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The influence of extravascular lung water on cardiac output measurements using thoracic impedance cardiography. 1998

E Raaijmakers, and T J Faes, and P W Kunst, and J Bakker, and J H Rommes, and H G Goovaerts, and R M Heethaar
Department of Medical Physics and Informatics, Institute of Cardiovascular Research VU, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.

The purpose of this study was to investigate the influence of pulmonary oedema as measured with the double indicator dilution technique on the accuracy of cardiac output (CO) measurement using thoracic impedance cardiography (TIC) compared with thermodilution in thirteen sepsis patients. Differences in the Kubicek and Sramek-Bernstein equation with respect to pulmonary oedema were explored theoretically and experimentally. From a parallel two cylinder model a hypothesis can be derived that CO determined with the Kubicek equation is oedema independent, whereas CO determined using the Sramek-Bernstein equation is oedema dependent. Experimentally, CO determined using Kubicek's equation correlated better with thermodilution CO (r = 0.75) than CO determined with the Sramek-Bernstein equation (r = 0.25). The effect of oedema on the accuracy of TIC was investigated by comparing the differences in the CO of impedance and thermodilution to the extravascular lung water index. For the Kubicek equation the difference was not influenced by oedema (r = 0.04, p = 0.84), whereas for the Sramek-Bernstein equation the difference was affected by oedema (r = 0.39, p = 0.05). Thus, the effects of pulmonary oedema on the accuracy of TIC measurements can better be understood with the parallel cylinder model. Moreover, the Kubicek equation still holds when pulmonary oedema is present, in contrast to the Sramek-Bernstein equation.

UI MeSH Term Description Entries
D007201 Indicator Dilution Techniques Methods for assessing flow through a system by injection of a known quantity of an indicator, such as a dye, radionuclide, or chilled liquid, into the system and monitoring its concentration over time at a specific point in the system. (From Dorland, 28th ed) Dilution Techniques,Dilution Technics,Indicator Dilution Technics,Dilution Technic,Dilution Technic, Indicator,Dilution Technics, Indicator,Dilution Technique,Dilution Technique, Indicator,Dilution Techniques, Indicator,Indicator Dilution Technic,Indicator Dilution Technique,Technic, Dilution,Technic, Indicator Dilution,Technics, Dilution,Technics, Indicator Dilution,Technique, Dilution,Technique, Indicator Dilution,Techniques, Dilution,Techniques, Indicator Dilution
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011654 Pulmonary Edema Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening. Wet Lung,Edema, Pulmonary,Edemas, Pulmonary,Pulmonary Edemas,Lung, Wet,Lungs, Wet,Wet Lungs
D002302 Cardiac Output The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat). Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D002307 Cardiography, Impedance A type of impedance plethysmography in which bioelectrical impedance is measured between electrodes positioned around the neck and around the lower thorax. It is used principally to calculate stroke volume and cardiac volume, but it is also related to myocardial contractility, thoracic fluid content, and circulation to the extremities. Impedance, Transthoracic,Plethysmography, Impedance, Transthoracic,Impedance Cardiography,Impedance Plethysmography, Transthoracic,Plethysmography, Transthoracic Impedance,Transthoracic Impedance Plethysmography,Cardiographies, Impedance,Impedance Cardiographies,Impedance Plethysmographies, Transthoracic,Impedances, Transthoracic,Plethysmographies, Transthoracic Impedance,Transthoracic Impedance,Transthoracic Impedance Plethysmographies,Transthoracic Impedances
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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