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Precision of the transpulmonary thermodilution measurements 英文参考文献
Monnetetal.CriticalCare2011,15:R204
/content/15/4/R204
RESEARCH
OpenAccess
Precisionofthetranspulmonarythermodilution
measurements
XavierMonnet1,2*,RomainPersichini1,2,MariemKtari1,2,MathieuJozwiak1,2,ChristianRichard1,2 and
Jean-LouisTeboul1,2
Abstract
Introduction:Wewantedtodeterminethenumberofcoldbolusinjectionsthatarenecessaryforachievingan
acceptablelevelofprecisionformeasuringcardiacindex(CI),indexedglobalend-diastolicvolume(GEDVi)and
indexedextravascularlungwater(EVLWi)bytranspulmonarythermodilution.
Methods:Weincluded91hemodynamicallystablepatients(age59(25%to75%interquartilerange:39to79)
years,simplifiedacutephysiologicscore(SAPS)II59(53to65),56%undernorepinephrine)whoweremonitoredby
aPiCCO2device.Weperformedfivesuccessivecoldsaline(15mL,6°C)injectionsandrecordedthemeasurements
ofCI,GEDViandEVLWi.
Results:Consideringfiveboluses,thecoefficientofvariation(CV,calculatedasstandarddeviationdividedbythe
meanofthefivemeasurements)was7(5to11)%,7(5to12)%and7(6to12)%forCI,GEDViandEVLWi,
respectively.Iftheresultsoftwobolusinjectionswereaveraged,theprecision(2×CV/√numberofboluses)was
10(7to15)%,10(7to17)%and8(7to14)%forCI,GEDViandEVLWi,respectively.Iftheresultsofthreebolus
injectionswereaveraged,theprecisiondroppedbelow10%,thatis,thecut-offthatisgenerallyconsideredas
acceptable(8(6to12)%,8(6to14)%and8(7to14)%forCI,GEDViandEVLWi,respectively).Iftwoinjections
wereperformed,theleastsignificantchange,thatis,theminimalchangeinvaluethatcouldbetrustedtobe
significant,was14(10to21)%,14(10to24)%and14(11to23)%forCI,GEDViandEVLWi,respectively.Ifthree
injectionswereperformed,theleastsignificantchangewas12(8to17)%,12(8to19)%and12(9to19)%forCI,
GEDViandEVLWi,respectively,thatis,belowthe15%cut-offthatisusuallyconsideredasclinicallyrelevant.
Conclusions:Theseresultssupporttheinjectionofatleastthreecoldbolusesforobtaininganacceptable
precisionwhentranspulmonarythermodilutionisusedformeasuringCI,GEDViandEVLWi.
Introduction
acceptable precision. In addition to CI, TPTD also
Trans
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