Indexation of cardiac output to biometric parameters in critically ill patients: A systematic analysis of a transpulmonary thermodilution–derived database

Saugel, Bernd; Mair, Sebastian; Götz, Simon Q.; Tschirdewahn, Julia; Frank, Johanna; Höllthaler, Josef; Schmid, Roland M.; Huber, Wolfgang

doi:10.1016/j.jcrc.2015.06.011

Cited by 13 publications

(9 citation statements)

References 16 publications

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“…However, reference ranges are given for a population with a representative age distribution. A recent study demonstrated that cardiac function as measured by cardiac output (CO) substantially decreases with older age (independent decrease of CO of 66 mL/min per year) 33 . Therefore, GEF, SVI and dPmax might be considered within the age-adjusted normal range.…”

Section: Discussionmentioning

confidence: 99%

Increased extravascular lung water index (EVLWI) reflects rapid non-cardiogenic oedema and mortality in COVID-19 associated ARDS

Rasch

Schmidle

Sancak

et al. 2021

Sci Rep

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Nearly 5% of patients suffering from COVID-19 develop acute respiratory distress syndrome (ARDS). Extravascular lung water index (EVLWI) is a marker of pulmonary oedema which is associated with mortality in ARDS. In this study, we evaluate whether EVLWI is higher in patients with COVID-19 associated ARDS as compared to COVID-19 negative, ventilated patients with ARDS and whether EVLWI has the potential to monitor disease progression. EVLWI and cardiac function were monitored by transpulmonary thermodilution in 25 patients with COVID-19 ARDS subsequent to intubation and compared to a control group of 49 non-COVID-19 ARDS patients. At intubation, EVLWI was noticeably elevated and significantly higher in COVID-19 patients than in the control group (17 (11–38) vs. 11 (6–26) mL/kg; p < 0.001). High pulmonary vascular permeability index values (2.9 (1.0–5.2) versus 1.9 (1.0–5.2); p = 0.003) suggested a non-cardiogenic pulmonary oedema. By contrast, the cardiac parameters SVI, GEF and GEDVI were comparable in both cohorts. High EVLWI values were associated with viral persistence, prolonged intensive care treatment and in-hospital mortality (23.2 ± 6.7% vs. 30.3 ± 6.0%, p = 0.025). Also, EVLWI showed a significant between-subjects (r = − 0.60; p = 0.001) and within-subjects correlation (r = − 0.27; p = 0.028) to Horowitz index. Compared to non COVID-19 ARDS, COVID-19 results in markedly elevated EVLWI-values in patients with ARDS. High EVLWI reflects a non-cardiogenic pulmonary oedema in COVID-19 ARDS and could serve as parameter to monitor ARDS progression on ICU.

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Section: Discussionmentioning

confidence: 99%

Increased extravascular lung water index (EVLWI) reflects rapid non-cardiogenic oedema and mortality in COVID-19 associated ARDS

Rasch

Schmidle

Sancak

et al. 2021

Sci Rep

Self Cite

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show abstract

“…A recent study demonstrated that cardiac function as measured by cardiac output (CO) substantially decreases with older age (independent decrease of CO of 66mL/min per year). 31 Therefore, GEF, SVI and dPmax might be considered within the age-adjusted normal range.…”

Section: Discussionmentioning

confidence: 99%

Increased extravascular lung water index (EVLWI) reflects rapid inflammatory oedema and mortality in COVID-19 associated ARDS

Rasch

Schmidle

Sancak

et al. 2020

Preprint

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OBJECTIVE: Nearly 5 % of the patients with COVID-19 develop an acute respiratory distress syndrome (ARDS). Extravascular lung water index (EVLWI) is a marker of pulmonary oedema which is associated with mortality in ARDS. In this study we evaluate whether EVLWI is higher in patients with COVID-19 associated ARDS as compared to controls and whether EVLWI has the potential to monitor disease progression. METHODS: From the day of intubation, EVLWI, cardiac function were monitored by transpulmonary thermodilution in n=25 patients with COVID-19 and compared to a control group of 49 non-COVID-19 ARDS-patients. RESULTS: EVLWI in COVID-19-patients was noticeably elevated and significantly higher than in the control group (17 (11-38) vs. 11 (6-26) mL/kg; p<0.001). High pulmonary vascular permeability index values (2.9 (1.0-5.2) versus 1.9 (1.0-5.2); p=0.003) suggest inflammatory oedema. By contrast, the cardiac parameters SVI, GEF and GEDVI were comparable. High EVLWI values were associated with viral persistence, prolonged intensive care treatment and mortality (23.2±6.7% vs. 30.3±6.0%, p=0.025). CONCLUSIONS: Compared to the control group, COVID-19 results in markedly elevated EVLWI-values in patients with ARDS. EVLWI reflects a non-cardiogenic pulmonary oedema in COVID-19 associated ARDS and could serve as parameter to monitor ARDS progression.

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“…We previously published data on indexation of EVLW and cardiac output from the same database [17,25].…”

Section: Patients and Study Designmentioning

confidence: 99%

“…TPTD measurements of GEDV were performed with the PiCCO system as described before [17,25,26]. Briefly, a 5-French thermistor-tipped arterial line (Pulsiocath; Pulsion Medical Systems SE) placed in the femoral artery and a hemodynamic monitor (PiCCO-Plus or PiCCO-2; Pulsion Medical Systems SE) were used for creation and analysis of a thermodilution curve after injection of a cold indicator bolus through a central venous catheter.…”

Section: Tptdmentioning

confidence: 99%

A systematic database-derived approach to improve indexation of transpulmonary thermodilution-derived global end-diastolic volume

Huber

Mair

Götz

et al. 2016

J Clin Monit Comput

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Global end-diastolic volume (GEDV) has been indexed to body surface area (BSA). However, data validating this indexation of GEDV are scarce. Furthermore, it has been suggested to index GEDV to "predicted BSA" based on predicted body weight. Therefore, we aimed to identify biometric parameters independently associated with GEDV. We analyzed a database including 3812 TPTD measurements in 234 patients treated in the ICU of a German university hospital. GEDVI indexed to actual BSA was significantly lower than GEDVI indexed to predicted BSA (748 ± 179 vs. 804 ± 190 mL/m; p < 0.001). GEDV was independently associated with older age, male sex, height, and actual body weight. In a regression model for the estimation of GEDV, age and height were the most important parameters: Each year in age and each cm in height increased GEDV by 9 and 15 mL, respectively. In addition to height and weight also age and sex should be considered for indexation of GEDV.

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Indexation of cardiac output to biometric parameters in critically ill patients: A systematic analysis of a transpulmonary thermodilution–derived database

Cited by 13 publications

References 16 publications

Increased extravascular lung water index (EVLWI) reflects rapid non-cardiogenic oedema and mortality in COVID-19 associated ARDS

Increased extravascular lung water index (EVLWI) reflects rapid non-cardiogenic oedema and mortality in COVID-19 associated ARDS

Increased extravascular lung water index (EVLWI) reflects rapid inflammatory oedema and mortality in COVID-19 associated ARDS

A systematic database-derived approach to improve indexation of transpulmonary thermodilution-derived global end-diastolic volume

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