Hemodynamic Monitoring by Pulse-Indicated Continuous Cardiac Output Analysis During Lung Transplantation_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

YAN Jie ¹ , XU Hongyang ¹ , ZHU Yanhong ¹ , WANG Yanjuan ² , LIANG Fengming ¹ , YANG Ting ¹ , CHEN Jinyu. ³

Department of Critical Care Medicine, Wuxi People’s Hospital. Wuxi, Jiangsu,214002, ChinaCorresponding Author: YAN Jie, E-mail: yjeast@ 163. com;

Corresponding author：

Keywords：

Pulse-indicated continuous cardiac output; Lung transplantation; Hemodynamics

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Objective To explore the hemodynamic monitoring value of pulse-indicated continuous cardiac output( PiCCO) during lung transplantation. Methods Twenty patients with end-stage lung disease undergone lung transplantation were enrolled. Hemodynamic states were monitored by PiCCO and Swan-Ganz standard thermodilution pulmonary artery catheter( PAC) simultaneously at six stages throughout the study. Changes in the variables were calculated by subtracting the first fromthe second measurement( Δ1 ) and so on ( Δ1 to Δ5 ) . Results The linear correlation between intra-thoracic blood volume index( ITBVI) and stroke volume index( SVIpa) was significant ( r = 0. 654, P lt; 0. 05) , whereas pulmonary artery wedge pressure ( PAWP) poorly correlated with SVIpa( P gt; 0. 05) . Changes in ITBVI correlated with changes in SVIpa ( Δ1 , r =0. 621; Δ2 , r = 0. 784; Δ3 , r = 0. 713; Δ4 , r = 0. 740; Δ5 , r = 0. 747; all P lt; 0. 05) , whereas PAWP failed. The mean bias between CIart and CIpa was ( 0. 09 ±0. 5) L·min-1 ·m-2 ; the limit of agreement was ( - 0. 89 ～1. 07) L·min-1 ·m-2 . Conclusions There is good correlation between the two methods of PiCCO and PAC for reflecting the change of heart preload. PiCCO is reliable in hemodynamic monitoring in patients undergone lung transplantation.

Citation： YAN Jie,XU Hongyang,ZHU Yanhong,WANG Yanjuan,LIANG Fengming,YANG Ting,CHEN Jinyu.. Hemodynamic Monitoring by Pulse-Indicated Continuous Cardiac Output Analysis During Lung Transplantation. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(2): 184-187. doi: Copy

1.	Sander M, von Heymann C, Foer A, et al. Pulse contour analysis after normothermic cardiopulmonary bypass in cardiac surgery patients. Crit Care, 2005, 9: R729-734 .
2.	Gil Antón J, Cecchetti C, Menéndez S, et al. Preliminary clinical experience with PiCCO system in children with shock. An Pediatr ( Barc) , 2009, 71 : 135-140.
3.	López-Herce J, Bustinza A, Sancho L, et al. Cardiac output and blood volume parameters using femoral arterial thermodilution.Pediatr Int, 2009, 51: 59-65.
4.	Bein B, Meybohm P, Cavus E, et al. The reliability of pulse contourderived cardiac output during hemorrhage and after vasopressor administration. Anesth Analg, 2007, 105: 107-113 .
5.	Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1986, 1: 307-310.
6.	Werawatganon T, Punyatavorn S, Chatkaew P, et al. Validity and reliability of cardiac output by arterial thermodilution and arterial pulse contour analysis compared with pulmonary artery thermodilution in intensive care unit. J Med Assoc Thai, 2003, 86( Suppl 2) : S323-S330 .
7.	Della Rocca G, Costa MG, Pompei L, et al. Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth, 2002 , 88 :350-356.
8.	Chatterjee K. The Swan-Ganz catheters: past, present, and future. A viewpoint. Circulation, 2009, 119: 147 -152.
9.	Rubenfeld GD, McNamara-Aslin E, Rubinson L. The pulmonary artery catheter, 1967 -2007 : rest in peace? JAMA, 2007, 298: 458 -461.
10.	Kumar A, Anel R, Bunnell E, et al. Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects. Crit Care Med, 2004, 32 : 691-699.
11.	Katzenelson R, Perel A, Berkenstadt H, et al. Accuracy of transpulmonary thermodilution versus gravimetric measurement of extravascular lung water. Crit Care Med, 2004, 32: 1550-1554.
12.	Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge.Crit Care Med, 2007, 35 : 64-68.
13.	Luecke T, Roth H, Herrmann P, et al. Assessment of cardiac preload and left ventricular function under increasing levels of positive endexpiratory pressure. Intensive Care Med, 2004, 30: 119 -126.
14.	Reuter DA, Felbinger TW, Schmidt C, et al. Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med, 2002, 28: 392-398 .
15.	Rex S, Brose S, Metzelder S, et al. Prediction of fluid responsiveness in patients during cardiac surgery. Br JAnaesth, 2004, 93: 782-788 .
16.	Hofer CK, Furrer L, Matter-Ensner S, et al. Volumetric preload measurement by thermodilution: a comparison with transoesophageal echocardiography. Br J Anaesth, 2005, 94: 748-755.

