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CLC number: R472

On-line Access: 2016-07-06

Received: 2015-10-10

Revision Accepted: 2016-01-02

Crosschecked: 2016-06-20

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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
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%P 561-567
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%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
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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

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