Der PiCCO-Katheter

Gassanov, Natig; Caglayan, Evren; NIa, Aksenova; Erdmann, E; Er, Fikret

doi:10.1055/s-0030-1267517

Cited by 7 publications

(4 citation statements)

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“…However, pulmonary artery catheter is the gold standard of thermodilution-based cardiac output measurement [ 32 ]. PiCCO™ is less invasive, and it is less influenced by respiratory fluctuations and has a longer dwell time [ 33 , 34 ]. The European Society of Intensive Care Medicine suggests the application of artery pulmonary catheter only in refractory shock with concomitant right-ventricular failure [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

An Interaction Effect Analysis of Thermodilution-Guided Hemodynamic Optimization, Patient Condition, and Mortality after Successful Cardiopulmonary Resuscitation

Kovács

Gyarmathy

Pilecky

et al. 2021

IJERPH

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Proper hemodynamic management is necessary among post-cardiac arrest patients to improve survival. We aimed to investigate the effects of PiCCO™-guided (pulse index contour cardiac output) hemodynamic management on mortality in post-resuscitation therapy. In this longitudinal analysis of 63 comatose patients after successful cardiopulmonary resuscitation cooled to 32–34 °C, 33 patients received PiCCO™, and 30 were not monitored with PiCCO™. Primary and secondary outcomes were 30 day and 1 year mortality. Kaplan–Meier curves and log-rank tests were used to assess differences in mortality among the groups. Interaction effects to disentangle the relationship between patient’s condition, PiCCO™ application, and mortality were assessed by means of Chi-square tests and logistic regression models. A 30 day mortality was significantly higher among PiCCO™ patients, while 1 year mortality was marginally higher. More severe patient condition per se was not the cause of higher mortality rate in the PiCCO™ group. Patients in better health conditions (without ST-elevation myocardial infarction, without cardiogenic shock, without intra-aortic balloon pump device, or without stroke in prior history) had worse outcomes with PiCCO™-guided therapy. Catecholamine administration worsened both 30 day and 1 year mortality among all patients. Our analysis showed that there was a complex interaction relationship between PiCCO™-guided therapy, patients’ condition, and 30 day mortality for most conditions.

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Section: Discussionmentioning

confidence: 99%

An Interaction Effect Analysis of Thermodilution-Guided Hemodynamic Optimization, Patient Condition, and Mortality after Successful Cardiopulmonary Resuscitation

Kovács

Gyarmathy

Pilecky

et al. 2021

IJERPH

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show abstract

“…28 PiCCO™ is less invasive, it is less in uenced by respiratory uctuations, and has a longer dwell time. 29,30 The European Society of Intensive Care Medicine suggests the application of artery pulmonary catheter only in refractory shock with concomitant right ventricular failure. 15 PiCCO™ was found to be effective in the evaluation of hemodynamic situations in critically ill patients, leading to a faster decision making.…”

Section: Discussionmentioning

confidence: 99%

An interaction effect analysis of thermodilution-guided hemodynamic optimization, patient condition, and mortality among successful cardiopulmonary resuscitation patients

Kovács

Gyarmathy²,

Pilecky

et al. 2020

Preprint

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Background Post-cardiac arrest syndrome and target temperature management have an influence on hemodynamics in a complex way. Proper hemodynamic monitoring is necessary among post-cardiac arrest patients. The aim of our study was to investigate the effects of PiCCO™-guided hemodynamic management on short- and long-term mortality in post-resuscitation therapy and to disentangle the relationship between PiCCO™-application, the patients' condition, and mortality by assessing it as an interaction effect. Methods In this longitudinal analysis of 63 comatose patients after successful cardiopulmonary resuscitation cooled to 32–34˚C, 30 patients received no PiCCO™ monitor application and 33 received PiCCO™. Primary and secondary outcomes were 30-day and one-year mortality. Kaplan-Meyer curves and corresponding Log-rank tests were used to assess differences in mortality among PiCCO™ vs non-PiCCO™ patients. Interaction effects (patient`s condition vs. PiCCO™ application vs. mortality) were assessed by means of Chi-square tests and logistic regression models. Results 30-day mortality was significantly, and one-year mortality was marginally higher among PiCCO™ patients. We found five interaction patterns between patients’ condition and being monitored with PiCCO™ with regard to mortality after 30 days, which distilled down to three interaction patterns by the end of the first year. More severe patient condition per se was not the cause of higher mortality rate in the PiCCO™ group. Moreover, patients in better health conditions (without ST-elevation myocardial infarction, without cardiogenic shock, without intra-aortic balloon pump device or without stroke in prior history) had worse outcomes in PiCCO™-guided therapy. Furthermore, catecholamine administration worsened both 30-day and one-year mortality among all patients. Conclusions Our analysis showed that there was a complex interaction relationship between PiCCO™-guided therapy, patients’ condition, and 30-day mortality for most conditions. Furthermore, in terms of one-year mortality, there was either no benefit whatsoever of PiCCO™ monitoring on survival or there was worse survival among patients who had no underlying conditions but received PiCCO™ (such as among patients who had no STEMI or had no stroke).

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“…Standard procedure after surgical interventions under general anaesthesia is for the patient to be monitored postoperatively and there are dedicated guidelines in anaesthetics [39], [88], [89]. Observation is the responsibility of the anaesthetist, who also decides when the patient may leave the recovery room.…”

Section: Risk: Surgical Interventionsmentioning

confidence: 99%

Management of patients with risk factors

Waldfahrer

2013

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 12:Doc02; ISSN 1865-1011

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Der PiCCO-Katheter

Cited by 7 publications

References 0 publications

An Interaction Effect Analysis of Thermodilution-Guided Hemodynamic Optimization, Patient Condition, and Mortality after Successful Cardiopulmonary Resuscitation

An Interaction Effect Analysis of Thermodilution-Guided Hemodynamic Optimization, Patient Condition, and Mortality after Successful Cardiopulmonary Resuscitation

An interaction effect analysis of thermodilution-guided hemodynamic optimization, patient condition, and mortality among successful cardiopulmonary resuscitation patients

Management of patients with risk factors

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