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Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters

INTRODUCTION: Transpulmonary thermodilution is used to measure cardiac output (CO), global end-diastolic volume (GEDV) and extravascular lung water (EVLW). A system has been introduced (VolumeView/EV1000™ system, Edwards Lifesciences, Irvine CA, USA) that employs a novel algorithm for the mathematic...

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Autores principales: Kiefer, Nicholas, Hofer, Christoph K, Marx, Gernot, Geisen, Martin, Giraud, Raphaël, Siegenthaler, Nils, Hoeft, Andreas, Bendjelid, Karim, Rex, Steffen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580647/
https://www.ncbi.nlm.nih.gov/pubmed/22647561
http://dx.doi.org/10.1186/cc11366
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author Kiefer, Nicholas
Hofer, Christoph K
Marx, Gernot
Geisen, Martin
Giraud, Raphaël
Siegenthaler, Nils
Hoeft, Andreas
Bendjelid, Karim
Rex, Steffen
author_facet Kiefer, Nicholas
Hofer, Christoph K
Marx, Gernot
Geisen, Martin
Giraud, Raphaël
Siegenthaler, Nils
Hoeft, Andreas
Bendjelid, Karim
Rex, Steffen
author_sort Kiefer, Nicholas
collection PubMed
description INTRODUCTION: Transpulmonary thermodilution is used to measure cardiac output (CO), global end-diastolic volume (GEDV) and extravascular lung water (EVLW). A system has been introduced (VolumeView/EV1000™ system, Edwards Lifesciences, Irvine CA, USA) that employs a novel algorithm for the mathematical analysis of the thermodilution curve. Our aim was to evaluate the agreement of this method with the established PiCCO™ method (Pulsion Medical Systems SE, Munich, Germany, clinicaltrials.gov identifier: NCT01405040) METHODS: Seventy-two critically ill patients with clinical indication for advanced hemodynamic monitoring were included in this prospective, multicenter, observational study. During a 72-hour observation period, 443 sets of thermodilution measurements were performed with the new system. These measurements were electronically recorded, converted into an analog resistance signal and then re-analyzed by a PiCCO(2)™ device (Pulsion Medical Systems SE). RESULTS: For CO, GEDV, and EVLW, the systems showed a high correlation (r(2 )= 0.981, 0.926 and 0.971, respectively), minimal bias (0.2 L/minute, 29.4 ml and 36.8 ml), and a low percentage error (9.7%, 11.5% and 12.2%). Changes in CO, GEDV and EVLW were tracked with a high concordance between the two systems, with a traditional concordance for CO, GEDV, and EVLW of 98.5%, 95.1%, and 97.7% and a polar plot concordance of 100%, 99.8% and 99.8% for CO, GEDV, and EVLW, respectively. Radial limits of agreement for CO, GEDV and EVLW were 0.31 ml/minute, 81 ml and 40 ml, respectively. The precision of GEDV measurements was significantly better using the VolumeView™ algorithm compared to the PiCCO™ algorithm (0.033 (0.03) versus 0.040 (0.03; median (interquartile range), P = 0.000049). CONCLUSIONS: For CO, GEDV, and EVLW, the agreement of both the individual measurements as well as measurements of change showed the interchangeability of the two methods. For the VolumeView method, the higher precision may indicate a more robust GEDV algorithm. TRIAL REGISTRATION: clinicaltrials.gov NCT01405040.
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spelling pubmed-35806472013-03-01 Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters Kiefer, Nicholas Hofer, Christoph K Marx, Gernot Geisen, Martin Giraud, Raphaël Siegenthaler, Nils Hoeft, Andreas Bendjelid, Karim Rex, Steffen Crit Care Research INTRODUCTION: Transpulmonary thermodilution is used to measure cardiac output (CO), global end-diastolic volume (GEDV) and extravascular lung water (EVLW). A system has been introduced (VolumeView/EV1000™ system, Edwards Lifesciences, Irvine CA, USA) that employs a novel algorithm for the mathematical analysis of the thermodilution curve. Our aim was to evaluate the agreement of this method with the established PiCCO™ method (Pulsion Medical Systems SE, Munich, Germany, clinicaltrials.gov identifier: NCT01405040) METHODS: Seventy-two critically ill patients with clinical indication for advanced hemodynamic monitoring were included in this prospective, multicenter, observational study. During a 72-hour observation period, 443 sets of thermodilution measurements were performed with the new system. These measurements were electronically recorded, converted into an analog resistance signal and then re-analyzed by a PiCCO(2)™ device (Pulsion Medical Systems SE). RESULTS: For CO, GEDV, and EVLW, the systems showed a high correlation (r(2 )= 0.981, 0.926 and 0.971, respectively), minimal bias (0.2 L/minute, 29.4 ml and 36.8 ml), and a low percentage error (9.7%, 11.5% and 12.2%). Changes in CO, GEDV and EVLW were tracked with a high concordance between the two systems, with a traditional concordance for CO, GEDV, and EVLW of 98.5%, 95.1%, and 97.7% and a polar plot concordance of 100%, 99.8% and 99.8% for CO, GEDV, and EVLW, respectively. Radial limits of agreement for CO, GEDV and EVLW were 0.31 ml/minute, 81 ml and 40 ml, respectively. The precision of GEDV measurements was significantly better using the VolumeView™ algorithm compared to the PiCCO™ algorithm (0.033 (0.03) versus 0.040 (0.03; median (interquartile range), P = 0.000049). CONCLUSIONS: For CO, GEDV, and EVLW, the agreement of both the individual measurements as well as measurements of change showed the interchangeability of the two methods. For the VolumeView method, the higher precision may indicate a more robust GEDV algorithm. TRIAL REGISTRATION: clinicaltrials.gov NCT01405040. BioMed Central 2012 2012-05-30 /pmc/articles/PMC3580647/ /pubmed/22647561 http://dx.doi.org/10.1186/cc11366 Text en Copyright ©2012 Kiefer et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Kiefer, Nicholas
Hofer, Christoph K
Marx, Gernot
Geisen, Martin
Giraud, Raphaël
Siegenthaler, Nils
Hoeft, Andreas
Bendjelid, Karim
Rex, Steffen
Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title_full Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title_fullStr Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title_full_unstemmed Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title_short Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
title_sort clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580647/
https://www.ncbi.nlm.nih.gov/pubmed/22647561
http://dx.doi.org/10.1186/cc11366
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