J Korean Soc Emerg Med.  2017 Aug;28(4):309-317. 10.0000/jksem.2017.28.4.309.

Comparison of Hemodynamic Variables Associated with Cardiac Output in Patients in the Intensive Care Unit

Affiliations
  • 1Department of Emergency Medicine, College of Medicine, Dong-A University, Busan, Korea. leetoloc@dau.ac.kr
  • 2Department of Emergency Medicine, Graduate School, College of Medicine, Kangwon National University, Chuncheon, Korea.
  • 3Department of Statistics, Daejeon University, Daejeon, Korea.

Abstract

PURPOSE
Dynamic parameters, including end-tidal carbon dioxide (ETCOâ‚‚), peak velocity variation in the common carotid artery (pvvCCA), distensibility index of the internal jugular vein (dIJV), and distensibility index of the inferior vena cava (dIVC) have been used to predict fluid responsiveness in fully sedated patients under positive mechanical ventilation. We aimed to compare the cardiac output (CO) with all these dynamic parameters upon changing positions.
METHODS
This prospective cohort study compared the changes in all parameters that alter CO after changing positions, including upper body at 60°and 30°, supine position, and lower body at 30°and 60°, as measured using ultrasonography, between June 2015 and September 2016.
RESULTS
CO was correlated with parameters, including dIJV, pvvCCA, and ETCOâ‚‚, in positively ventilated patients with nonspontaneous breathing (p=0.001, p=0.014, and p=0.006, respectively). Among these parameters, ETCOâ‚‚ showed to have the best correlation with CO change after position change (coefficient 0.412). Correlations of CO with central venous pressure, blood pressure, and dIVC were not statistically significant. The mean value of CO in elevated lower body positions was slightly lower than the mean value of CO in supine position (5.231 vs. 5.752 L/min, p=0.516).
CONCLUSION
Measuring the changes of ETCOâ‚‚ in patients with positive mechanical ventilation might allow the most accurate prediction of CO changes. The position change from elevated upper body to supine position could better induce CO changes than that performed similarly with passive leg raising.

Keyword

Cardiac output; Ultrasonography; Carbon dioxide; Jugular veins; Carotid artery; Common
Full Text Links
  • JKSEM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2021 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr