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Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView~®: do the same criteria apply as for the PiCCO~®?

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2016年第7期17卷 561-567页

作者： Wolfgang HUBERt Veit PHILLIP Josef HOLLTHALER Caroline SCHULTHEISS Bemd SAUGEL Roland M. SCHMID Second Medical Department Klinikum rechts der lsar Technical University of Munich 81675 Munich Germany

Objective： Comparison of global end-diastolic volume index （GEDVI） obtained by femoral and jugular transpulmonary thermodilution （TPTD） indicator injections using the EV1000NolumnView device （Edwards Lifesci- ences, Irvine, USA）. Methods： In an 87-year-old woman with hypovolemic shock and equipped with both jugular and femoral vein access and monitored with the EV1000NolumeView device, we recorded 10 datasets, each comprising duplicate TPTD via femoral access and duplicate TPTD （20 ml cold saline） via jugular access. Results： Mean femoral GEDVI （（674.6±52.3） ml/m2） was significantly higher than jugular GEDVI （（552.3±69.7） ml/m2）, with P=-0.003. Bland-Airman analysis demonstrated a bias of （＋122±61） ml/m2, limits of agreement of -16 and ＋260 ml/m2, and a percentage error of 22%. Use of the correction-formula recently suggested for the PiCCO device significantly reduced bias and percentage error. Similarly, mean values of parameters derived from GEDVI such as pulmonary vascular permeability index （PVPI; 1.244±0.101 vs. 1.522±0.139; P〈0.001） and global ejection fraction （GEF; （24.7±1.6）% vs. （28.1±1.8）%; P〈0.001） were significantly different in the case of femoral compared to jugular indicator injection. Fur- thermore, the mean cardiac index derived from femoral indicator injection （（4.50±0.36） L/（min.m2）） was significantly higher （P=0.02） than that derived from jugular indicator injection （（4.12±0.44） L/（min.m2））, resulting in a bias of （＋0.38±0.37） L/（min.m2） and a percentage error of 19.4%. Conclusions： Femoral access for indicator injection results in markedly altered values provided by the EV1000NolumeView , particularly for GEDVI, PVPI, and GEF.

关键词： Hemodynamic monitoring transpulmonary thermodilution Central venous catheter Femoral vein Jugular vein Global end-diastolic volume EVlOOONolumeView PiCCO

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Monitoring extravascular lung water in acute respiratory distress syndrome induced by probable 2009 pandemic influenza A （H1N1） virus： report of two cases

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Chinese Medical Journal 2010年第9期123卷 1225-1227页

作者： LI Hong-liang WANG Zong-yu YAO Gai-qi ZHU Xi Department of Intensive Care Peking University Third Hospital Peking University Beijing 100191 China

During the spring of 2009, a pandemic novel influenza A （H1NI） virus emerged and spread globally. As of January 3, 2009, more than 208 countries and overseas territories or communities have reported laboratoryconfirmed cases of pandemic influenza H1N1 2009, including at least 12 799 death cases.1 Critical cases developed severe acute respiratory distress syndrome （ARDS） rapidly, which was refractory to conventional mechanical ventilation and rescue therapies.

关键词： extravascular lung water transpulmonary thermodilution acute respiratory distress syndrome pandemic influenza A H1N1

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How to integrate hemodynamic variables during resuscitation of septic shock?

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Journal of Intensive Medicine 2023年第2期3卷 131-137页

作者： Jean-Louis Teboul Service de Médecine Intensive-Réanimation Hopital de BicêtreGHU AP-HPUniversitéParis-SaclayParis 94270France

Resuscitation of septic shock is a complex issue because the cardiovascular disturbances that characterize septic shock vary from one patient to another and can also change over time in the same patient. Therefore, different therapies (fluids, vasopressors, and inotropes) should be individually and carefully adapted to provide personalized and adequate treatment. Implementation of this scenario requires the collection and collation of all feasible information, including multiple hemodynamic variables. In this review article, we propose a logical stepwise approach to integrate relevant hemodynamic variables and provide the most appropriate treatment for septic shock.

关键词： Lactate Capillary refill time Central venous oxygen saturation Veno-arterial carbon dioxide gap transpulmonary thermodilution

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