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- e...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.展开更多
文摘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.