Comparison of hemodynamic measurements from invasive and noninvasive monitoring during early resuscitation

Tchorz, Kathryn M.; Chandra, Mukul; Markert, Ronald J.; Healy, M. J. R.; Anderson, Harry; Ekeh, Akpofure Peter; Saxe, Jonathan M.; Walusimbi, Mbaga S.; Woods, Randy J.; Dominguez, Kathleen M.; McCarthy, Mary C.

doi:10.1097/ta.0b013e31824b1764

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…CUS performed by intensivists has played an important role in ICUs because it is a noninvasive test that provides useful hemodynamic information [1][2][3][4][5][6][7][8]. Furthermore, problem-focused US can help identify specific problems e.g., fluid collection, DVT, biliary tract diseases, and urinary tract obstruction, which are common in surgical patients as seen in the present study [13,14].…”

Section: Discussionmentioning

confidence: 87%

“…Ultrasonography (US) has become an essential tool in almost every subdivision of medical practice including critical care medicine. Various applications of US have been used in ICUs, for instance, monitoring of hemodynamic parameters such as intravascular volume (preload) and cardiac contractility [1][2][3][4][5][6][7][8]. Despite the fact that US has some inherent limitations and is largely operator dependent, it enables clinicians to rapidly assess unstable patients by the bedside and is relatively inexpensive.…”

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confidence: 99%

“…Furthermore, US also aids in performing various bedside procedures (e.g., central venous catheter placement, and percutaneous drainage), and in detecting fluid collection, pneumothorax, and venous thrombosis. Hence, US has a significant impact in managing ICU patients and is replacing invasive hemodynamic monitoring in ICU [1][2][3][4][5][6][7]. Recently, several studies evaluating the use of cardiac ultrasonography (CUS) in the surgical ICU (SICU) and critically-ill trauma patients have been reported [2][3][4][5][6][7].…”

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confidence: 99%

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Evaluation of the utility of cardiac ultrasonography of patients in a surgical intensive care unit

et al. 2016

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BackgroundUltrasonography is being more commonly used by intensivists to assess the hemodynamic status of patients in intensive care units (ICUs) and for other purposes.ObjectiveTo review the indications for and evaluate the impact of cardiac ultrasonography (CUS) on the management of patients in a surgical ICU (SICU).MethodWe conducted a retrospective observational cohort study of patients in the SICU who underwent CUS performed by intensivists at King Chulalongkorn Memorial Hospital from January 2011 to March 2013. CUS was used to determine (1) preload (using inferior vena cava (IVC) diameter and collapsibility index), (2) cardiac contractility (using subjective assessment and fractional shortening), and (3) other miscellaneous findings.ResultWe included data from 157 patients (96 male and 61 female) whose age ranged from 15 to 99 years (mean 63.5 years) in the study. CUS was performed 190 times in these 157 patients. The most common indication for CUS was hemodynamic status assessment (78), followed by shock (69), oliguria (35), and other (8). CUS results led to 71 changes in management (37% of cases) ; namely, fluid challenge (38), inotropic drug management (7), drainage of pleural/abdominal fluid (12), and other changes (14). A weakly-positive correlation between the IVC diameter and CVP (Pearson’s r = 0.45) was demonstrated. The overall mortality rate was 14.6%.ConclusionCUS performed by intensivists can be used to assess the hemodynamic status of patients in the SICU, especially those with shock or oliguria, and lead to changes in the management of these patients.

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Section: Discussionmentioning

confidence: 87%

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confidence: 99%

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confidence: 99%

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Evaluation of the utility of cardiac ultrasonography of patients in a surgical intensive care unit

et al. 2016

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“…Cardiac output can reliably be measured with echocardiography using Doppler measurements of left ventricular outflow tract [8][9][10]. In trauma patients, cardiac output measurements from pulmonary artery catheter and transthoracic echocardiography were significantly related and agreed with moderate strength [9].…”

Section: Echocardiography In Shockmentioning

confidence: 83%

Ultrasonic evaluation of the heart

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2014

Current Opinion in Critical Care

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“…Whether echocardiography can replace TD method in CO measurement remains controversial. Some studies [13–15] have revealed that echocardiography is a rapid, accurate, and noninvasive monitoring technology suitable for patients in ICU. Although differences were observed, some studies [10, 16] showed the correlation was good.…”

Section: Introductionmentioning

confidence: 99%

Cardiac output measurements via echocardiography versus thermodilution: A systematic review and meta-analysis

et al. 2019

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Echocardiography, as a noninvasive hemodynamic evaluation technique, is frequently used in critically ill patients. Different opinions exist regarding whether it can be interchanged with traditional invasive means, such as the pulmonary artery catheter thermodilution (TD) technique. This systematic review aimed to analyze the consistency and interchangeability of cardiac output measurements by ultrasound (US) and TD. Five electronic databases were searched for studies including clinical trials conducted up to June 2019 in which patients’ cardiac output was measured by ultrasound techniques (echocardiography) and TD. The methodological quality of the included studies was evaluated by two independent reviewers who used the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), which was tailored according to our systematic review in Review Manager 5.3. A total of 68 studies with 1996 patients were identified as eligible. Meta-analysis and subgroup analysis were used to compare the cardiac output (CO) measured using the different types of echocardiography and different sites of Doppler use with TD. No significant differences were found between US and TD (random effects model: mean difference [MD], -0.14; 95% confidence interval, -0.30 to 0.02; P = 0.08). No significant differences were observed in the subgroup analyses using different types of echocardiography and different sites except for ascending aorta (AA) (random effects model: mean difference [MD], -0.37; 95% confidence interval, -0.74 to -0.01; P = 0.05) of Doppler use. The median of bias and limits of agreement were -0.12 and ±0.94 L/min, respectively; the median of correlation coefficient was 0.827 (range, 0.140–0.998). Although the difference in CO between echocardiography by different types or sites and TD was not entirely consistent, the overall effect of meta-analysis showed that no significant differences were observed between US and TD. The techniques may be interchangeable under certain conditions.

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Comparison of hemodynamic measurements from invasive and noninvasive monitoring during early resuscitation

Abstract: Measurements of CO and SV were moderately strong in correlation and agreement which may suggest PAC measurements overestimate actual values. The significance of tricuspid regurgitation and mitral regurgitation during early resuscitation is unknown.

Cited by 11 publications

References 22 publications

Evaluation of the utility of cardiac ultrasonography of patients in a surgical intensive care unit

Evaluation of the utility of cardiac ultrasonography of patients in a surgical intensive care unit

Ultrasonic evaluation of the heart

Cardiac output measurements via echocardiography versus thermodilution: A systematic review and meta-analysis

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