PMID- 9710107
OWN - NLM
STAT- MEDLINE
DCOM- 19980901
LR  - 20201209
IS  - 0090-3493 (Print)
IS  - 0090-3493 (Linking)
VI  - 26
IP  - 8
DP  - 1998 Aug
TI  - Determination of cardiac output during mechanical ventilation by electrical 
      bioimpedance or thermodilution in patients with acute lung injury: effects of 
      positive end-expiratory pressure.
PG  - 1441-5
AB  - OBJECTIVE: 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). DESIGN: Prospective, repeated-measures study. SETTING: 
      University-affiliated intensive care center. PATIENTS: Ten patients with acute 
      lung injury. INTERVENTIONS: 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. MEASUREMENTS AND MAIN RESULTS: 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). CONCLUSIONS: In patients with acute lung injury: a) the agreement 
      between TEB-CO and TD-CO measurements is poor; b) agreement is not clinically 
      improved by application of PEEP; and c) TEB cannot monitor trends in CO.
FAU - Genoni, M
AU  - Genoni M
AD  - Unit of Interdisciplinary Intensive Care, Regional Hospital, Lugano, Switzerland.
FAU - Pelosi, P
AU  - Pelosi P
FAU - Romand, J A
AU  - Romand JA
FAU - Pedoto, A
AU  - Pedoto A
FAU - Moccetti, T
AU  - Moccetti T
FAU - Malacrida, R
AU  - Malacrida R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Crit Care Med
JT  - Critical care medicine
JID - 0355501
SB  - IM
CIN - Crit Care Med. 1999 Dec;27(12):2848-9. PMID: 10628650
MH  - Body Composition/*physiology
MH  - *Cardiac Output
MH  - Catheterization, Central Venous
MH  - Electric Impedance
MH  - Female
MH  - Hospitals, University
MH  - Humans
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - *Positive-Pressure Respiration
MH  - Prospective Studies
MH  - Pulmonary Artery
MH  - Respiration, Artificial/*methods
MH  - Respiratory Distress Syndrome/*physiopathology/therapy
MH  - *Thermodilution
EDAT- 1998/08/26 02:19
MHDA- 2000/05/08 09:00
CRDT- 1998/08/26 02:19
PHST- 1998/08/26 02:19 [pubmed]
PHST- 2000/05/08 09:00 [medline]
PHST- 1998/08/26 02:19 [entrez]
AID - 10.1097/00003246-199808000-00035 [doi]
PST - ppublish
SO  - Crit Care Med. 1998 Aug;26(8):1441-5. doi: 10.1097/00003246-199808000-00035.