Determination of cardiac output during mechanical ventilation by electrical bioimpedance or thermodilution in patients with acute lung injury: effects of positive end-expiratory pressure. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: To evaluate the usefulness of transthoracic electrical bioimpedance in sedated and paralyzed patients with acute lung injury during mechanical ventilation with and without early application of positive end-expiratory pressure (PEEP). DESIGN: Prospective, repeated-measures study. SETTING: University-affiliated intensive care center. PATIENTS: Ten patients with acute lung injury. INTERVENTIONS: Simultaneous, three-paired cardiac output (CO) measurements by transthoracic electrical bioimpedance (TEB) and thermodilution (TD) were made at 0 and 15 cm H2O of PEEP. MEASUREMENTS AND MAIN RESULTS: The average of the TD-CO measurements was 7.22 +/- 2.12 (SD) L/min during 0 cm H2O of positive end-expiratory pressure (ZEEP), and 6.91 +/- 1.72 L/min during PEEP (NS). The average of the TEB-CO measurements was 4.48 +/- 1.37 L/min during ZEEP, and 6.03 +/- 2.03 L/min during PEEP (p < .05). For each level of PEEP, bias and precision between methods were calculated. Bias calculations between TD-CO and TEB-CO ranged from -1.54 +/- 7.02 L/min at ZEEP to -2.52 +/- 4.28 L/ min at PEEP, and -2.47 +/- 6.09 L/min for mixed data at ZEEP and PEEP. There was no significant correlation between the percent change with PEEP in TEB-CO and TD-CO (r2 =.05, NS). CONCLUSIONS: In patients with acute lung injury: a) the agreement between TEB-CO and TD-CO measurements is poor; b) agreement is not clinically improved by application of PEEP; and c) TEB cannot monitor trends in CO.

publication date

  • August 1, 1998

Research

keywords

  • Body Composition
  • Cardiac Output
  • Positive-Pressure Respiration
  • Respiration, Artificial
  • Respiratory Distress Syndrome
  • Thermodilution

Identity

Scopus Document Identifier

  • 0031926922

Digital Object Identifier (DOI)

  • 10.1097/00003246-199808000-00035

PubMed ID

  • 9710107

Additional Document Info

volume

  • 26

issue

  • 8