Monitoring intra-cardiac shunts correction with transpulmonary thermodilution curve: the best is yet to come!

Bendjelid, Karim

doi:10.1007/s10877-011-9286-0

Cited by 2 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In conclusion, by looking at TPTD curves, it is possible to detect a wide variety of shunts (intracardiac, arteriovenous fistula) and it has been suggested that TPTD curves could also be useful during surgery to evaluate the success of intra-cardiac shunt closure [75]. (Fig.…”

Section: Step 2 Shuntsmentioning

confidence: 99%

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Hofkens¹,

Verrijcken²,

Merveille³

et al. 2015

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Background: Haemodynamic monitoring with transpulmonary thermodilution (TPTD) is less invasive than a pulmonary artery catheter, and is increasingly used in the Intensive Care Unit and the Operating Room. Optimal treatment of the critically ill patient demands adequate, precise and continuous monitoring of clinical parameters. Little is known about staff knowledge of the basic principles and practical implementation of TPTD measurements at the bedside. The aims of this review are to: 1) present the results of a survey on the knowledge of TPTD measurement among 252 nurses and doctors; and 2) to focus on specific situations and common pitfalls in order to improve patient management in daily practice. Methods: Web-based survey on knowledge of PiCCO technology (Pulsion Medical Systems, Feldkirchen, Germany), followed by PubMed and Medline search with review of the relevant literature regarding the use of TPTD in specific situations. Results: In total, 252 persons participated in the survey: 196 nurses (78%) and 56 medical doctors (22%) of whom 17 were residents in training. Knowledge on the use of TPTD appears to be suboptimal, with an average score of 58.3%. Doctors performed better than nurses (62.7% vs 57.0%, P = 0.012). About 190 out of 252 (75.4%) scored at least 50% but only 45 respondents (17.9%) obtained a score of 70% or more. Having five years of PiCCO experience was present in 15.8% of the participants and this was correlated to passing the test, defined as obtaining a test result of ≥ 50% (P = 0.07) or obtaining a test result of ≥ 70% (P = 0.05). There were no other parameters significantly predictive for obtaining a result above 50% or above 70% such as gender or doctor versus nurse or Belgian versus Dutch residency, or years of ICU experience. High quality education of nursing and medical staff is necessary to perform the technique correctly and to analyse and interpret the information that can be obtained. Visual inspection of thermodilution curves is important as this can point towards specific pathology. Interpretation of the parameters that can be obtained with TPTD in specific conditions is discussed. Finally, a practical approach is given in ten easy steps for nurses and doctors. Conclusion: TPTD has gained its place in the haemodynamic monitoring field, but, as with any technique, its virtue is only fully appreciated with correct use and interpretation.

show abstract

Section: Step 2 Shuntsmentioning

confidence: 99%

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Hofkens¹,

Verrijcken²,

Merveille³

et al. 2015

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

show abstract

“…On one hand, these findings suggest the consideration of presence of high flow arteriovenous fistula among the potential contraindications of TPTD-based hemodynamic assessment in critically ill patients, while on the other hand they support the likelihood of detecting and monitoring a wide variety of shunts by analyzing TPTD curves. 2,15 Nonetheless it should be noted that the utility of TPTD depends not only on the clinical relevance and therapeutic implications of findings in terms of improved patient outcomes in different scenarios but also on the correct measurement technique and accurate interpretation of the obtained values. 2 It is not common for arteriovenous fistulas to reach the high flow because of the narrow vessel diameters in the anterior arm.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Utility of transpulmonary thermodilution with Pulse Index Continuous Cardiac Output system for hemodynamic assessment in a hemodialysis patient with arteriovenous fistula and continuous renal replacement therapy: A case report

Ozkan

Arbatlı

2019

J Vasc Access

View full text Add to dashboard Cite

Close hemodynamic monitoring is of paramount importance among critically ill patients to guide cardiovascular therapy for the optimal management and thus improved outcomes. 1-3 Although the pulmonary artery catheter has been the mainstay of hemodynamic monitoring for years, its use is decreasing given the inconclusive data on the outcome benefit in terms of improved morbidity and mortality among critically ill patients. 2-5 Another factor seems to be the introduction of less invasive hemodynamic monitoring methods such as transpulmonary thermodilution (TPTD) as validated in a variety of clinical settings. 2,3,6 Currently,

show abstract

Monitoring intra-cardiac shunts correction with transpulmonary thermodilution curve: the best is yet to come!

Cited by 2 publications

References 8 publications

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Common pitfalls and tips and tricks to get the most out of your transpulmonary thermodilution device: results of a survey and state-of-the-art review

Utility of transpulmonary thermodilution with Pulse Index Continuous Cardiac Output system for hemodynamic assessment in a hemodialysis patient with arteriovenous fistula and continuous renal replacement therapy: A case report

Contact Info

Product

Resources

About