For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
56
views
31
references
 Top references
cited by
11
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      515
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO

      other

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring). The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points) on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO ( n = 70). Seventy paired left-sided CO measurements (transaortic access = CO US-A) were obtained. The mean CO US-A were 6.55 l/min (±2.19) versus CO PiCCO 6.5 l/min (±2.18). The correlation coefficient was r = 0.89. Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min) leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO). It seems to be appropriate in situations where CO measurements are most pertinent to patient management.

          Related collections

          Most cited references31

          • Record: found
          • Abstract: found
          • Article: not found

          Estimation of left ventricular systolic function by single transpulmonary thermodilution.

          Jean-Baptiste Berneau, Jean-Louis Trouillet, Alain Combes … (2004)
          The single-indicator transpulmonary thermodilution technique (PiCCO system) provides two derived indices of cardiac systolic function: the cardiac function index and the global ejection fraction. We used transesophageal echocardiography to compare theses indices with left ventricular fractional area of change only for patients with no isolated right ventricular dysfunction. (The global cardiac systolic function may be decreased despite preserved left ventricular function in this situation.) Prospective, open, clinical study. Intensive care unit (ICU) in a university hospital. Thirty-three mechanically ventilated patients. Left ventricular fractional area of change (LVFAC) was measured using transesophageal echocardiography. The cardiac function index (CFI) and the global ejection fraction (GEF) were determined from transpulmonary thermodilution-derived cardiac output and thoracic volumes. Transesophageal echocardiography identified 3 patients with isolated right ventricular failure (PiCCO underestimated LVFAC in this situation). Significant correlations were established between LVFAC and CFI (r=0.87, n=30, p /=40% using CFI or GEF was 0.92. CFI >4 and GEF >18% estimated LVFAC >/=40% with respective sensitivities of 86 and 88% and specificities of 88 and 79%. Significant correlations were established between changes of LVFAC and CFI/GEF over time. In mechanically ventilated ICU patients, PiCCO-derived cardiac function index and global ejection fraction provide reliable estimations of LV systolic function but may underestimate it in the cases of isolated right ventricular failure.
          Article 0 comments Cited 28 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit.

            Daniel Parsons, Mary Roberts, Aaitje Tan … (2005)
            The USCOM ultrasonic cardiac output monitor (USCOM Pty Ltd, Coffs Harbour, NSW, Australia) is a non-invasive device that determines cardiac output by continuous-wave Doppler ultrasound. The aim of this study was to evaluate the accuracy of the USCOM device compared with the thermodilution technique in intensive care patients who had just undergone cardiac surgery. We conducted a prospective study in the 18-bed intensive care unit of a 600-bed tertiary referral hospital. Twenty-four mechanically ventilated patients were studied immediately following cardiac surgery. We evaluated the USCOM monitor by comparing its output with paired measurements obtained by the standard thermodilution technique using a pulmonary artery catheter. Forty paired measurements were obtained in 22 patients. We were unable to obtain an acceptable signal in the remaining two patients. Comparison of the two techniques showed a bias of 0.18 and limits of agreement of -1.43 to 1.78. The agreement may not be as good between techniques at higher cardiac output values. The USCOM monitor has a place in intensive care monitoring. It is accurate, rapid, safe, well-tolerated, non-invasive and cost-effective. The learning curve for skill acquisition is very short. However, during the learning phase the USCOM monitor measurements are rather 'operator dependent'. Its suitability for use in high and low cardiac output states requires further validation.
            Article 0 comments Cited 22 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Measurement of cardiac output before and after cardiopulmonary bypass: Comparison among aortic transit-time ultrasound, thermodilution, and noninvasive partial CO2 rebreathing.

              E Staples, N Gravenstein, P M Botero … (2004)
              A noninvasive continuous cardiac output system (NICO) has been developed recently. NICO uses a ratio of the change in the end-tidal carbon dioxide partial pressure and carbon dioxide elimination in response to a brief period of partial rebreathing to measure CO. The aim of this study was to compare the agreement among NICO, bolus (TDCO), and continuous thermodilution (CCO), with transit-time flowmetry of the ascending aorta using an ultrasonic flow probe (UFP) before and after cardiopulmonary bypass (CPB). Prospective, observational human study. Veterans Affairs Medical Center Hospital. Sixty-eight patients. Matched sets of CO measurements between NICO, TDCO, CCO, and UFP were collected in 68 patients undergoing elective CABG at specific time periods before and after separation from CPB. After anesthetic induction, all patients had an NICO sensor attached between the endotracheal tube and the breathing circuit, a PAC floated into the pulmonary artery for TDCO and CCO monitoring, and a UFP positioned on the ascending aorta and used for the reference CO. Bland-Altman analysis was used to compare the agreement among the different methods. Bland-Altman analysis of CO measurements before CPB yielded a bias, precision, and percent error of 0.04 L/min +/- 1.07 L/min (44.8%) for NICO, 0.18 L/min +/- 1.01 L/min (41.7%) for TDCO, and 0.29 L/min +/- 1.40 L/min (57.5%) for CCO compared with simultaneous UFP CO measurements, respectively. After separation from CPB (average 29 mins), bias, precision, and percent error were -0.46 L/min +/- 1.06 L/min (37.3%) for NICO, 0.35 L/min +/- 1.39 L/min (46.1%) for TDCO, and 0.36 L/min +/- 1.96 L/min (64.7%) for CCO compared with UFP CO measurements, respectively. Before initiation of CPB, the accuracy for all 3 techniques was similar. After separation from CPB, the tendency was for NICO to underestimate CO and for TDCO and CCO to overestimate it. NICO offers an alternative to invasive CO measurement.
              Article 0 comments Cited 16 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Crit Care Res Pract
                Journal ID (publisher-id): CCRP
                Title: Critical Care Research and Practice
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-1305
                ISSN (Electronic): 2090-1313
                Publication date (Print): 2012
                Publication date (Electronic): 29 November 2011
                Volume: 2012
                Electronic Location Identifier: 270631
                Affiliations
                1Medical Department II, Ludwig Maximilian University of Munich, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany
                2Medical Department III, Ludwig Maximilian University of Munich, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany
                3Department of Anesthesia II, Ludwig Maximilian University of Munich, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany
                4Medical Department I, Ludwig Maximilian University of Munich, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany
                Author notes

                Academic Editor: Karim Bendjelid

                Article
                DOI: 10.1155/2012/270631
                PMC ID: 3235433
                PubMed ID: 22191019
                SO-VID: 2480f5d0-3dce-424b-b8ee-45051c2fd093
                Copyright © Copyright © 2012 Sophia Horster et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 July 2011
                Date accepted : 10 October 2011
                Categories
                Subject: Clinical Study

                ScienceOpen disciplines: Emergency medicine & Trauma
                Data availability:
                ScienceOpen disciplines: Emergency medicine & Trauma

                Comments

                Comment on this article

                scite_

                Similar content515

                See all similar

                Cited by9

                See all cited by

                Most referenced authors231

                See all reference authors