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Erschienen in:
01.11.2004 | Correspondence
Calculated global end-diastolic volume does not correspond to the largest heart blood volume: a bias for cardiac function index?
Erschienen in: Intensive Care Medicine | Ausgabe 11/2004
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Sir: Among the various methods used for fluid management and cardiac preload assessment, a major therapeutic goal during sepsis [1], the new device PiCCO system (Pulsion Medical System, Munich, Germany) provides continuous cardiac output (CO) based on arterial pulse contour and displays permanent cardiac function index (CFI) and global ejection fraction (GEF). In the last issue, Combes et al. evaluated their accuracy [2]. Despite significant correlations between these calculated indexes and left ventricular function evaluated by transoesophageal echocardiography, PiCCO cardiac indexes may be a matter of debate in view of the global end-diastolic volume (GEDV) estimated by the monitor (Table 1).
Table 1
Values of global end-diastolic volume ( GEDV) calculated by the PiCCO system
|
Authors
|
Number of patients
|
Type of patients
|
GEDV index
|
GEDV
|
|
(ml/m2)
|
(ml)
|
|||
|
Sakka et al. [3]
|
266
|
Critically ill
|
413–1500
|
|
|
Wiesenack et al. [4]
|
18
|
Elective CBAG
|
||
|
Baseline
|
1270±210a,b
|
|||
|
After volume correction
|
1430±235b
|
|||
|
Michard et al. [5]
|
36
|
Septic shock
|
||
|
Before volume loading
|
711±164a,c
|
|||
|
After volume loading
|
769±144c
|
|||