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Titolo:
Thermal filament continuous thermodilution cardiac output delayed responselimits its value during acute hemodynamic instability
Autore:
de Figueiredo, LFP; Malbouisson, LMS; Varicoda, EY; Carmona, MJ; Auler, JO; Silva, MRE;
Indirizzi:
Univ Sao Paulo, Inst Heart, INCOR, Dept Cardiopneumol,Res Div, BR-05403000Sao Paulo, Brazil Univ Sao Paulo Sao Paulo Brazil BR-05403000 BC-05403000Sao Paulo, Brazil Univ Sao Paulo, Inst Heart, INCOR, Dept Surg, BR-05403000 Sao Paulo, Brazil Univ Sao Paulo Sao Paulo Brazil BR-05403000 BC05403000 Sao Paulo, Brazil
Titolo Testata:
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
fascicolo: 2, volume: 47, anno: 1999,
pagine: 288 - 293
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENOUS OXYGEN-SATURATION; CRITICALLY ILL PATIENTS; BOLUS THERMODILUTION; CLINICAL VALIDATION; SURGICAL PATIENTS; ANEURYSM REPAIR; SHEEP;
Keywords:
continuous cardiac output; hemodynamics; hemorrhage; resuscitation; shock;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: de Figueiredo, LFP Univ Sao Paulo, Inst Heart, INCOR, Dept Cardiopneumol,Res Div, Av Eneas deCarvalho Aguiar 44, BR-05403000 Sao Paulo, Brazil Univ Sao Paulo Av Eneas de Carvalho Aguiar 44 Sao Paulo Brazil BR-05403000 BC
Citazione:
L.F.P. de Figueiredo et al., "Thermal filament continuous thermodilution cardiac output delayed responselimits its value during acute hemodynamic instability", J TRAUMA, 47(2), 1999, pp. 288-293

Abstract

Background: It has been suggested that measurement of continuous cardiac output (CCO) is an advancement in the management of critically ill patients. Our objective was to determine the accuracy of CCO during the rapid hemodynamic changes induced by hemorrhage and resuscitation. Methods: In 12 anesthetized dogs (20.2 +/- 0.9 kg), pulmonary artery bloodflow, our "gold standard" cardiac output, was measured with an sonographicflowprobe, whereas CCO, intermittent bolus cardiac output (ICO), and mixedvenous oxygen saturation were measured with a thermodilution fiberoptic pulmonary artery catheter with a thermal filament. ii graded hemorrhage (20 mL/min) was produced to a mean arterial pressure of 40 mm Hg, which was maintained at this level for 30 minutes. Total shed blood volume (701 +/- 53 mi) was retransfused at a rate of 40 mL/min, over 30 minutes, after which a massive hemorrhage (100 mL/min) was produced over 10 minutes. Results: Hemorrhage induced significant decreases in mean arterial pressure, mixed venous oxygen saturation, and oxygen delivery, which were all restored during early resuscitation, However, CCO showed a delayed response after hemorrhage and resuscitation, compared with pulmonary blood flow, throughout the study (r = 0.559), matching only at baseline and at the end of both graded hemorrhage and resuscitation periods. There was a good correlationbetween ICO and pulmonary artery blood flow (r = 0.964) and no significantdifferences between them throughout the study,Conclusion: CCO has a delayed response during acute hemodynamic changes induced by hemorrhage and resuscitation. When sudden changes in mean arterialpressure or in mixed venous oxygen saturation are detected, cardiac outputmust be estimated by the standard bolus thermodilution technique, not by CCO.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 00:44:16