean-Luc
AU  - Fellahi JL
AD  - Department of Anesthesiology and Critical Care Medicine, CHU de Caen, Caen, 
      France. fellahi-jl@chu-caen.fr
FAU - Fischer, Marc-Olivier
AU  - Fischer MO
FAU - Rebet, Olivier
AU  - Rebet O
FAU - Massetti, Massimo
AU  - Massetti M
FAU - Gerard, Jean-Louis
AU  - Gerard JL
FAU - Hanouz, Jean-Luc
AU  - Hanouz JL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20110831
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
MH  - Aged
MH  - Cardiac Output/*physiology
MH  - Cardiac Surgical Procedures/*methods
MH  - Cardiography, Impedance/methods
MH  - Electric Impedance
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Thermodilution/methods
EDAT- 2011/09/02 06:00
MHDA- 2012/12/10 06:00
CRDT- 2011/09/02 06:00
PHST- 2011/05/06 00:00 [received]
PHST- 2011/09/02 06:00 [entrez]
PHST- 2011/09/02 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - S1053-0770(11)00469-1 [pii]
AID - 10.1053/j.jvca.2011.06.023 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2012 Apr;26(2):217-22. doi: 
      10.1053/j.jvca.2011.06.023. Epub 2011 Aug 31.