Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Wurzer, P; Branski, LK; Jeschke, MG; Ali, A; Kinsky, MP; Bohanon, FJ; Hundeshagen, G; Norbury, WB; Williams, FN; Kamolz, LP; Finnerty, CC; Herndon, DN.
Transpulmonary Thermodilution Versus Transthoracic Echocardiography for Cardiac Output Measurements in Severely Burned Children.
Shock. 2016; 46(3):249-253
Doi: 10.1097/SHK.0000000000000627
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- Führende Autor*innen der Med Uni Graz
- Wurzer Paul
- Co-Autor*innen der Med Uni Graz
- Branski Ludwik
- Kamolz Lars-Peter
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- Abstract:
- Severe burns trigger a hyperdynamic state, necessitating accurate measurement of cardiac output (CO) for cardiovascular observation and guiding fluid resuscitation. However, it is unknown whether, in burned children, the increasingly popular transthoracic echocardiography (TTE) method of CO measurement is as accurate as the widely used transpulmonary thermodilution (TPTD) method. We retrospectively compared near-simultaneously performed CO measurements in severely burned children using TPTD with the Pulse index Continuous Cardiac Output (PiCCO) system or TTE. Outcomes were compared using t tests, multiple linear regression, and a Bland-Altman plot. Fifty-four children (9 ± 5 years) with 68 ± 18% total body surface area burns were studied. An analysis of 105 data pairs revealed that PiCCO yielded higher CO measurements than TTE (190 ± 39% vs. 150 ± 50% predicted values; P < 0.01). PiCCO- and TTE-derived CO measurements correlated moderately well (R = 0.54, P < 0.01). A Bland-Altman plot showed a mean bias of 1.53 L/min with a 95% prediction interval of 4.31 L/min. TTE-derived estimates of CO may underestimate severity of the hyperdynamic state in severely burned children. We propose using the PiCCO system for objective cardiovascular monitoring and to guide goal-directed fluid resuscitation in this population.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Burns - physiopathology
- Cardiac Output - physiology
- Child -
- Child, Preschool -
- Echocardiography - methods
- Female -
- Heart Rate - physiology
- Humans -
- Male -
- Monitoring, Physiologic - methods
- Retrospective Studies -
- Thermodilution - methods
- Find related publications in this database (Keywords)
- Burns
- cardiac index
- cardiac output
- hypermetabolism
- transpulmonary thermodilution
- transthoracic echocardiography