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Received: 2023-10-17

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Journal of Zhejiang University SCIENCE B 2016 Vol.17 No.7 P.561-567

http://doi.org/10.1631/jzus.B1500244


Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?


Author(s):  Wolfgang Huber, Veit Phillip, Josef Höllthaler, Caroline Schultheiss, Bernd Saugel, Roland M. Schmid

Affiliation(s):  Second Medical Department, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany

Corresponding email(s):   Wolfgang.Huber@lrz.tu-muenchen.de

Key Words:  Hemodynamic monitoring, Transpulmonary thermodilution, Central venous catheter, Femoral vein, Jugular vein, Global end-diastolic volume, EV1000/VolumeView®, PiCCO®


Wolfgang Huber, Veit Phillip, Josef Höllthaler, Caroline Schultheiss, Bernd Saugel, Roland M. Schmid. Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?[J]. Journal of Zhejiang University Science B, 2016, 17(7): 561-567.

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author="Wolfgang Huber, Veit Phillip, Josef Höllthaler, Caroline Schultheiss, Bernd Saugel, Roland M. Schmid",
journal="Journal of Zhejiang University Science B",
volume="17",
number="7",
pages="561-567",
year="2016",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1500244"
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%T Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?
%A Wolfgang Huber
%A Veit Phillip
%A Josef Höllthaler
%A Caroline Schultheiss
%A Bernd Saugel
%A Roland M. Schmid
%J Journal of Zhejiang University SCIENCE B
%V 17
%N 7
%P 561-567
%@ 1673-1581
%D 2016
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1500244

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T1 - Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?
A1 - Wolfgang Huber
A1 - Veit Phillip
A1 - Josef Höllthaler
A1 - Caroline Schultheiss
A1 - Bernd Saugel
A1 - Roland M. Schmid
J0 - Journal of Zhejiang University Science B
VL - 17
IS - 7
SP - 561
EP - 567
%@ 1673-1581
Y1 - 2016
PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B1500244


Abstract: 
Objective: Comparison of global end-diastolic volume index (GEDVI) obtained by femoral and jugular transpulmonary thermodilution (TPTD) indicator injections using the EV1000/VolumnView® device (Edwards Lifesciences, Irvine, USA). Methods: In an 87-year-old woman with hypovolemic shock and equipped with both jugular and femoral vein access and monitored with the EV1000/VolumeView® device, we recorded 10 datasets, each comprising duplicate TPTD via femoral access and duplicate TPTD (20 ml cold saline) via jugular access. Results: Mean femoral GEDVI ((674.6±52.3) ml/m2) was significantly higher than jugular GEDVI ((552.3±69.7) ml/m2), with P=0.003. Bland-Altman analysis demonstrated a bias of (+122±61) ml/m2, limits of agreement of −16 and +260 ml/m2, and a percentage error of 22%. Use of the correction-formula recently suggested for the PiCCO® device significantly reduced bias and percentage error. Similarly, mean values of parameters derived from GEDVI such as pulmonary vascular permeability index (PVPI; 1.244±0.101 vs. 1.522±0.139; P<0.001) and global ejection fraction (GEF; (24.7±1.6)% vs. (28.1±1.8)%; P<0.001) were significantly different in the case of femoral compared to jugular indicator injection. Furthermore, the mean cardiac index derived from femoral indicator injection ((4.50±0.36) L/(min·m²)) was significantly higher (P=0.02) than that derived from jugular indicator injection ((4.12±0.44) L/(min·m²)), resulting in a bias of (+0.38±0.37) L/(min·m²) and a percentage error of 19.4%. Conclusions: Femoral access for indicator injection results in markedly altered values provided by the EV1000/VolumeView®, particularly for GEDVI, PVPI, and GEF.

经股静脉注射指标剂进行经肺热稀释检测:EV1000/VolumeView®是否与PiCCO®一样需要校正?

目的:临床上因各种原因(如穿刺位置烧伤、感染、颈静脉和锁骨下静脉血栓形成)在行经肺热稀释检测时只能通过股静脉注射指示剂,用PiCCO®设备时会使检测结果产生偏差,而用EV1000/VolumeView®是否同样会产生偏差目前尚不清楚。本研究的主要目的是观察股静脉注射指示剂对EV1000/VolumeView®检测数据的影响。
方法:通过EV1000/VolumeView®设备对一例低容量休克患者(87岁,女性)进行经肺热稀释检测,分别通过颈内静脉和股静脉注射冰盐水指示剂,对所测得的两组数据进行对比,分析股静脉注射指示剂对全心舒张末容积指数(GEDVI)、血管外肺水指数(ELWI)、心指数(CI)、肺血管通透性指数(PVPI)和全心射血分数(GEF)等参数的影响。
结论:经股静脉注射指示剂同样会影响EV1000/VolumeView®设备所检测的热稀释数据,尤其会高估GEDVI和CI值,而PVPI和GEF也会受到影响,用适合PiCCO®的校正公式校正数据后则可以明显减少偏差。
(感谢浙江大学附属第二医院俞文桥主治医师提供中文概要)

关键词:血流动力学监测;经肺热稀释;中心静脉导管;股静脉;颈静脉;全心舒张末容积;EV1000/VolumeView®;PiCCO®

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Bendjelid, K., Giraud, R., Siegenthaler, N., et al., 2010. Validation of a new transpulmonary thermodilution system to assess global end-diastolic volume and extravascular lung water. Crit. Care, 14(6):R209.

