Assessment of Changes in Hemodynamics and Intrathoracic Fluid Using Electrical Cardiometry During Autologous Blood Harvest

Narula, Jitin; Kiran, Usha; Kapoor, Poonam Malhotra; Choudhury, Minati; Rajashekar, Palleti; Chowdhary, Ujjwal

doi:10.1053/j.jvca.2016.07.032

Cited by 12 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thoracic fluid content showed moderate predictive ability for weaning failure; this predictive ability became excellent in the subgroup of patients with impaired systolic function. Measurement of the TFC depends on the impedance cardiography phenomenon which changes according to the resistance of thoracic contents to electric current [9]. The presence of lung congestion is an important cause for weaning failure especially in cardiac patients [12].…”

Section: Discussionmentioning

confidence: 99%

“…In the last few years, TFC had been also measured using the newer electric cardiometry technology. The electrical cardiometry-based TFC showed useful results in evaluation of the volume status of patients undergoing autologous blood transfusion [9]. In late preterm and term newborn, TFC correlated with the occurrence of respiratory distress in the first 24 h after birth [19].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the previously used measures required either frequent blood sampling, such as brain natriuretic peptide [7], or expert operator, such as echocardiography [8]. The electrical cardiometry-derived thoracic fluid content (TFC) is measured through the impedance cardiography technology; TFC is assessed through the changes in the impedance of thoracic tissue to the electric current [9]. Thoracic fluid content represents the whole (extravascular, intravascular, and intrapleural) fluid component in the thorax; thus, TFC was postulated to provide an estimation of the extravascular lung water.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation

et al. 2020

View full text Add to dashboard Cite

Background: Weaning of patients from the mechanical ventilation remains one of the critical decisions in intensive care unit. This study aimed to evaluate the accuracy of thoracic fluid content (TFC) as a predictor of weaning outcome.Methods: An observational cohort study included 64 critically ill surgical patients who were eligible for extubation. Before initiating the spontaneous breathing trial, the TFC was measured using the electrical cardiometry technology. Patients were followed up after extubation and divided into successful weaning group and failed weaning group. Both groups were compared according to respiratory and cardiovascular parameters. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of TFC to predict weaning outcome. Results: The number of successfully weaned patients was 41/64 (64%). Twenty (31%) patients had impaired cardiac contractility, and of them, 13/20 (64%) patients were successfully extubated. Both groups, successful weaning group and failed weaning group, were comparable in most of baseline characteristics; however, the TFC was significantly higher in the failed weaning group compared to the successful weaning group. The area under the ROC curves (AUCs) showed moderate predictive ability for the TFC in predicting weaning failure (AUC [95% confidence interval] 0.69 [0.57-0.8], cutoff value > 50 kΩ −1 ), while the predictive ability of TFC was excellent in the subgroup of patients with ejection fraction < 40% (AUC [95% confidence interval 0.93 [0.72-1], cutoff value > 50 kΩ −1 ). Conclusions: Thoracic fluid content showed moderate ability for predicting weaning outcome in surgical critically ill patients. However, in the subgroup of patients with ejection fraction less than 40%, TFC above 50 kΩ −1 has an excellent ability to predict weaning failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Воспалительные процессы в легких с накоплением жидкости в легочном интерстиции, сердечная недостаточность и общая гипергидратация организма обусловливают рост указанных показателей. В то же время успешная терапия сердечной недостаточности, эффективная искусственная вентиляция легких (ИВЛ) и рестриктивная жидкостная терапия в условиях острого респираторного дистресс-синдрома (ОРДС), применение диуретиков приводят к снижению величины показателя TFC, определенного импедансным методом [2, 13,18].…”

Section: рисунок 3 расположение электродов при измерении трансторакального импеданса согласно методике: а -Medis (Medizinische Messtechniunclassified

“…Возможность мониторирования TFC становится все более востребованной, и необходимую аппаратуру стали производить в других странах. В частности, последние научные сообщения связаны с оценкой TFC и работы приборов фирмы ICON monitor: Osypka Medical, Inc., La Jolla (California and Berlin) [1, 13,14].…”

Section: Introductionunclassified

Методика Оценки Количества Жидкости В Грудной Клетке, Основанная На антропометрических Данных Пациента И определении Электрического Импеданса Грудной Клетки

