The effect of variable arterial transducer level on the accuracy of pulse contour waveform-derived measurements in critically ill patients.
We know that a 10 cm departure from the reference level of pressure transducer position is equal to a 7.5 mmHg change of invasive hemodynamic pressure monitoring in a fluid-filled system. However, the relationship between the site level of a variable arterial pressure transducer and the pulse contou...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 30; no. 5; pp. 569 - 576 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Oct2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118091217&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118091217 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Oct2016 vid: 30 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 118091217 118091217 NLM26298710 10.1007/s10877-015-9756-x NLM26298710 118091217 ppf: 569 ppct: 7 formats: fmt: @attributes: type: P tig: atl: The effect of variable arterial transducer level on the accuracy of pulse contour waveform-derived measurements in critically ill patients. aug: au: He, Huai-wu Liu, Da-wei Long, Yun Wang, Xiao-ting Zhao, Mei-ling Lai, Xiao-li affil: Department of Critical Care Medicine, Peking Union Medical College Hospital , Chinese Academy of Medical Science , 1 Shuaifuyuan, Dongcheng District Beijing 100730 China sug: subj: Transducers Pulse Arterial Pressure Adult Prospective Studies Hemodynamics Aged Heart Rate Monitoring, Physiologic Methods Arteries Pathology Cardiac Output Systole Stroke Volume Middle Age Critical Illness Male Critical Care Methods Reproducibility of Results Pressure Female Blood Pressure Scales Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Male Female ab: We know that a 10 cm departure from the reference level of pressure transducer position is equal to a 7.5 mmHg change of invasive hemodynamic pressure monitoring in a fluid-filled system. However, the relationship between the site level of a variable arterial pressure transducer and the pulse contour-derived parameters has yet to be established in critically ill patients. Moreover, the related quantitative analysis has never been investigated. Forty-two critically ill patients requiring PiCCO-Plus cardiac output monitoring were prospectively studied. The phlebostatic axis was defined as the zero reference level; the arterial pressure transducer was then vertically adjusted to different positions (+5, +10, +15, +20, -20, -15, -10, -5 cm) of departure from the zero reference site. The pulse contour waveform-derived parameters were recorded at each position. Elevation of the pressure transducer caused significantly positive changes in the continuous cardiac index (+CCI), stroke volume index (+SVI), and stroke volume variation (+SVV), and negative changes in the rate of left ventricular pressure rise during systole (-dP/dtmax), the systemic vascular resistance index (-SVRI), and vice versa. At the 5 cm position, the SVRI changes reached statistical significance with error. At the 10 cm position, the changes in CCI and dP/dtmax reached statistical significance with error, while the change in SVV reached statistical significance at 15 cm. The change rate of CCI was more than 5 % at the 15 cm position and approximately 10 % at the 20 cm position. On average, for every centimeter change of the transducer, there was a corresponding 0.014 L/min/m(2) CCI change and 0.36 % change rate, a 1.41 mmHg/s dP/dtmax change and 0.13 % change rate, and a 25 dyne/s/cm(5) SVRI change and 1.2 % change rate. The variation of arterial transducer position can result in inaccurate measurement of pulse contour waveform-derived parameters, especially when the transducer's vertical distance is more than 10 cm from the phlebostatic axis. These findings have clinical implications for continuous hemodynamic monitoring. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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