Impact of Impedance Cardiography on Diagnosis and Therapy of Emergent Dyspnea: The ED‐IMPACT Trial

Peacock, W. Frank; Summers, Richard L.; Vogel, Jody A.; Emerman, Charles

doi:10.1197/j.aem.2005.11.078

Cited by 26 publications

(11 citation statements)

References 28 publications

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“…The clinical application of TIC has been assessed in patients with acute dyspnea in the emergency department 6,7 . TIC made physicians change patients' diagnosis in 13% of the cases, and medications in 39% of the patients 6 .…”

Section: Villacorta Et Al Impedance In the Assessment Of Cardiac Outputmentioning

confidence: 99%

“…TIC made physicians change patients' diagnosis in 13% of the cases, and medications in 39% of the patients 6 . In another study, it was useful to differentiate cardiac form noncardiac dyspnea 7 .…”

Section: Villacorta Et Al Impedance In the Assessment Of Cardiac Outputmentioning

confidence: 99%

“…Thus, hemodynamic parameters and the volemic status can be estimated. Although TIC has been evaluated in some clinical situations [6][7][8][9] , some questions remain on its accuracy and usefulness 10 . Cardiac magnetic resonance imaging (CMRI) is considered the gold-standard for the calculation of cardiac volumes 11,12 , and no previous study comparing the two methods has ever been conducted.…”

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confidence: 99%

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Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco

Villacorta¹,

Villacorta²,

Amador

et al. 2012

Arq. Bras. Cardiol.

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ResumoBackground: Cardiac magnetic resonance imaging is considered the gold-standard method for the calculation of cardiac volumes. Transthoracic impedance cardiography assesses the cardiac output. No studies validating this measurement, in comparison to that obtained by magnetic resonance imaging, are available.Objective:To evaluate the performance of transthoracic impedance cardiography in the calculation of the cardiac output, cardiac index and stroke volume using magnetic resonance imaging as the gold-standard.Methods:31 patients with a mean age of 56.7 ± 18 years were assessed; of these, 18 (58%) were males. Patients whose indication for magnetic resonance imaging required pharmacologic stress test were excluded. Correlation between methods was assessed using the Pearson's coefficient, and dispersion of absolute differences in relation to the mean was demonstrated using the Bland-Altman's method. Agreement between methods was analyzed using the intraclass correlation coefficient.

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Section: Villacorta Et Al Impedance In the Assessment Of Cardiac Outputmentioning

confidence: 99%

Section: Villacorta Et Al Impedance In the Assessment Of Cardiac Outputmentioning

confidence: 99%

mentioning

confidence: 99%

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Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco

Villacorta¹,

Villacorta²,

Amador

et al. 2012

Arq. Bras. Cardiol.

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“…Although clinical utility has been increasingly recognized in some clinical settings (13,14), bioimpedance has been found to be inaccurate in intensive care units (ICUs) and other settings where significant electrical noise and body motion exist (5,9). Also, the technique is sensitive to placement of the electrodes on the body, variations in patient body size, and other physical factors that impact on electrical conductivity between the electrodes and skin (e.g., temperature and humidity).…”

mentioning

confidence: 99%

Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance

Keren¹,

Burkhoff²,

Squara³

2007

American Journal of Physiology-Heart and Circulatory Physiology

266

203

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Noninvasive cardiac output (CO) measurement can be useful in many clinical settings where invasive monitoring is not desired. Bioimpedance (intrabeat measurement of changes in transthoracic voltage amplitude in response to an injected high-frequency current) has been explored for this purpose but is limited in some clinical settings because of inherently low signal-to-noise ratio. Since changes in fluid content also induce changes in thoracic capacitive and inductive properties, we tested whether a noninvasive CO measurement could be obtained through measurement of the relative phase shift of an injected current (i.e., bioreactance). We constructed a prototype device that applies a 75-kHz current and determines the relative phase shift (dΦ/d t) of the recorded transthoracic voltage. CO was related to the product of peak dΦ/d t, heart rate, and ventricular ejection time. The preclinical study was done in nine open-chest pigs put on right heart bypass so that CO could be varied at known values. This was followed by a feasibility study in 27 postoperative patients who had a Swan-Ganz catheter (SGC). The measurements of noninvasive CO measurement and cardiopulmonary bypass pump correlated to each other ( r = 0.84) despite the large variation in CO and temperatures. Similarly, in patients, mean CO values were 5.18 and 5.17 l/min as measured by SGC and the noninvasive CO measurement system, respectively, and were highly correlated over the range of values studied ( r = 0.90). Preclinical and clinical data demonstrate the feasibility of using blood flow-related phase shifts of transthoracic electric signals to perform noninvasive continuous CO monitoring.

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“…In a study evaluating the cause of dyspnea in elderly patients admitted to the emergency department, the assessment by bioimpedance was able to alter the initial clinical diagnosis in 13% of patients and had an impact in changing the treatment in 39% 33 . This method has the advantage of being performed at the bedside in real time by monitoring the response to therapeutic interventions.…”

Section: E/e' -Peak Velocity Of Transmitral Diastolic Flow (E) / Earlmentioning

confidence: 99%

Avaliação hemodinâmica na insuficiência cardíaca: papel do exame físico e dos métodos não invasivos

Júnior¹,

Xavier

Garcia

et al. 2012

Arq. Bras. Cardiol.

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Among the cardiovascular diseases, heart failure (HF) has a high rate of hospitalization, morbidity and mortality, consuming vast resources of the public health system in Brazil and other countries. The correct determination of the filling pressures of the left ventricle by noninvasive or invasive assessment is critical to the proper treatment of patients with decompensated chronic HF, considering that congestion is the main determinant of symptoms and hospitalization. Physical examination has shown to be inadequate to predict the hemodynamic pattern. Several studies have suggested that agreement on physical findings by different physicians is small and that, ultimately, adaptive physiological alterations in chronic HF mask important aspects of the physical examination. As the clinical assessment fails to predict hemodynamic aspects and because the use of Swan-Ganz catheter is not routinely recommended for this purpose in patients with HF, noninvasive hemodynamic assessment methods, such as BNP, echocardiography and cardiographic bioimpedance, are being increasingly used. The present study intends to carry out, for the clinician, a review of the role of each of these tools when defining the hemodynamic status of patients with decompensated heart failure, aiming at a more rational and individualized treatment.

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Impact of Impedance Cardiography on Diagnosis and Therapy of Emergent Dyspnea: The ED‐IMPACT Trial

Abstract: Impedance cardiography data result in significant changes in ED physician diagnosis and therapeutic plan during the evaluation of dyspneic patients 65 years and older.

Cited by 26 publications

References 28 publications

Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco

Bioimpedância transtorácica comparada à ressonância magnética na avaliação do débito cardíaco

Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance

Avaliação hemodinâmica na insuficiência cardíaca: papel do exame físico e dos métodos não invasivos

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