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Annals of Intensive Care

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Open Access 01-12-2012 | Research

Can endotracheal bioimpedance cardiography assess hemodynamic response to passive leg raising following cardiac surgery?

Authors: Jean-Luc Fellahi, Marc-Olivier Fischer, Audrey Dalbera, Massimo Massetti, Jean-Louis Gérard, Jean-Luc Hanouz

Published in: Annals of Intensive Care | Issue 1/2012

Abstract

Background

The utility of endotracheal bioimpedance cardiography (ECOM) has been scarcely reported. We tested the hypothesis that it could be an alternative to pulse contour analysis for cardiac index measurement and prediction in fluid responsiveness.

Methods

Twenty-five consecutive adult patients admitted to the intensive care unit following conventional cardiac surgery were prospectively included and investigated at baseline, during passive leg raising, and after fluid challenge. Comparative cardiac index data points were collected from pulse contour analysis (CI_PC) and ECOM (CI_ECOM). Correlations were determined by linear regression. Bland-Altman analysis was used to compare the bias, precision, and limits of agreement. Percentage error was calculated. Changes in CI_PC (ΔCI_PC) and CI_ECOM (ΔCI_ECOM) during passive leg raising were collected to assess their discrimination in predicting fluid responsiveness.

Results

A significant relationship was found between CI_PC and CI_ECOM (r = 0.45; P < 0.001). Bias, precision, and limits of agreement were 0.44 L.min^-1.m^-2 (95% confidence interval, 0.33-0.56), 0.59 L.min^-1.m^-2, and −0.73 to 1.62 L.min^-1.m^-2, respectively. Percentage error was 45%. A significant relationship was found between percent changes in CI_PC and CI_ECOM after fluid challenge (r = 0.42; P = 0.035). Areas under the ROC curves for ΔCI_PC and ΔCI_ECOM to predict fluid responsiveness were 0.72 (95% confidence interval, 0.5–0.88) and 0.81 (95% confidence interval, 0.61-0.94), respectively.

Conclusions

ECOM is not interchangeable with pulse contour analysis but seems consistent to monitor cardiac index continuously and could help to predict fluid responsiveness by using passive leg raising.

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Title: Can endotracheal bioimpedance cardiography assess hemodynamic response to passive leg raising following cardiac surgery?
Authors: Jean-Luc Fellahi
Marc-Olivier Fischer
Audrey Dalbera
Massimo Massetti
Jean-Louis Gérard
Jean-Luc Hanouz
Publication date: 01-12-2012
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2012
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-2-26

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can endotracheal bioimpedance cardiography assess hemodynamic response to passive leg raising following cardiac surgery?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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