medigraphic.com
ISSN 1995-9427 (Print)

2017, Number 1

<< Back Next >>

Invest Medicoquir 2017; 9 (1)

Chest ultrasound in the hemodynamic evaluation of the critical patient as compared with parameters of transpulmonary thermodilution

Cueto MA, Quevedo BY, Abdo CA, Alonso DPL, Martínez CR, Leal AG

Language: Spanish
References: 37
Page: 26-38
PDF size: 289.55 Kb.


ABSTRACT

Introduction. Chest ultrasound is a non-invasive technique which is useful for the diagnosis and follow-up of hemodynamic parameters. Pulmonary ultrasound (PU), transthoracic echocardiography (ECHO) and the measurement of the inferior vena cava (IVC) were compared with parameters of trans pulmonary thermo dilution and its value in the follow-up of hemodynamics was demonstrated. Methods. The sample comprised 61 patients who underwent PU for the punctuation of lines B from 2010 to 2016, given by the summation of B lines in 8 pulmonary quadrants; ECHO was performed to determine the left-ventricular ejection fraction (LVEF) and ICV. The cases were monitored by taking the values of global end-diastolic volume index (GEDI), global ejection fraction (GEF), and extra vascular lung water index (ELWI). It was calculated with 95 % of confidence intervals, and linear correlations were determined by Pearson´s method. Results. The ICV correlated with the GEDI (r = 0.385, p = 0.002), but not the central venous pressure (r = 0.058, p = 0.66). Good correlation was found between LVEF and GEF (r = 0.583, p = 0.00). Similarly, B-lines score obtained by PU with ELWI showed p = 0.01. Conclusions. Pulmonary ultrasound is of great value in hemodynamic estimate.


REFERENCES

  1. Hollenberg SM. Hemodynamic monitoring. Chest. 2013;143(5):1480-8.

  2. Mateu ML, Ferrandiz Selles A, Gruartmoner de Vera G, Mesquida Febrer J, Sabatier Cloarec C, Poveda Hernandez Y, et al. [Techniques available for hemodynamic monitoring. Advantages and limitations]. Med Intensiva. 2012;36(6):434-44.

  3. Aguilar G, Belda FJ, Perel A. [Minimally invasive cardiopulmonary monitoring with the PiCCO Plus system]. Rev Esp Anestesiol Reanim. 2008;55(2):90-100.

  4. Martin A, Saboya S, Patino M, Silva JA, Gomez S, Blanco JJ. [Hemodynamic monitoring: PiCCO system]. Enfermeria intensiva / Sociedad Espanola de Enfermeria Intensiva y Unidades Coronarias. 2008;19(3):132-40.

  5. Garcia-Vicente E, Campos-Nogue A, Gobernado MM. [Echocardiography in the Intensive Care Unit]. Med Intensiva. 2008;32(5):236-47.

  6. Shah BN, Ahmadvazir S, Pabla JS, Zacharias K, Senior R. The role of urgent transthoracic echocardiography in the evaluation of patients presenting with acute chest pain. Eur J Emerg Med. 2012;19(5):277-83.

  7. Zhang Z, Xu X, Ye S, Xu L. Ultrasonographic Measurement of the Respiratory Variation in the Inferior Vena Cava Diameter Is Predictive of Fluid Responsiveness in Critically Ill Patients: Systematic Review and Meta-analysis. Ultrasound Med Biol. 2014;40(5):845-53.

  8. Bekemeyer WB, Crapo RO, Calhoon S, Cannon CY, Clayton PD. Efficacy of chest radiography in a respiratory intensive care unit. A prospective study. Chest. 1985;88(5):691-6.

  9. Trotman-Dickenson B. Radiology in the intensive care unit (Part I). J Intensive Care Med. 2003;18(4):198-210.

  10. Trotman-Dickenson B. Radiology in the intensive care unit (part 2). J Intensive Care Med. 2003;18(5):239-52.

  11. Colmenero M, Garcia-Delgado M, Navarrete I, Lopez-Milena G. [Utility of the lung ultrasound in the intensive medicine unit]. Med Intensiva. 2010;34(9):620-8.

  12. Lichtenstein D, Meziere G, Biderman P, Gepner A, Barre O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med. 1997;156(5):1640-6.

  13. Carrillo-Esper R, Brom-Valladares R, Carrillo-Cordova LD, Carrillo-Cordova JR. [Pulmonary ultrasound in the intensive care unit]. Cir Cir. 2009;77(4):323-8; 01-6.