1. Sander M, von Heymann C, Foer A, et al. Pulse contour analysis after normothermic cardiopulmonary bypass in cardiac surgery patients. Crit Care, 2005, 9: R729-734 .
2. Gil Antón J, Cecchetti C, Menéndez S, et al. Preliminary clinical experience with PiCCO system in children with shock. An Pediatr ( Barc) , 2009, 71 : 135-140.
3. López-Herce J, Bustinza A, Sancho L, et al. Cardiac output and blood volume parameters using femoral arterial thermodilution.Pediatr Int, 2009, 51: 59-65.
4. Bein B, Meybohm P, Cavus E, et al. The reliability of pulse contourderived cardiac output during hemorrhage and after vasopressor administration. Anesth Analg, 2007, 105: 107-113 .
5. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1986, 1: 307-310.
6. Werawatganon T, Punyatavorn S, Chatkaew P, et al. Validity and reliability of cardiac output by arterial thermodilution and arterial pulse contour analysis compared with pulmonary artery thermodilution in intensive care unit. J Med Assoc Thai, 2003, 86( Suppl 2) : S323-S330 .
7. Della Rocca G, Costa MG, Pompei L, et al. Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth, 2002 , 88 :350-356.
8. Chatterjee K. The Swan-Ganz catheters: past, present, and future. A viewpoint. Circulation, 2009, 119: 147 -152.
9. Rubenfeld GD, McNamara-Aslin E, Rubinson L. The pulmonary artery catheter, 1967 -2007 : rest in peace? JAMA, 2007, 298: 458 -461.
10. Kumar A, Anel R, Bunnell E, et al. Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects. Crit Care Med, 2004, 32 : 691-699.
11. Katzenelson R, Perel A, Berkenstadt H, et al. Accuracy of transpulmonary thermodilution versus gravimetric measurement of extravascular lung water. Crit Care Med, 2004, 32: 1550-1554.
12. Osman D, Ridel C, Ray P, et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge.Crit Care Med, 2007, 35 : 64-68.
13. Luecke T, Roth H, Herrmann P, et al. Assessment of cardiac preload and left ventricular function under increasing levels of positive endexpiratory pressure. Intensive Care Med, 2004, 30: 119 -126.
14. Reuter DA, Felbinger TW, Schmidt C, et al. Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med, 2002, 28: 392-398 .
15. Rex S, Brose S, Metzelder S, et al. Prediction of fluid responsiveness in patients during cardiac surgery. Br JAnaesth, 2004, 93: 782-788 .
16. Hofer CK, Furrer L, Matter-Ensner S, et al. Volumetric preload measurement by thermodilution: a comparison with transoesophageal echocardiography. Br J Anaesth, 2005, 94: 748-755.

Chinese Journal of Respiratory and Critical Care Medicine

Hemodynamic Monitoring by Pulse-Indicated Continuous Cardiac Output Analysis During Lung Transplantation

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