Assessment of Reliability of Cardiac Output Measurement Based on Impedance (NICCOMO) - Method of Noninvasive Cardiac Output Measurement, Compared to Transthoracic Thermodilution (PiCCO) at Different PEEP Levels
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cardiovascular Diagnostic Techniques
- Sponsor
- Medical University of Gdansk
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Numbers of measurements of haemodynamic parameters (CO, CI, SV, SVV, CI, SVR, SVRI) obtained with impedance, that differ from those obtained with thermodilution
- Last Updated
- 6 years ago
Overview
Brief Summary
Thermodilution cardiac output measurement is a reliable method, but it is an invasive one. PiCCO device requires cannulation of central vein and peripheral artery. Impedance method requires only attachment of special electrodes. Non-invasive methods are less accurate. Aim of study is to assess accuracy and reliability of impedance method ( using NICCOMO device) in comparison of thermodilution method ( using PiCCO device) at different PEEP levels.
Detailed Description
Echocardiography is performed prior to measurement to exclude patients with heart valve abnormalities. Patients without spontaneous ventilation ( deeply unconscious, sedated or sedated and paralysed), ventilated with controlled mechanical ventilation mode with tidal volume 6-8 ml/ideal body weight, resulting in EtCO2 35-45 mmHg, with PiCCO catheters implemented have additionally NICCOMO device attached. Fraction of inspired oxygen (FiO2) is set to achieve saturation \>96% at positive end expiratory pressure (PEEP) 0 cmH2O. Measurement of cardiac output are performed on expiration at PEEP 0, 5, 10, 15 20 cmH2O and at optimal PEEP (obtained from P-V curve). Simultaneously CO value from impedance device is noted. Other haemodynamic parameters, calculated by both devices are also noted - stroke volume (SV), stroke volume variation (SVV), Cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI).
Investigators
Magdalena Wujtewicz
assistant professor
Medical University of Gdansk
Eligibility Criteria
Inclusion Criteria
- •critically ill patients
- •patients on mechanical ventilation
- •circulatory insufficiency (present or in the past) monitored with with PiCCO device
Exclusion Criteria
- •morbid obesity,
- •short neck,
- •severe pneumonia,
- •inability to NICCOMO electrodes attachment,
- •massive tissue oedema,
- •non-sinus cardiac rhythm,
- •tachycardia,
- •low cardiac output,
- •septic shock,
- •heart valve pathologies,
Outcomes
Primary Outcomes
Numbers of measurements of haemodynamic parameters (CO, CI, SV, SVV, CI, SVR, SVRI) obtained with impedance, that differ from those obtained with thermodilution
Time Frame: up to 90 minutes
measurements taken with impedance and thermodilution simultaneously, at PEEP 0, 5, 10, 15, 20 and at optimal PEEP