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Estimation of left ventricular systolic function by single transpulmonary thermodilution
Alain Combes1, Jean-Baptiste Berneau, Charles-Edouard Luyt
1Service de Réanimation Médicale, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47, boulevard de l'Hôpital, 75651 Paris Cedex 13, France. alain.combes@psl.ap-hop-paris.fr
Intensive Care Medicine
|April 24, 2004
Summary
The cardiac function index (CFI) and global ejection fraction (GEF) from the PiCCO system reliably estimate left ventricular systolic function in ICU patients. However, these indices may underestimate function in cases of isolated right ventricular failure.
Area of Science:
- Critical care medicine
- Cardiovascular physiology
- Hemodynamic monitoring
Background:
- The PiCCO system offers cardiac function index (CFI) and global ejection fraction (GEF) for assessing cardiac systolic function.
- Transesophageal echocardiography (TEE) is a standard method for evaluating left ventricular (LV) systolic function.
Purpose of the Study:
- To compare the PiCCO-derived CFI and GEF with LV fractional area of change (LVFAC) measured by TEE.
- To assess the reliability of CFI and GEF in estimating LV systolic function in mechanically ventilated ICU patients without isolated right ventricular dysfunction.
Main Methods:
- A prospective, open clinical study was conducted in an intensive care unit.
- Thirty-three mechanically ventilated patients were included.
- LVFAC was measured using TEE, while CFI and GEF were derived from transpulmonary thermodilution.
Main Results:
- Significant correlations were found between LVFAC and CFI (r=0.87) and GEF (r=0.82).
- The PiCCO-derived indices accurately estimated LVFAC, with minimal mean differences.
- CFI and GEF demonstrated high sensitivity and specificity in identifying LVFAC above 40%.
Conclusions:
- PiCCO-derived CFI and GEF are reliable indicators of LV systolic function in mechanically ventilated ICU patients.
- These indices may underestimate LV systolic function in patients with isolated right ventricular failure.