Cardiovascular Diagnostic Techniques
Conditions
Brief summary
Thermodilution cardiac output measurement is a reliable method, but it is an invasive one. PiCCO device requires cannulation of central vein and peripheral artery. Impedance method requires only attachment of special electrodes. Non-invasive methods are less accurate. Aim of study is to assess accuracy and reliability of impedance method ( using NICCOMO device) in comparison of thermodilution method ( using PiCCO device) at different PEEP levels.
Detailed description
Echocardiography is performed prior to measurement to exclude patients with heart valve abnormalities. Patients without spontaneous ventilation ( deeply unconscious, sedated or sedated and paralysed), ventilated with controlled mechanical ventilation mode with tidal volume 6-8 ml/ideal body weight, resulting in EtCO2 35-45 mmHg, with PiCCO catheters implemented have additionally NICCOMO device attached. Fraction of inspired oxygen (FiO2) is set to achieve saturation \>96% at positive end expiratory pressure (PEEP) 0 cmH2O. Measurement of cardiac output are performed on expiration at PEEP 0, 5, 10, 15 20 cmH2O and at optimal PEEP (obtained from P-V curve). Simultaneously CO value from impedance device is noted. Other haemodynamic parameters, calculated by both devices are also noted - stroke volume (SV), stroke volume variation (SVV), Cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI).
Interventions
Sponsors
Medical University of Gdansk
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* critically ill patients * patients on mechanical ventilation * circulatory insufficiency (present or in the past) monitored with with PiCCO device
Exclusion criteria
* morbid obesity, * short neck, * severe pneumonia, * inability to NICCOMO electrodes attachment, * massive tissue oedema, * non-sinus cardiac rhythm, * tachycardia, * low cardiac output, * septic shock, * heart valve pathologies, * severe atherosclerosis, * aortic prosthesis, * severe hypertension, * extremes of height and weight, * intraaortic pump
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numbers of measurements of haemodynamic parameters (CO, CI, SV, SVV, CI, SVR, SVRI) obtained with impedance, that differ from those obtained with thermodilution | up to 90 minutes | measurements taken with impedance and thermodilution simultaneously, at PEEP 0, 5, 10, 15, 20 and at optimal PEEP |
Countries
Poland
Contacts
Primary ContactMagdalena A Wujtewicz
Backup ContactRadoslaw Owczuk
Outcome results
None listed