Kursov¹,

Nіkonov²,

Biletskyi³

et al. 2021

ЕМ

View full text Add to dashboard Cite

Background. Determination of the thoracic fluid content in the dynamics is becoming increasingly common in clinical trials and is a promising method for monitoring patients of intensive care units of various profiles. The most affordable and cost-effective methods for monitoring the amount of fluid in the chest at present are those based on measuring the electrical impedance of the chest when scanning it with high-frequency current. These techniques provide good repeatability of results, and are virtually independent of the operator. The purpose of the work is to develop own original technique for determining the thoracic fluid content. Materials and methods. The electric chest impedance was measured when scanning the chest with an electric current of 32 KHz using two pairs of band electrodes according to V. Kubicek. The circumference of the base of the neck and chest at the site of application of the electrodes was measured carefully. The distance between electrodes was also determined. Chest volume was calculated based on the truncated cone model. The thoracic fluid content was evaluated by the equation: V = γν/Z(R – r), where V is the volume of fluid in the chest; γ is the average electrical blood conductivity; ν is the volume of the thorax, calculated on the model of a truncated cone; Z is the value of the electrical impedance of the chest; R is the radius of the thorax, and r is the radius of the base of the neck. The difference between them in this equation should reduce the error associated with the presence in the thorax of connective tissue that has an electrical conductivity different from the electrical conductivity of the blood. Studies were performed in both apparently healthy volunteers and in polytrauma patients with thoracic injury and signs of acute respiratory failure. Results. Our observations showed that the amount of fluid in the chest, calculated by our method, normally approaches 60 % — 59 ± 2 % of the chest volume, calculated on the base of the truncated cone model. In the most severe cases of thoracic injury, the relative fluid content in the chest of victims reached 75–80 %, and the amount of fluid in the chest, expressed in conventional units per 1/KΩ, was at the level of 45–50 conventional 1/КΩ. These events were associated with the presence of a clinical picture of acute respiratory distress syndrome degree 2, and all patients were on mandatory pulmonary mechanical ventilation with the creation of constant positive airway pressure and respiratory plateau at the level of 25–27 cm H2O. The positive dynamics of the process was associated with an increase in the oxygenation index, the ability to transfer patients to spontaneous breathing. At the same time, the relative thoracic fluid content in patients decreased to 60–67 %, and in those who needed continued mechanical ventilation — to 68–73 %. The thoracic fluid content, expressed in conventional units per 1/KΩ, with rapid improvement and the possibility of discontinuation of ventilation was 37–42 conditional 1/KΩ, and if it was necessary to continue mechanical ventilation — 43–46 conditional 1/KΩ. The results of determining the thoracic fluid content by the authors’ method better corresponded to the clinical picture of thoracic trauma, the severity of the manifestations of acute respiratory distress syndrome than the noninvasive cardiac output monitoring. Conclusions. The developed method for determining the thoracic fluid content can be applied in researches and clinical practice during intensive care of patients with acute respiratory distress syndrome.

show abstract

Thoracic fluid content: a novel parameter for detection of pulmonary edema in parturients with preeclampsia

Hammad

Hasanin

El‐Sakka

et al. 2018

J Clin Monit Comput

View full text Add to dashboard Cite

Acute pulmonary oedema is a serious complication of preeclampsia. Early detection of pulmonary edema in preeclampsia would improve fluid management and would also allow earlier detection of severe cases. The aim of this work is to evaluate the ability of thoracic fluid content measured by electrical cardiometry for early detection of pulmonary edema in parturients with preeclampsia. A prospective observational study included a cohort of preeclamptic parturients. On admission, lung ultrasound score was calculated, and thoracic fluid content was recorded using electrical cardiometry ICON device. Area under receiver operating characteristic (AUROC) curve was calculated for lung ultrasound score, thoracic fluid content for detection of pulmonary edema. Spearman correlation coefficient was calculated for correlation between lung ultrasound score and thoracic fluid content. Sixty patients were included in the study; of them, 6 patients (10%) required diuretics for pulmonary edema. Patients with pulmonary edema had higher lung ultrasound score and thoracic fluid content compared to other patients. Good correlation was reported between Lung ultrasound score and thoracic fluid content (r = 0.82). Thoracic fluid content and lung ultrasound score showed excellent diagnostic properties for pulmonary edema {AUROC: 0.941 (0.849-0.986), best cut-off value: 40 k ohm}, and {AUROC: 0.961 (0.887-0.994), best cut-off value of 15.7}. In parturients with preeclampsia, both lung ultrasound score and thoracic fluid content showed excellent properties for detection pulmonary edema. The high negative predictive value of both tests makes them useful screening tests to rule out pulmonary edema. The excellent correlation between both measures suggests that electrical cardiometry could be a promising surrogate to ultrasound for assessment of extravascular lung water.

show abstract

Assessment of Changes in Hemodynamics and Intrathoracic Fluid Using Electrical Cardiometry During Autologous Blood Harvest

Cited by 12 publications

References 19 publications

Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation

Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation

Методика Оценки Количества Жидкости В Грудной Клетке, Основанная На антропометрических Данных Пациента И определении Электрического Импеданса Грудной Клетки

Thoracic fluid content: a novel parameter for detection of pulmonary edema in parturients with preeclampsia

Contact Info

Product

Resources

About