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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1002/2014JA020939

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1432-1238

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Transpulmonary thermodilution measurements are not

Authors: Nicolas Dufour Marianne Delville JeanLouis Teboul Laurent Camous Aude Favier du Noyer Christian Richard Xavier Monnet
Publish Date: 2012/04/28
Volume: 38, Issue: 7, Pages: 1162-1168
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Abstract

To assess whether continuous venovenous hemofiltration CVVH with high blood pump flow alters the measurements of cardiac index CI global enddiastolic volume indexed GEDVI and extravascular lung water indexed EVLWI performed by transpulmonary thermodilutionSixtynine patients were included if they were monitored by a PiCCO2 device and received CVVH through a femoral n = 62 or an internal jugular n = 7 dialysis catheter The blood pump flow was set at 250 mL/min n = 31 or 350 mL/min n = 38 and the filtration flow at 6000 mL/h A first set of data was collected with a first transpulmonary thermodilution TDon The blood pump was stopped and the continuous CI derived from pulse contour analysis was recorded PCoff A second data set TDoff was collected before and a last one TDonlast after restarting the blood pump textCI textTD texton textCI textPC textoff textCI textTD textoff and textCI textTD texton textlast were not significantly different in patients with a femoral dialysis catheter 349 ± 096 351 ± 096 351 ± 099 and 344 ± 100 L min−1 m−2 respectively This was observed with a blood pump flow at 350 mL/min and at 250 mL/min In these patients with a femoral dialysis catheter GEDVI did not significantly change when the blood pump was stopped EVLWI significantly decreased when the blood pump was stopped but to a nonclinically relevant extent −03 ± 08 mL/kg No significant changes in CI GEDVI and EVLWI were observed in patients with an internal jugular dialysis catheter over the study period

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