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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Annals of Intensive Care 1/2012

Can endotracheal bioimpedance cardiography assess hemodynamic response to passive leg raising following cardiac surgery?

Zeitschrift:
Annals of Intensive Care > Ausgabe 1/2012
Autoren:
Jean-Luc Fellahi, Marc-Olivier Fischer, Audrey Dalbera, Massimo Massetti, Jean-Louis Gérard, Jean-Luc Hanouz
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​2110-5820-2-26) contains supplementary material, which is available to authorized users.

Competing interests

The author(s) declare that they have no competing interests.

Authors’ contributions

JLF conceived the study, participated in its design and coordination, performed statistical analysis and interpretation of the data, and wrote the manuscript. MOF participated in the coordination of the study, performed acquisition of data, and helped to write the manuscript. AD performed acquisition of data. MM, JLG, and JLH participated in the design and coordination of the study. All authors have read and approved the final manuscript.

Abstract

Background

The utility of endotracheal bioimpedance cardiography (ECOM) has been scarcely reported. We tested the hypothesis that it could be an alternative to pulse contour analysis for cardiac index measurement and prediction in fluid responsiveness.

Methods

Twenty-five consecutive adult patients admitted to the intensive care unit following conventional cardiac surgery were prospectively included and investigated at baseline, during passive leg raising, and after fluid challenge. Comparative cardiac index data points were collected from pulse contour analysis (CIPC) and ECOM (CIECOM). Correlations were determined by linear regression. Bland-Altman analysis was used to compare the bias, precision, and limits of agreement. Percentage error was calculated. Changes in CIPC (ΔCIPC) and CIECOM (ΔCIECOM) during passive leg raising were collected to assess their discrimination in predicting fluid responsiveness.

Results

A significant relationship was found between CIPC and CIECOM (r = 0.45; P < 0.001). Bias, precision, and limits of agreement were 0.44 L.min-1.m-2 (95% confidence interval, 0.33-0.56), 0.59 L.min-1.m-2, and −0.73 to 1.62 L.min-1.m-2, respectively. Percentage error was 45%. A significant relationship was found between percent changes in CIPC and CIECOM after fluid challenge (r = 0.42; P = 0.035). Areas under the ROC curves for ΔCIPC and ΔCIECOM to predict fluid responsiveness were 0.72 (95% confidence interval, 0.5–0.88) and 0.81 (95% confidence interval, 0.61-0.94), respectively.

Conclusions

ECOM is not interchangeable with pulse contour analysis but seems consistent to monitor cardiac index continuously and could help to predict fluid responsiveness by using passive leg raising.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Authors’ original file for figure 4
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Authors’ original file for figure 5
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