Thoracic bioimpedence accurately determines cardiac output in patients with left ventricular assist devices

Silver, Marc A.; Lazzara, Deborah; Slaughter, Mark S.; Szabo, Szabolcs; Pappas, Patroklos

doi:10.1016/s1071-9164(99)91483-5

Journal of Cardiac Failure

1999

DOI: 10.1016/s1071-9164(99)91483-5

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Thoracic bioimpedence accurately determines cardiac output in patients with left ventricular assist devices

Marc A. Silver¹,

Deborah Lazzara²,

Mark S. Slaughter³

et al.

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Cited by 3 publications

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“…Impedance cardiography (ICG) is a noninvasive method for obtaining hemodynamic parameters, including measurements of flow (stroke volume and cardiac output), afterload (systemic vascular resistance), work (left cardiac work), contractility (velocity index and acceleration index), fluid status (thoracic fluid content [TFC]), and electromechanical timing intervals (preejection period, left ventricular ejection time, and systolic time ratio) 18 . ICG accuracy has been validated in numerous clinical states, including heart failure, 19–21 pulmonary hypertension, 22 mechanical ventilation, 23 and postcoronary artery bypass 24,25 …”

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confidence: 99%

Evaluation of Impedance Cardiography as an Alternative to Pulmonary Artery Catheterization in Critically Ill Patients

Silver

Cianci

Brennan

et al. 2004

Congestive Heart Failure

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Invasive pulmonary artery catheterization has historically been the method of choice for the evaluation of hemodynamic status. Impedance cardiography (ICG) is an accurate, noninvasive technique to obtain hemodynamic status information without the risk and cost associated with invasive methods. The purpose of this prospective, observational study was to determine whether the availability of ICG could decrease the need for placement of a pulmonary artery catheter in critically ill patients in coronary care units. After the need for hemodynamic data was determined, ICG parameters were provided to the attending physician who then decided whether pulmonary artery catheter insertion was still necessary. Of 107 subjects enrolled in the study, 14 (13%; 95% confidence interval, 7.3%-21.0%) were judged by the treating physicians to have indications for hemodynamic monitoring. In these subjects, the provision of ICG data allowed the physician to avoid placement of a pulmonary artery catheter in 10/14 patients (71%; 95% confidence interval, 41.9%-91.6%). When ICG was utilized, clinicians reported that the information was helpful in 10/10 patients (100%; 95% confidence interval, 74.1%-100.0%) and improved outcome in 6/10 patients (60%; 95% confidence interval, 26.2%-87.8%). ICG can replace the pulmonary artery catheter in coronary care unit patients, and clinicians utilizing ICG believe it aids medical decision making and improves patient outcomes.

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mentioning

confidence: 99%

Evaluation of Impedance Cardiography as an Alternative to Pulmonary Artery Catheterization in Critically Ill Patients

Silver

Cianci

Brennan

et al. 2004

Congestive Heart Failure

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Transthoracic Impedance Cardiography: A Noninvasive Method of Hemodynamic Assessment

Bayram

Yancy

2009

Heart Failure Clinics

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Equivalence of the Bioimpedance and Thermodilution Methods in Measuring Cardiac Output in Hospitalized Patients With Advanced, Decompensated Chronic Heart Failure

Albert

Hail

et al. 2004

American Journal of Critical Care

113

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• Background An accurate and reliable noninvasive method for determining cardiac output/cardiac index would be valuable for patients with acutely decompensated advanced systolic heart failure.• Objectives To determine whether a correlation exists for cardiac output and index determined by using bioimpedance and thermodilution in patients with acutely decompensated complex heart failure and if differences between results with the 2 methods could be explained by the patients’ advanced condition.• Methods Cardiac output and index were determined by using bioimpedance and thermodilution in 33 patients. Echocardiographic and electrocardiographic data were assessed to determine if differences between results with the 2 methods could be explained by the patients’ advanced condition. Concordance correlation coefficients and Bland-Altman agreement between methods were calculated.• Results Four patients were excluded from analysis because reliable measurements could not be obtained; the remaining 29 patients constituted the study population. Mean cardiac outputs determined by thermodilution and bioimpedance were 5.48 and 5.40 L/min, respectively (ρc =0.89, P < .001), and mean cardiac indexes were 2.67 and 2.65 (ρc = 0.82, P < .001). Mean bias (limits of agreement) between data pairs was 0.08 (−0.18 to 0.35) L/min (P = .52) for cardiac output and 0.03 (−0.097 to 0.16; P = .61) for cardiac index. Six data pairs (21%) had an absolute percent difference greater than 15%. Of these, 50% had a higher thermodilution value.• Conclusion Determinations of cardiac output and index by both methods were significantly correlated. Mean bias between the 2 methods was small, suggesting clinical utility for bioimpedance in patients with complex decompensated heart failure.

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Thoracic bioimpedence accurately determines cardiac output in patients with left ventricular assist devices

Cited by 3 publications

References 0 publications

Evaluation of Impedance Cardiography as an Alternative to Pulmonary Artery Catheterization in Critically Ill Patients

Evaluation of Impedance Cardiography as an Alternative to Pulmonary Artery Catheterization in Critically Ill Patients

Transthoracic Impedance Cardiography: A Noninvasive Method of Hemodynamic Assessment

Equivalence of the Bioimpedance and Thermodilution Methods in Measuring Cardiac Output in Hospitalized Patients With Advanced, Decompensated Chronic Heart Failure

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