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The Accuracy of PiCCO® in Measuring Cardiac Output in Patients Under Therapeutic Hypothermia: Comparison With Transthoracic Echocardiography

2018Journal article Open access
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dc.contributor.authorSouto Moura, T
dc.contributor.authorAguiar Rosa, S
dc.contributor.authorGermano, N
dc.contributor.authorCavaco, R
dc.contributor.authorSequeira, T
dc.contributor.authorAlves, M
dc.contributor.authorPapoila, AL
dc.contributor.authorBento, L
dc.date.accessioned2024-08-28T15:42:50Z
dc.date.available2024-08-28T15:42:50Z
dc.date.issued2018
dc.description.abstractBackground: Invasive cardiac monitoring using thermodilution methods such as PiCCO® is widely used in critically ill patients and provides a wide range of hemodynamic variables, including cardiac output (CO). However, in post-cardiac arrest patients subjected to therapeutic hypothermia, the low body temperature possibly could interfere with the technique. Transthoracic Doppler echocardiography (ECHO) has long proved its accuracy in estimating CO, and is not influenced by temperature changes. Objective: To assess the accuracy of PiCCO® in measuring CO in patients under therapeutic hypothermia, compared with ECHO. Design and patients: Thirty paired COECHO/COPiCCO measurements were analyzed in 15 patients subjected to hypothermia after cardiac arrest. Eighteen paired measurements were obtained at under 36°C and 12 at ≥36°C. A value of 0.5l/min was considered the maximum accepted difference between the COECHO and COPiCCO values. Results: Under conditions of normothermia (≥36°C), the mean difference between COECHO and COPiCCO was 0.030 l/min, with limits of agreement (-0.22, 0.28) - all of the measurements differing by less than 0.5 l/min. In situations of hypothermia (<36°C), the mean difference in CO measurements was -0.426 l/min, with limits of agreement (-1.60, 0.75), and only 44% (8/18) of the paired measurements fell within the interval (-0.5, 0.5). The calculated temperature cut-off point maximizing specificity was 35.95°C: above this temperature, specificity was 100%, with a false-positive rate of 0%. Conclusions: The results clearly show clinically relevant discordance between COECHO and COPiCCO at temperatures of <36°C, demonstrating the inaccuracy of PiCCO® for cardiac output measurements in hypothermic patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMed Intensiva (Engl Ed) . 2018 Mar;42(2):92-98.pt_PT
dc.identifier.doi10.1016/j.medin.2017.03.007pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/5017
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSJ MEDpt_PT
dc.subjectHSJ UUMpt_PT
dc.subjectHSM CARpt_PT
dc.subjectCHLC CINVpt_PT
dc.subjectHumanspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectAgedpt_PT
dc.subjectEchocardiography, Dopplerpt_PT
dc.subjectCardiac Output*pt_PT
dc.subjectHypothermia, Induced*pt_PT
dc.subjectMonitoring, Physiologic / methods*pt_PT
dc.subjectObserver Variationpt_PT
dc.subjectProspective Studiespt_PT
dc.subjectReproducibility of Resultspt_PT
dc.subjectTemperaturept_PT
dc.subjectTertiary Care Centerspt_PT
dc.subjectThermodilution / methods*pt_PT
dc.titleThe Accuracy of PiCCO® in Measuring Cardiac Output in Patients Under Therapeutic Hypothermia: Comparison With Transthoracic Echocardiographypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage98pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage92pt_PT
oaire.citation.titleMedicina Intensivapt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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