Precision of the transpulmonary thermodilution measurements 英文参考文献.docVIP

Precision of the transpulmonary thermodilution measurements 英文参考文献.doc

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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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