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Báo cáo y học: "Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices. | Mon net et al. Critical Care 2010 14 R109 http ccforum.eom content 14 3 R109 c CRITICAL CARE RESEARCH Open Access Arterial pressure-based cardiac output in septic patients different accuracy of pulse contour and uncalibrated pressure waveform devices Xavier Monnet 1 2 Nadia Anguel1 2 Brice Naudin1 2 Julien Jabot1 2 Christian Richard1 2 and Jean-Louis Teboul1 2 Abstract Introduction We compared the ability of two devices estimating cardiac output from arterial pressure-curve analysis to track the changes in cardiac output measured with transpulmonary thermodilution induced by volume expansion and norepinephrine in sepsis patients. Methods In 80 patients with septic circulatory failure we administered volume expansion 40 patients or introduced increased norepinephrine 40 patients . We measured the pulse contour-derived cardiac index CI provided by the PiCCO device CIpc the arterial pressure waveform-derived CI provided by the Vigileo device CIpw and the transpulmonary thermodilution CI CItd before and after therapeutic interventions. Results The changes in CIpc accurately tracked the changes in CItd induced by volume expansion bias -0.20 0.63 L min m2 as well as by norepinephrine bias -0.05 0.74 L min m2 . The changes in CIpc accurately detected an increase in CItd 15 induced by volume expansion and norepinephrine introduction increase area under ROC curves 0.878 0.736 to 0.960 and 0.924 0.795 to 0.983 respectively P 0.05 versus 0.500 for both . The changes in CIpw were less reliable for tracking the volume-induced changes in CItd bias -0.23 0.95 L min m2 and norepinephrine-induced changes in CItd bias -0.01 1.75 L min m2 . The changes in CIpw were unable to detect an increase in CItd 15 induced by volume expansion and norepinephrine introduction increase area under ROC curves 0.564 0.398 to 0.720 and 0.541 0.377 to 0.700 respectively both not significantly different from versus 0.500 . Conclusions The CIpc was reliable and accurate for assessing the CI changes .