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Echocardiography and pulse contour analysis to assess cardiac output in trauma patients.
Franchi, F; Falciani, E; Donadello, K; Zacà, V; Silvestri, R; Taccone, F S; Cubattoli, L; Mongelli, P; Giomarelli, P; Scolletta, S.
Afiliación
  • Franchi F; Department of Anesthesia and Intensive Care, University of Siena, Siena, Italy. franchif@unisi.it
Minerva Anestesiol ; 79(2): 137-46, 2013 Feb.
Article en En | MEDLINE | ID: mdl-23032925
BACKGROUND: Echocardiography is a valuable technique to assess cardiac output (CO) in trauma patients, but it does not allow a continuous bedside monitoring. Beat-to-beat CO assessment can be obtained by other techniques, including the pulse contour method MostCare. The aim of our study was to compare CO obtained with MostCare (MC-CO) with CO estimated by transthoracic echocardiography (TTE-CO) in trauma patients. METHODS: Forty-nine patients with blunt trauma admitted to an intensive care unit and requiring hemodynamic optimization within 24 hours from admission were studied. TTE-CO and MC-CO were estimated simultaneously at baseline, after a fluid challenge and after the start of vasoactive drug therapy. RESULTS: One hundred sixteen paired CO values were obtained. TTE-CO values ranged from 2.9 to 7.6 L·min(-1), and MC-CO ranged from 2.8 to 8.2 L·min(-1). The correlation between the two methods was 0.94 (95% confidence interval [CI]=0.89 to 0.97; P<0.001). The mean bias was -0.06 L·min(-1) with limits of agreements (LoA) of -0.94 to 0.82 L·min(-1) (lower 95% CI, -1.16 to -0.72; upper 95% CI, 0.60 to 1.04) and a percentage error of 18%. Changes in CO showed a correlation of 0.91 (95% CI=0.87 to 0.95; P<0.001), a mean bias of -0.01 L·min(-1) with LoA of -0.67 to 0.65 L·min(-1) (lower 95% CI, -0.83 to -0.51; upper 95% CI, 0.48 to 0.81). CONCLUSION: CO measured by MostCare showed good agreement with CO obtained by transthoracic echocardiography. Pulse contour analysis can complement echocardiography in evaluating hemodynamics in trauma patients.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pulso Arterial / Heridas y Lesiones / Ecocardiografía / Gasto Cardíaco / Monitoreo Fisiológico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Minerva Anestesiol Año: 2013 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pulso Arterial / Heridas y Lesiones / Ecocardiografía / Gasto Cardíaco / Monitoreo Fisiológico Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Minerva Anestesiol Año: 2013 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Italia