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ZJUS-B
Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology)  2016, Vol. 17 Issue (7): 561-567    DOI: 10.1631/jzus.B1500244
Case Report     
Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?
Wolfgang Huber, Veit Phillip, Josef H?llthaler, Caroline Schultheiss, Bernd Saugel, Roland M. Schmid
Second Medical Department, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
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Abstract  Objective: Comparison of global end-diastolic volume index (GEDVI) obtained by femoral and jugular transpulmonary thermodilution (TPTD) indicator injections using the EV1000/VolumnView® device (Edwards Lifesciences, Irvine, USA). Methods: In an 87-year-old woman with hypovolemic shock and equipped with both jugular and femoral vein access and monitored with the EV1000/VolumeView® device, we recorded 10 datasets, each comprising duplicate TPTD via femoral access and duplicate TPTD (20 ml cold saline) via jugular access. Results: Mean femoral GEDVI ((674.6±52.3) ml/m2) was significantly higher than jugular GEDVI ((552.3±69.7) ml/m2), with P=0.003. Bland-Altman analysis demonstrated a bias of (+122±61) ml/m2, limits of agreement of −16 and +260 ml/m2, and a percentage error of 22%. Use of the correction-formula recently suggested for the PiCCO® device significantly reduced bias and percentage error. Similarly, mean values of parameters derived from GEDVI such as pulmonary vascular permeability index (PVPI; 1.244±0.101 vs. 1.522±0.139; P<0.001) and global ejection fraction (GEF; (24.7±1.6)% vs. (28.1±1.8)%; P<0.001) were significantly different in the case of femoral compared to jugular indicator injection. Furthermore, the mean cardiac index derived from femoral indicator injection ((4.50±0.36) L/(min·m²)) was significantly higher (P=0.02) than that derived from jugular indicator injection ((4.12±0.44) L/(min·m²)), resulting in a bias of (+0.38±0.37) L/(min·m²) and a percentage error of 19.4%. Conclusions: Femoral access for indicator injection results in markedly altered values provided by the EV1000/VolumeView®, particularly for GEDVI, PVPI, and GEF.

Key words： Hemodynamic monitoring      Transpulmonary thermodilution      Central venous catheter      Femoral vein      Jugular vein      Global end-diastolic volume      EV1000/VolumeView®      PiCCO®     
Received: 10 October 2015      Published: 06 July 2016
CLC:  R472  
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Wolfgang Huber
Veit Phillip
Josef H?llthaler
Caroline Schultheiss
Bernd Saugel
Roland M. Schmid
Cite this article:

Wolfgang Huber, Veit Phillip, Josef H?llthaler, Caroline Schultheiss, Bernd Saugel, Roland M. Schmid. Femoral indicator injection for transpulmonary thermodilution using the EV1000/VolumeView®: do the same criteria apply as for the PiCCO®?. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2016, 17(7): 561-567.

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http://www.zjujournals.com/xueshu/zjus-b/10.1631/jzus.B1500244     OR     http://www.zjujournals.com/xueshu/zjus-b/Y2016/V17/I7/561

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