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De Vos Jelke , ICU ZNA Stuivenberg, Belgium

P17: Differences between room-temperature vs iced saline indicator injection for transpulmonary thermodilution. De Vos Jelke , ICU ZNA Stuivenberg, Belgium

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De Vos Jelke , ICU ZNA Stuivenberg, Belgium

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  1. P17: Differences between room-temperature vs iced saline indicator injection for transpulmonary thermodilution De Vos Jelke, ICU ZNA Stuivenberg, Belgium Hofkens P-J1, Verburgh P1, Van De Kerkhove C1, Philipse E1, Huygh J1, Van Regenmortel N1, De laet I1, Schoonheydt K1, Dits H1, Saugel B2, Huber W2, Malbrain MLNG1

  2. Introduction • Cardiac index is a cornerstone of goal-directed therapy. • Ice-cold injectateis assumed to provide best accuracy of transpulmonarythermodilution (TPTD)-derived CI, GEDVI and EVLWI. • Room-temperature injectatemight facilitate TPTDs outside the ICU, e.g. in the operating room. • This substantiated by few data.

  3. Methods • 26 adult mixed ICU-patients with PiCCO-monitoring (Pulsion Medical Systems, Munich, Germany) • 6x 20ml TPTDs (3 times with room temperature 22°C and 3 times with ice-cold 4°C saline). • Means of the 3 room-temperature TPTDs were compared with the means of the 3 cold TPTDs (primary endpoint) • Bland-Altman • Means of 1st warm and 1st cold measurements were compared to means of the 2nd measurements.

  4. Mean Values

  5. Correlations GEDVI CI EVLWI

  6. Bland and Altman PE 14% CI

  7. Bland and Altman (volumes) PE 18% PE 13% GEDVI EVLWI

  8. 1st measurement2nd measurement3th measurement

  9. Effect 1st measurement • Means of first warm and first cold measurement exceeded means of second measurements for CI, GEDVI, EVLWI

  10. Conclusions • TPTDRoom results in slight, but significant overestimation of CI, GEDVI and EVLWI. • In routine, bias and PE values are acceptable for CI and EVLWI. • Loss of indicator within the catheter may result in significant (albeit clinically irrelevant) overestimation of 1st measurements of CI and GEDVI.

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