[2]Bendjelid, K., Marx, G., Kiefer, N., et al., 2013. Performance of a new pulse contour method for continuous cardiac output monitoring: validation in critically ill patients. Br. J. Anaesth., 111(4):573-579.

[3]Berbara, H., Mair, S., Beitz, A., et al., 2014. Pulmonary vascular permeability index and global end-diastolic volume: are the data consistent in patients with femoral venous access for transpulmonary thermodilution: a prospective observational study. BMC Anesthesiol., 14:81.

[4]Bland, J.M., Altman, D.G., 1999. Measuring agreement in method comparison studies. Stat. Methods Med. Res., 8(2):135-160.

[5]Calbet, J.A., Boushel, R., 2015. Assessment of cardiac output with transpulmonary thermodilution during exercise in humans. J. Appl. Physiol., 118(1):1-10.

[6]Cho, Y.J., Koo, C.H., Kim, T.K., et al., 2015. Comparison of cardiac output measures by transpulmonary thermodilution, pulse contour analysis, and pulmonary artery thermodilution during off-pump coronary artery bypass surgery: a subgroup analysis of the cardiovascular anaesthesia registry at a single tertiary centre. J. Clin. Monit. Comput., online first.

[7]Critchley, L.A., Critchley, J.A., 1999. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J. Clin. Monit. Comput., 15(2):85-91.

[8]Deshpande, K.S., Hatem, C., Ulrich, H.L., et al., 2005. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Crit. Care Med., 33(1):13-20, discussion 234-235.

[9]Goepfert, M.S.G., Reuter, D.A., Akyol, D., et al., 2007. Goal-directed fluid management reduces vasopressor and catecholamine use in cardiac surgery patients. Intensive Care Med., 33(1):96-103.

[10]Gowardman, J.R., Robertson, I.K., Parkes, S., et al., 2008. Influence of insertion site on central venous catheter colonization and bloodstream infection rates. Intensive Care Med., 34(6):1038-1045.

[11]Jozwiak, M., Silva, S., Persichini, R., et al., 2013. Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit. Care Med., 41(2):472-480.

[12]Kiefer, N., Hofer, C.K., Marx, G., et al., 2012. Clinical validation of a new thermodilution system for the assessment of cardiac output and volumetric parameters. Crit. Care, 16(3):R98.

[13]Kuzkov, V.V., Kirov, M.Y., Sovershaev, M.A., et al., 2006. Extravascular lung water determined with single transpulmonary thermodilution correlates with the severity of sepsis-induced acute lung injury. Crit. Care Med., 34(6):1647-1653.

[14]Malbrain, M.L., de Potter, T.J., Dits, H., et al., 2010. Global and right ventricular end-diastolic volumes correlate better with preload after correction for ejection fraction. Acta Anaesthesiol. Scand., 54(5):622-631.

[15]Michard, F., Alaya, S., Zarka, V., et al., 2003. Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock. Chest, 124(5):1900-1908.

[16]Renner, J., Gruenewald, M., Brand, P., et al., 2007. Global end-diastolic volume as a variable of fluid responsiveness during acute changing loading conditions. J. Cardiothorac. Vasc. Anesth., 21(5):650-654.

[17]Saugel, B., Umgelter, A., Schuster, T., et al., 2010. Transpulmonary thermodilution using femoral indicator injection: a prospective trial in patients with a femoral and a jugular central venous catheter. Crit. Care, 14:R95.

[18]Schmidt, S., Westhoff, T.H., Hofmann, C., et al., 2007. Effect of the venous catheter site on transpulmonary thermodilution measurement variables. Crit. Care Med., 35(3):783-786.

[19]Sun, Y., Lu, Z.H., Zhang, X.S., et al., 2015. The effects of fluid resuscitation according to PiCCO on the early stage of severe acute pancreatitis. Pancreatology, 15(5):497-502.

[20]Yu, W.Q., Zhang, Y., Zhang, S.Y., et al., 2016. Impact of misplaced subclavian vein catheter into jugular vein on transpulmonary thermodilution measurement variables. J. Zhejiang Univ.-Sci. B (Biomed. & Biotechnol.), 17(1):60-66.

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