Noninvasive Cardiac Output Monitoring in Paediatric Cardiac Surgery: Correlation between Change in Thoracic Fluid Content and Change in Patient Body Weight

Ws, Kang; Jh, Lee; Hj, Shin; Sh, Kim; Ty, Kim; Dm, Seo; Tg, Yoon

doi:10.1177/030006051204000627

Cited by 9 publications

(9 citation statements)

References 27 publications

(38 reference statements)

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“…This finding is not surprising given the known relationship between BNP and increased myocardial stretch and wall tension (Bhatia, Nayyar, & Dhindsa, 2003). Thoracic fluid content, as measured by NCCO, is a qualitative measure of directional changes in total thoracic fluid content (Kang et al, 2012). Therefore, as thoracic fluid volume increases, theoretically both myocardial stretch and wall tension will increase.…”

Section: Discussionmentioning

confidence: 99%

The Relationships Between BNP and Neurocardiac Injury Severity, Noninvasive Cardiac Output, and Outcomes After Aneurysmal Subarachnoid Hemorrhage

McAteer

Hravnak

Chang

et al. 2017

Biological Research For Nursing

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Introduction Neurocardiac injury is a type of myocardial dysfunction associated with neurological insult to the brain and occurs in 31–48% of aneurysmal subarachnoid hemorrhage (aSAH) patients. Cardiac troponin I (cTnI) is commonly used to diagnose neurocardiac injury. Brain natriuretic peptide (BNP) is another cardiac marker more often used to evaluate degree of heart failure. The purpose of this study was to examine the relationships between BNP and a) neurocardiac injury severity according to cTnI, b) noninvasive continuous cardiac output (NCCO), and c) outcomes in aSAH patients. Methods This descriptive longitudinal study enrolled 30 adult aSAH patients. Data collected for 14 days included BNP and cTnI levels, NCCO parameters, and outcomes (modified Rankin scale [mRS] and mortality) at discharge and three months. Generalized estimating equations (GEE) evaluated the associations between BNP and cTnI, NCCO, and outcomes. Results Elevated BNP was significantly associated with cTnI. For every 1 unit increase in log BNP, cTnI increased by 0.05 ng/ml (p = .001). BNP was also significantly associated with thoracic fluid content (p = .0003) but no other NCCO parameters. On multivariable analyses, significant associations were found between BNP and poor mRS. For every 1 unit log BNP, patients were 3.16 times more likely to have a poor mRS at discharge (p = .021) and 5.40 times more likely at 3 months (p < .0001). Conclusion There was a significant relationship between BNP, cTnI, and poor outcomes after aSAH. BNP may have utility as a potential marker of neurocardiac injury and outcomes after aSAH.

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Section: Discussionmentioning

confidence: 99%

The Relationships Between BNP and Neurocardiac Injury Severity, Noninvasive Cardiac Output, and Outcomes After Aneurysmal Subarachnoid Hemorrhage

McAteer

Hravnak

Chang

et al. 2017

Biological Research For Nursing

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“…Fifth, other indices measured by bioreactance were not evaluated in the current study. For example, thoracic fluid content and its percentage change have shown promising results in hemodynamic managements of patients undergoing hemodialysis and in pediatric patients undergoing cardiac surgeries who are at greater risk for volume overload or depletion [ 26 , 27 ]. The use of these variables as either alternatives or adjuvants of thermodilution-derived variables requires further study.…”

Section: Discussionmentioning

confidence: 99%

Bioreactance Is Not Interchangeable with Thermodilution for Measuring Cardiac Output during Adult Liver Transplantation

et al. 2015

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BackgroundThermodilution technique using a pulmonary artery catheter is widely used for the assessment of cardiac output (CO) in patients undergoing liver transplantation. However, the unclearness of the risk-benefit ratio of this method has led to an interest in less invasive modalities. Thus, we evaluated whether noninvasive bioreactance CO monitoring is interchangeable with thermodilution technique.MethodsNineteen recipients undergoing adult-to-adult living donor liver transplantation were enrolled in this prospective observational study. COs were recorded automatically by the two devices and compared simultaneously at 3-minute intervals. The Bland–Altman plot was used to evaluate the agreement between bioreactance and thermodilution. Clinically acceptable agreement was defined as a percentage error of limits of agreement <30%. The four quadrant plot was used to evaluate concordance between bioreactance and thermodilution. Clinically acceptable concordance was defined as a concordance rate >92%.ResultsA total of 2640 datasets were collected. The mean CO difference between the two techniques was 0.9 l/min, and the 95% limits of agreement were -3.5 l/min and 5.4 l/min with a percentage error of 53.9%. The percentage errors in the dissection, anhepatic, and reperfusion phase were 50.6%, 56.1%, and 53.5%, respectively. The concordance rate between the two techniques was 54.8%.ConclusionBioreactance and thermodilution failed to show acceptable interchangeability in terms of both estimating CO and tracking CO changes in patients undergoing liver transplantation. Thus, the use of bioreactance as an alternative CO monitoring to thermodilution, in spite of its noninvasiveness, would be hard to recommend in these surgical patients.

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“…However, dynamic measurements of TFC using EC can reflect directional changes in thoracic fluids, whether increasing or decreasing. It is useful especially in patients undergoing volume shifts, which can include diuretic therapy and haemodialysis [20][21][22]. Studies have shown that during cardiac surgery total and thoracoabdominal impedances had the highest correlation to fluid balance.…”

Section: Discussionmentioning

confidence: 99%

The pilot study of role of electrical cardiometry in non-invasive assessment of hemodynamic parameters in patients with pulmonary arterial hypertension (RCD code: II-1A.1)

Kazimierczyk

Jasiewicz

Marcinkiewicz-Siemion

et al. 2017

Journal of Rare Cardiovascular Diseases

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Background: Electrical cardiometry (EC) technique could estimate cardiac output (CO), cardiac index (CI) and other parameters related to cardiac contractility and fluid status by measuring the thoracic electrical bioimpedance. We hypothesized that EC could assess right ventricle (RV) hemodynamic function in patients diagnosed with pulmonary arterial hypertension (PAH). Results: In our pilot study, enrolling 23 PAH patients, we observed a significant correlation (r = 0.71; p <0.001) between thermodilution CO measurement results (4.59 ±1.05 l/min) and CO results obtained by EC (4.86 ±1.20 l/min) and between systemic vascular resistance calculated by EC monitor and obtained during right heart catheterization (RHC) (r = 0.68; p = 0.002). Furthermore, EC parameter index of contractility (ICON) significantly correlated with tricuspid annular plane systolic excursion assessed by echocardiography (r = 0.57; p = 0.01). Conclusions: RHC cannot be replaced in obtaining accurate results of CO, however EC technique provides feasible insight into RV function at the bedside or outpatient care. JRCD 2017; 3 (2): 44-49

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Noninvasive Cardiac Output Monitoring in Paediatric Cardiac Surgery: Correlation between Change in Thoracic Fluid Content and Change in Patient Body Weight

Cited by 9 publications

References 27 publications

The Relationships Between BNP and Neurocardiac Injury Severity, Noninvasive Cardiac Output, and Outcomes After Aneurysmal Subarachnoid Hemorrhage

The Relationships Between BNP and Neurocardiac Injury Severity, Noninvasive Cardiac Output, and Outcomes After Aneurysmal Subarachnoid Hemorrhage

Bioreactance Is Not Interchangeable with Thermodilution for Measuring Cardiac Output during Adult Liver Transplantation

The pilot study of role of electrical cardiometry in non-invasive assessment of hemodynamic parameters in patients with pulmonary arterial hypertension (RCD code: II-1A.1)

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