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  • Impedance Cardiography, Hemodynamic and Fluid Status During Hemodiafiltration

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    Aniello De Nicola
    76 Ansichten1 Seite
    ICG technology provide a measurement of fluid status by using thoracic fluid content (TFC), along with cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) TFC is an indicator of total fluid volume, both intracellular and extracellular. NICCOMO(r) (Medis, Germany), a noninvasive ICG device that provides trustworthy measures of TFC and hemodynamic changes, could be a complementary monitor for CVVHDF.

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    Impedance cardiography, hemodynamic and fluid status during hemodiafiltration

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    ICG technology provide a measurement of fluid status by using thoracic fluid content (TFC), along with cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) TFC is an indicator of total fluid volume, both intracellular and extracellular. NICCOMO(r) (Medis, Germany), a noninvasive ICG device that provides trustworthy measures of TFC and hemodynamic changes, could be a complementary monitor for CVVHDF.

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    76 Ansichten1 Seite

    Impedance Cardiography, Hemodynamic and Fluid Status During Hemodiafiltration

    Hochgeladen von

    Aniello De Nicola
    ICG technology provide a measurement of fluid status by using thoracic fluid content (TFC), along with cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) TFC is an indicator of total fluid volume, both intracellular and extracellular. NICCOMO(r) (Medis, Germany), a noninvasive ICG device that provides trustworthy measures of TFC and hemodynamic changes, could be a complementary monitor for CVVHDF.

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    Attribution Non-Commercial (BY-NC)
    Als PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 1

    IMPEDANCECARDIOGRAPHY IMPEDANCECARDIOGRAPHY INTHEESTIMATIONOF HEMODYNAMICANDFLUIDSTATUSOFCOMAPATIENTSDURING CONTINUOUSVENOVENOUSHEMODIAFILTRATION. CONTINUOUS VENOVENOUSHEMODIAFILTRATION.

    Aniello De Nicola Maria Jos Sucre DeNicola,MariaJosSucre. DeNicola,MariaJosSucre.


    Dept.ofAnaesthesia andIntensiveCare SanLeonardoHospital CastellammarediStabia,Italy Dept.ofAnaesthesia andIntensiveCare SanLeonardoHospital
    Introduction MostICUpatientsoncontinuousveno venoushemodiafiltration (CVVHDF)arein multisystemfailureandrequireextensive multisystem failure and require extensive monitoring;particularlytheclinical assessmentofcardiacstatuscouldbe incompletewithoutanassessmentoffluid volumestatusduringCVVHDF[1] Impedancecardiography (ICG)technology provideameasurementoffluidstatusby usingthoracicfluidcontent(TFC),along withcardiacoutput(CO),cardiacindex(CI) andsystemicvascularresistanceindex (SVRI).TFCisanindicatoroftotalfluid volume,bothintracellularandextracellular. NICCOMO(Medis,Germany),anoninvasive ICG device that provides trustworthy ICGdevicethatprovidestrustworthy measuresofTFCandhemodynamic changes,couldbeacomplementary monitorforCVVHDF,withthepotentialof supportfluidbalanceandhelpingavoid hemodynamicinstabilityofcomapatients[2]. Methods Thestudywasaretrospectivedescriptiveanalysis ofcomapatientswithacuterenalfailureexamined whileundergoingCVVHDF(Equasmart Hemodec while undergoing CVVHDF (Equasmart,Hemodec, Italy).BymeansofNICCOMOwereconstantly recordedTFC,CI,CO,MAP(meanarterialpressure) andSVRI.EmployingthePearsonProductMoment correlationmethod,thepercentagevariationsin eachoftheparametersduringtheCVVHDF treatmentwerecorrelatedtotheamountoffluid removed(FR),normalizedtobodyweight. Results Tenpatientswerestudied(6menand4women); theagerangewas38to68(mean53.1 15.2) years. Atotalof16.6litersoffluidwereremovedduring A total of 16 6 liters of fluid were removed during CVVHDF(830mL/dayover740treatmenthours). MedianFRperdaywas1837mL andmedianhourly FRratewas252mL. TFCdiminishedinallpatients attheendofCVVHDFtreatment(average reduction14.8 9kohms1);whileallother hemodynamicparametersshowedbothincreases anddecreases. WefoundthatthepercentTFCchangeswere closelyandinverselyrelatedwiththoseofFR(r= 0.68,p<0.001);otherhemodynamicparameters showedamoderatecorrelationwithFR. TheICGdevicewashelpfultopromptlyidentifyone patientwhoexperiencedhemodynamicinstability patient who experienced hemodynamic instability andtopreventit.

    Conclusions ThesedataindicatethatTFC,measuredusingICG,isareliableandnoninvasivemethodforevaluating thequantityofFRduringCVVHDF. Incomparisonwiththeotherhemodynamicparametersmeasured,TFCchangedmostconsistently withfluidsubtractionandhiscontinuousmeasurementscanguidetheextentofFR. ThiscompactICGdeviceprovidessafelyandaccuratelyreadingsandseemstobeoneofthebest optionsforevaluationofbasichemodynamicparametersandTFCduringhemodiafiltration. References 1. VincentJLetal.RevMedBrux.29(1Suppl):S913,2008 2. WynneLetal. JSurgRes. 133(1):5560,2006 y g ( )
    Poster202 29thInternationalSymposiumonIntensiveCareand Emergency Medicine 29thInternationalSymposiumonIntensiveCareandEmergency Brussels,March24 Brussels ,March24 27,2009

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