Bioreactance is not reliable for estimating cardiac output and the effects of passive leg raising in critically ill patients
Bioreactance estimates cardiac output in a non-invasive way. We evaluated the ability of a bioreactance device (NICOM) to estimate cardiac index (CI) and to track relative changes induced by volume expansion. In 48 critically ill patients, we measured CI estimated by the NICOM device (CINicom) and b...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2013 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p4645 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/4645 |
| Access Level: | acceso abierto |
| Palabra clave: | equipment monitors dobutamine measurement cardiac output measurement techniques shock |
| Sumario: | Bioreactance estimates cardiac output in a non-invasive way. We evaluated the ability of a bioreactance device (NICOM) to estimate cardiac index (CI) and to track relative changes induced by volume expansion. In 48 critically ill patients, we measured CI estimated by the NICOM device (CINicom) and by transpulmonary thermodilution (CItd, PiCCO(2) device) before and after a 500 ml saline infusion. Before volume expansion, we performed a passive leg raising (PLR) test and measured the changes it induced in CINicom and in pulse contour analysis-derived CI. Considering the values recorded before PLR and before and after volume expansion (n144), the bias (lower and upper limits of agreement) between CItd and CINicom was 0.9 (2.2 to 4.1) litre min(1) m(2). The percentage error was 82. There was no significant correlation between the changes in CItd and CINicom induced by volume expansion (P0.24). An increase in CI estimated by pulse contour analysis 9 during the PLR test predicted fluid responsiveness with a sensitivity of 84 (95 confidence interval 6097) and a specificity of 97 (95 confidence interval 82100). The area under the receiver operating characteristic curve constructed to test the ability of the PLR-induced changes in CINicom in predicting fluid responsiveness did not differ significantly from 0.5 (P0.77). The NICOM device cannot accurately estimate the cardiac output in critically ill patients. Moreover, it could not predict fluid responsiveness through the PLR test. |
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