Volume assessment in patients with necrotizing pancreatitis: A comparison of intrathoracic blood volume index, central venous pressure, and hematocrit, and their correlation to cardiac index and extravascular lung water index*

Huber, Wolfgang; Umgelter, Andreas; Reindl, Wolfgang; Franzen, Michael; Schmidt, Christian; Delius, Stefan von; Geisler, Fabian; Eckel, Florian; Fritsch, Ralph; Siveke, Jens T.; Henschel, Benedikt; Schmid, Roland M.

doi:10.1097/ccm.0b013e3181809928

Cited by 107 publications

(61 citation statements)

References 25 publications

(37 reference statements)

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“…The TPTD with integrated invasive arterial pulse contour analysis is a haemodynamic monitoring system gaining favourable reception in intensive care units since it allows both intermittent and continuous CO measurements [1,2]. It operates via a single thermal indicator technique to determine EVLW, CO and volumetric variables.…”

Section: Discussionmentioning

confidence: 99%

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Transpulmonary thermodilution curves for detection of shunt

et al. 2010

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Purpose: Monitoring using transpulmonary thermodilution (TPTD) via a single thermal indicator technique allows measurement of cardiac output, extravascular lung water (EVLW) and volumetric variables. Methods and results: This report describes two cases of systemic-venous circulation shunt generating early recirculation of thermal indicator with overestimation of EVLW. Conclusion: In the case of recirculation of thermal indicator, the observed overestimated EVLW in absence of gas exchanges abnormality could be an indicator suggesting the search for a circulatory shunt.

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Section: Discussionmentioning

confidence: 99%

“…The impact of intracardiac shunt on volumetric variables derived from the TPTD curve has not previously been studied. The present two case reports, describe the impact of ventricular septal defect (VSD) and aorto cava fistula (ACF) on the TPTD curve and EVLW measurements in critically ill patients monitored with TPTD [1,2].…”

Section: Introductionmentioning

confidence: 99%

Transpulmonary thermodilution curves for detection of shunt

et al. 2010

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“…This has been shown to provide optimal volume management for critically ill patients with necrotising pancreatitis [15], and to reduce the vasopressor requirements of cardiac surgery patients [14]. Furthermore, this system allows estimation of extravascular lung water and the pulmonary vascular permeability index, which may be used to assess the severity of pulmonary dysfunction.…”

mentioning

confidence: 99%

“…There is good evidence regarding the efficacy of goal-directed fluid management based on transpulmonary thermodilution-measured variables using the PiCCO Ò monitoring system (Pulsion Medical Systems, Munich, Germany) [14][15][16]. This has been shown to provide optimal volume management for critically ill patients with necrotising pancreatitis [15], and to reduce the vasopressor requirements of cardiac surgery patients [14].…”

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confidence: 99%

The precision of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

Tagami

Kushimoto

Tosa³

et al. 2012

Anaesthesia

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SummaryThe aim of the present study was to determine the precision of the PiCCO Ò system for post-cardiac arrest patients who underwent therapeutic hypothermia. The precision of the measurements for cardiac output, global end-diastolic volume, extravascular lung water and the pulmonary vascular permeability index was assessed using the least significant change; this was regarded as precise when less than 15%. A total of 462 measurement sets were prospectively performed on 88 patients following successful resuscitation after cardiac arrest. Using the mean value of three injections for a measurement, the least significant change for the cardiac output, global end-diastolic volume, extravascular lung water and pulmonary vascular permeability index measurements were found to be 7.8%, 8.5%, 7.8% and 12.1%, respectively. No significant differences between hypothermia (n = 150) and non-hypothermia (n = 312) were found. The PiCCO-derived variables were found to be precise for post-cardiac arrest patients even under conditions of varying body temperature.

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“…However, CVP often does not identify the true value of blood volume, fluid changes, fluid responsiveness and cardiac preload; sometimes, there is no relation between low CVP values and blood loss during liver resection [9]. Modern hemodynamic parameters such as the global end-diastolic volume index and variation in stroke volume have been demonstrated to be superior to pressure-based preload parameters, such as CVP and pulmonary arterial occlusion pressure [10][11][12]. We hypothesized that monitoring other hemodynamic parameters such as GEDV (Global End-Diastolic Volume), during liver resection would provide more accurate cardiac preload information.…”

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confidence: 99%

Global end-diastolic volume could be more appropiate to reduce intraoperative bleeding than central venous pressure during major liver transection

Redondo

Padilla

Villazala

et al. 2017

Anaesthesiol Intensive Ther

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Background: Central venous pressure often fails to identify the true value of cardiac preload. Our purpose is to investigate whether Global End-Diastolic Volume (GEDV) values can control hemodynamic parameters for the measurement of fluid volume, cardiac preload and blood loss during liver transection. Methods: This was a prospective clinical study that included patients undergoing liver resection. All patients were monitored by means of PiCCO technology and 222 hemodynamic measurements were performed in 74 patients. Fluid restriction was used. Transpulmonary thermodilutions were performed at different times of surgery, namely: 1. at the beginning of surgery; 2. before hepatectomy and after selective vascular exclusion (Time 1); 3. approximately half way through the liver transection (Time 2); and 4. after liver resection (Time 3). Results: One hundred and twenty-nine of the 222 GEDV values were decreased (prevalence of hypovolemia of 58.1%). However, twenty two of the 222 CVP values were decreased (prevalence of 10.8%). Sensitivity of CVP with regard to volume depletion (GEDV > 650 mL m -2 ) on the times (1, 2 and 3) were ) and 21.43 (95% CI: 7.83-35.03), respectively. There was no correlation between CVP and GEDV. Conclusions: GEDV values may be more appropriate for monitoring cardiac preload during liver transection.

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Volume assessment in patients with necrotizing pancreatitis: A comparison of intrathoracic blood volume index, central venous pressure, and hematocrit, and their correlation to cardiac index and extravascular lung water index*

Cited by 107 publications

References 25 publications

Transpulmonary thermodilution curves for detection of shunt

Transpulmonary thermodilution curves for detection of shunt

The precision of PiCCO^®measurements in hypothermic post‐cardiac arrest patients

Global end-diastolic volume could be more appropiate to reduce intraoperative bleeding than central venous pressure during major liver transection

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Volume assessment in patients with necrotizing pancreatitis: A comparison of intrathoracic blood volume index, central venous pressure, and hematocrit, and their correlation to cardiac index and extravascular lung water index*

Cited by 107 publications

References 25 publications

Transpulmonary thermodilution curves for detection of shunt

Transpulmonary thermodilution curves for detection of shunt

The precision of PiCCO®measurements in hypothermic post‐cardiac arrest patients

Global end-diastolic volume could be more appropiate to reduce intraoperative bleeding than central venous pressure during major liver transection

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The precision of PiCCO^®measurements in hypothermic post‐cardiac arrest patients