Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery
Joint Authors
Høiseth, Lars Øivind
Landsverk, Svein Aslak
Hoff, Ingrid Elise
Kirkebøen, Knut Arvid
Source
Critical Care Research and Practice
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-05-30
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Background.
Exhaled carbon dioxide (CO2) reflects cardiac output (CO) provided stable ventilation and metabolism.
Detecting CO changes may help distinguish hypovolemia or cardiac dysfunction from other causes of haemodynamic instability.
We investigated whether CO2 measured as end-tidal concentration (EtCO2) and eliminated volume per breath (VtCO2) reflect sudden changes in cardiac output (CO).
Methods.
We measured changes in CO, VtCO2, and EtCO2 during right ventricular pacing and passive leg raise in 33 ventilated patients after open heart surgery.
CO was measured with oesophageal Doppler.
Results.
During right ventricular pacing, CO was reduced by 21% (CI 18–24; p<0.001), VtCO2 by 11% (CI 7.9–13; p<0.001), and EtCO2 by 4.9% (CI 3.6–6.1; p<0.001).
During passive leg raise, CO increased by 21% (CI 17–24; p<0.001), VtCO2 by 10% (CI 7.8–12; p<0.001), and EtCO2 by 4.2% (CI 3.2–5.1; p<0.001).
Changes in VtCO2 were significantly larger than changes in EtCO2 (ventricular pacing: 11% vs.
4.9% (p<0.001); passive leg raise: 10% vs.
4.2% (p<0.001)).
Relative changes in CO correlated with changes in VtCO2 (ρ=0.53; p=0.002) and EtCO2 (ρ=0.47; p=0.006) only during reductions in CO.
When dichotomising CO changes at 15%, only EtCO2 detected a CO change as judged by area under the receiver operating characteristic curve.
Conclusion.
VtCO2 and EtCO2 reflected reductions in cardiac output, although correlations were modest.
The changes in VtCO2 were larger than the changes in EtCO2, but only EtCO2 detected CO reduction as judged by receiver operating characteristic curves.
The predictive ability of EtCO2 in this setting was fair.
This trial is registered with NCT02070861.
American Psychological Association (APA)
Hoff, Ingrid Elise& Høiseth, Lars Øivind& Kirkebøen, Knut Arvid& Landsverk, Svein Aslak. 2019. Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery. Critical Care Research and Practice،Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1129116
Modern Language Association (MLA)
Hoff, Ingrid Elise…[et al.]. Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery. Critical Care Research and Practice No. 2019 (2019), pp.1-9.
https://search.emarefa.net/detail/BIM-1129116
American Medical Association (AMA)
Hoff, Ingrid Elise& Høiseth, Lars Øivind& Kirkebøen, Knut Arvid& Landsverk, Svein Aslak. Volumetric and End-Tidal Capnography for the Detection of Cardiac Output Changes in Mechanically Ventilated Patients Early after Open Heart Surgery. Critical Care Research and Practice. 2019. Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1129116
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1129116