  14. Lichtenstein D. Lung ultrasound in acute respiratory failure an introduction to the BLUE-protocol. Minerva Anestesiol. 2009;75(5):313-7.

  15. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134(1):117-25.

  16. Perera P, Mailhot T, Riley D, Mandavia D. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Emerg Med Clin North Am. 2010;28(1):29-56.

  17. Lichtenstein D. FALLS-protocol: lung ultrasound in hemodynamic assessment of shock. Heart, lung and vessels. 2013;5(3):142-7.

  18. Sargsyan A, Blaivas M, Karakitsos D. The Holistic Approach Ultrasound Concept and the Role of the Critical Care Ultrasound Laboratory: elsevier; 2014 [cited 2014]. Available from: https://www.inkling.com/read/lumb-critical-care-ultrasound-1st/chapter-36/the-hola-holistic-approach

  19. Vincent JL, Rhodes A, Perel A, Martin GS, Della Rocca G, Vallet B, et al. Clinical review: Update on hemodynamic monitoring--a consensus of 16. Crit Care. 2011;15(4):229.

  20. Antonelli M, Azoulay E, Bonten M, Chastre J, Citerio G, Conti G, et al. Year in review in Intensive Care Medicine 2010: III. ARDS and ALI, mechanical ventilation, noninvasive ventilation, weaning, endotracheal intubation, lung ultrasound and paediatrics. Intensive Care Med. 2011;37(3):394-410.

  21. Citerio G, Bakker J, Bassetti M, Benoit D, Cecconi M, Curtis JR, et al. Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition. Intensive Care Med. 2014;40(2):147-59.

  22. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38(4):577-91.

  23. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818-29.

  24. PiCCO-Tecnología: Valores Normales Germany: PULSION Medical Systems SE; [cited 2012 1]. Available from: http://www.pulsion.com/espanol/formacion/download/spanish/picco/arbol_de_decision.pdf

  25. Valls O, Parrilla M, Hernández F. Manual práctico de ecocardiografía en el adulto. La Habana 2001.

  26. Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, et al. "Ultrasound comet-tail images": a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest. 2005;127(5):1690-5.

  27. Baldi G, Gargani L, Abramo A, D'Errico L, Caramella D, Picano E, et al. Lung water assessment by lung ultrasonography in intensive care: a pilot study. Intensive Care Med. 2013;39(1):74-84.

  28. Monitorizacion hemodinamica-Coste y Efectividad 2012 [sept2013]. Available from: http://www.pulsion.com/espanol/formacion/download/spanish/picco/Monitorizacion_hemodinamica_-_Coste_Efectividad.pdf

  29. Sakka SG, Ruhl CC, Pfeiffer UJ, Beale R, McLuckie A, Reinhart K, et al. Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med. 2000;26(2):180-7.

  30. Lichtenstein D. Simple Critical Ultrasound Considering Hemodynamic Therapy: Our Limited Investigation. In: Heidelberg S-VB, editor. Whole Body Ultrasonography in the Critically Ill Berlin: Springer; 2010. 223-42.

  31. Schefold JC, Storm C, Bercker S, Pschowski R, Oppert M, Kruger A, et al. Inferior vena cava diameter correlates with invasive hemodynamic measures in mechanically ventilated intensive care unit patients with sepsis. J Emerg Med. 2010;38(5):632-7.

  32. Anderson KL, Jenq KY, Fields JM, Panebianco NL, Dean AJ. Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lung ultrasonography. Am J Emerg Med. 2013;31(8):1208-14.

  33. Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med. 2013;41(7):1774-81.

  34. Repesse X, Charron C, Vieillard-Baron A. Intensive care ultrasound: V. Goal-directed echocardiography. Annals of the American Thoracic Society. 2014;11(1):122-8.

  35. Abbasi S, Fazel K, Esfahani MA, Kashefi P, Harandi SA. Assess the clinical applicability of transthoracic echocardiography in laparotomy patients in a general intensive care unit. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2014;19(5):398-403.

  36. Shock cardiogénico: Pulsion medical system AG; 2012 [sept 2013]. Available from: http://www.pulsion.com/espanol/formacion/download/spanish/picco/Choque_cardiogenico.

  37. Trezzi M, Torzillo D, Ceriani E, Costantino G, Caruso S, Damavandi PT, et al. Lung ultrasonography for the assessment of rapid extravascular water variation: evidence from hemodialysis patients. Intern Emerg Med. 2013;8(5):409-15.




2020     |     www.medigraphic.com