Utility and economic benefit of thoracic bioimpedance in critical care patients

Ahmad, Faheem; Parvathaneni, Lakshmi; Silver, Marc A.

doi:10.1016/s1071-9164(99)91656-1

Cited by 3 publications

(3 citation statements)

References 1 publication

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“…Because ICG only requires minimal technical skill, it is also one of the easiest methods of CO determination available. In theory, ICG has the potential to selectively replace the other, more invasive procedures 32 of determination of CO, and extends hemodynamic monitoring to less acute settings outside the intensive care environment, including outpatient clinics.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Impedance Cardiography to Direct Fick and Thermodilution Cardiac Output Determination in Pulmonary Arterial Hypertension

Yung

Fedullo

Kinninger

et al. 2004

Congestive Heart Failure

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Cardiac output (CO) is an important diagnostic and prognostic tool for patients with ventricular dysfunction. Pulmonary hypertension patients undergo invasive right heart catheterization to determine pulmonary vascular and cardiac hemodynamics. Thermodilution (TD) and direct Fick method are the most common methods of CO determination but are costly and may be associated with complications. The latest generation of impedance cardiography (ICG) provides noninvasive estimation of CO and is now validated. The purpose of this study was to compare ICG measurement of CO to TD and direct Fick in pulmonary hypertension patients. Thirty-nine enrolled patients were analyzed: 44% were male and average age was 50.8+/-17.4 years. Results for bias and precision of cardiac index were as follows: ICG vs. Fick (-0.13 L/min/m2 and 0.46 L/min/m2), TD vs. Fick (0.10 L/min/m2 and 0.41 L/min/m2), ICG vs. TD (respectively, with a 95% level of agreement between -0.72 and 0.92 L/min/m2; CO correlation of ICG vs. Fick, TD vs. Fick, and ICG vs. TD was 0.84, 0.89, and 0.80, respectively). ICG provides an accurate, useful, and cost-effective method for determining CO in pulmonary hypertension patients, and is a potential tool for following responses to therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Comparison of Impedance Cardiography to Direct Fick and Thermodilution Cardiac Output Determination in Pulmonary Arterial Hypertension

Yung

Fedullo

Kinninger

et al. 2004

Congestive Heart Failure

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“…21 demonstrated a 71% reduction in PAC utilization with the availability of noninvasive ICG. In addition to invasive monitoring replacements, noninvasive ICG monitoring has dramatically increased the number of patients in whom hemodynamic monitoring can be provided.…”

Section: Limitations Oficgmentioning

confidence: 99%

“…Given its demonstrated validity when compared with invasive methods, which have considerable cost and risk, 20 ICG is potentially a valid and less costly alternative to pulmonary artery catheter (PAC) monitoring. Ahmad et al 21 demonstrated a 71% reduction in PAC utilization with the availability of noninvasive ICG. In addition to invasive monitoring replacements, noninvasive ICG monitoring has dramatically increased the number of patients in whom hemodynamic monitoring can be provided.…”

Section: Clinical Applicationmentioning

confidence: 99%

Noninvasive Hemodynamic Monitoring in Heart Failure: Utilization of Impedance Cardiography

Yancy

Abraham

2003

Congestive Heart Failure

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Equivalence of the Bioimpedance and Thermodilution Methods in Measuring Cardiac Output in Hospitalized Patients With Advanced, Decompensated Chronic Heart Failure

Albert

Hail

et al. 2004

American Journal of Critical Care

113

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• Background An accurate and reliable noninvasive method for determining cardiac output/cardiac index would be valuable for patients with acutely decompensated advanced systolic heart failure.• Objectives To determine whether a correlation exists for cardiac output and index determined by using bioimpedance and thermodilution in patients with acutely decompensated complex heart failure and if differences between results with the 2 methods could be explained by the patients’ advanced condition.• Methods Cardiac output and index were determined by using bioimpedance and thermodilution in 33 patients. Echocardiographic and electrocardiographic data were assessed to determine if differences between results with the 2 methods could be explained by the patients’ advanced condition. Concordance correlation coefficients and Bland-Altman agreement between methods were calculated.• Results Four patients were excluded from analysis because reliable measurements could not be obtained; the remaining 29 patients constituted the study population. Mean cardiac outputs determined by thermodilution and bioimpedance were 5.48 and 5.40 L/min, respectively (ρc =0.89, P < .001), and mean cardiac indexes were 2.67 and 2.65 (ρc = 0.82, P < .001). Mean bias (limits of agreement) between data pairs was 0.08 (−0.18 to 0.35) L/min (P = .52) for cardiac output and 0.03 (−0.097 to 0.16; P = .61) for cardiac index. Six data pairs (21%) had an absolute percent difference greater than 15%. Of these, 50% had a higher thermodilution value.• Conclusion Determinations of cardiac output and index by both methods were significantly correlated. Mean bias between the 2 methods was small, suggesting clinical utility for bioimpedance in patients with complex decompensated heart failure.

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Utility and economic benefit of thoracic bioimpedance in critical care patients

Cited by 3 publications

References 1 publication

Comparison of Impedance Cardiography to Direct Fick and Thermodilution Cardiac Output Determination in Pulmonary Arterial Hypertension

Comparison of Impedance Cardiography to Direct Fick and Thermodilution Cardiac Output Determination in Pulmonary Arterial Hypertension

Noninvasive Hemodynamic Monitoring in Heart Failure: Utilization of Impedance Cardiography

Equivalence of the Bioimpedance and Thermodilution Methods in Measuring Cardiac Output in Hospitalized Patients With Advanced, Decompensated Chronic Heart Failure

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