Navegando por Palavras-chave "Termodiluição"
Agora exibindo 1 - 4 de 4
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosComparacao dos valores de debito cardiaco obtidos por termodiluicao e dopplerfluxometria transesofagica(Universidade Federal de São Paulo (UNIFESP), 2008) Ferreira, Roberto Manara Victorio [UNIFESP]
- ItemAcesso aberto (Open Access)Comparação dos valores de débito cardíaco obtidos por termodiluição e dopplerfluxometria transesofágica(Associação Médica Brasileira, 2007-08-01) Ferreira, Roberto Manara Victorio [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; Valiatti, Jorge Luís dos Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: Thermodilution (TD) is the gold standard method for hemodynamic monitoring. Some parameters can be measured by Oesophageal Doppler (OD), which is simpler and less invasive. To evaluate the accuracy of OD, we compared this method with TD in measurement of cardiac output (CO). METHODS: One hundred and ninety two simultaneous measurements were made in 10 patients (5 male and 5 female) with different clinical situations, 8 with sepsis using vasoactive drugs and 2 monitored for laryngectomy and liver transplantation. Measurements were taken during 4 hours at 30 minute intervals. The two oesophageal dopplers used DeltexR and ArrowR, were introduced between 35 and 45 cm from the nose and located at the point of largest diameter of the descending aorta. In TD, we used the pulmonary artery catheter (Swan Ganz BaxterR) and the DX- 2001 monitorR positioning was confirmed with support of radiology and of pressures curves. Measurements of CO carried out by means of TD were achieved using an iced saline solution considering the mean of four measurements with less than a 5% difference. The statistical method used was the Bland-Altman scatter plot and dispersion graphic. RESULTS: No statistically significant difference was found between the two methods for hemodyamic measurement with a correlation coefficient of 0.8 for CO (Deltex DopplerR and Baxter Swan GanzR) and a correlation coefficient of 0.99 for CO (Arrow DopplerR and Baxter Swan GanzR). CONCLUSION: Homodynamic measurements with OD have the same accuracy as those with TD and were easily obtained in the 10 patients.
- ItemSomente MetadadadosComparação dos valores de debito cardíaco obtidos por termodiluição e reinalação parcial de gás carbônico em pacientes com lesão pulmonar aguda(Universidade Federal de São Paulo (UNIFESP), 2003) Valiatti, Jorge Luis dos Santos [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]Introdução: O debito cardiaco (DC) e parametro fundamental no tratamento de pacientes graves e diversos metodos tem sido empregados para monitoriza-lo a beira do leito. Apesar de muitos aspectos positivos, a termodiluicao (TDco), padrao atualmente adotado, tem significativos inconvenientes, como complexidade tecnica, riscos e custo. Dai justificar-se a procura de metodos nao invasivos, simples e menos onerosos para a medida do debito cardiaco. Entre estas alternativas, inclui-se a reinalacao parcial de C02 (RBco). O RBco aproxima-se da TDco na ausencia de lesao pulmonar, porem ha evidencias que sugerem discordancia de resultados na presenca de lesao pulmonar. Este estudo teve como objetivo comparar as medidas do debito cardiaco obtidas pelos metodos termodiluicao e reinalacao parcial de C02, em pacientes com lesao pulmonar aguda em dois niveis de gravidade. Metodos: Trata-se este estudo da comparacao de dois metodos, prospectivo e controlado, realizado em 20 pacientes, internados na Unidade de Terapia Intensiva do Hospital Padre Aibino da Faculdade de Medicina de Catanduva - Catanduva (SP) ou da Disciplina de Anestesiologia - Hospital São Paulo, UNIFESP-São Paulo. Foram incluidos os maiores de 12 anos de idade, submetidos a ventilacao artificial para tratamento de insufiCiência respiratoria hipoxemica aguda e que apresentavam monitoracao hemodinamica invasiva, previamente instalada em virtude de instabilidade hemodinamica. Foram excluidos, anteriormente a entrada no estudo, os portadores de doenca pulmonar obstrutiva cronica, aqueles em ventilacao espontanea e os pacientes em regime de ventilacao mecanica com tecnicas que nao assegurem ventilacao constante. Os 20 pacientes (idade media =45,90, variando de 21 a 80 anos ; 15 do genero masculino e 5 do feminino) considerados para estudo foram divididos segundo o grau de lesao pulmonar (Lung Injury Score - LIS) nos grupos A (LIS<2,5; n=11) e B (LIS > 2,5; n=9). O DC pela TD foi obtido em triplicata com a injecao de 10 mL de solucao salina a 0,9 por cento a temperatura entre 0 e 5ºC no orificio proximal de cateter de Swan-Ganz (Swan Ganz Baxter lnc, USA) conectado ao monitor DX-2010(Dixtal ©, Manaus Brasil). Para determinacao do RBco, tambem tomado em triplicata, foi utilizado o monitor modelo NIC02¸(Novametrix Medical Systems, Wallingford, CT USA ). Os dados assim obtidos foram tratados com analise de variancia, correlacao e regressao linear...(au)
- ItemAcesso aberto (Open Access)Comparison between cardiac output values measured by thermodilution and partial carbon dioxide rebreathing in patients with acute lung injury(Associação Paulista de Medicina - APM, 2004-12-01) Valiatti, Jorge Luís dos Santos; Amaral, José Luiz Gomes do [UNIFESP]; Faculdade de Medicina de Catanduva; Universidade Federal de São Paulo (UNIFESP)CONTEXT: Thermodilution, which is considered to be a standard technique for measuring the cardiac output in critically ill patients, is not free from relevant risks. There is a need to find alternative, noninvasive, automatic, simple and accurate methods for monitoring cardiac output at the bedside. OBJECTIVE: To compare cardiac output measurements by thermodilution and partial carbon dioxide rebreathing in patients with acute lung injury at two levels of severity (lung injury score, LIS: below 2.5, group A; and above 2.5, group B). TYPE OF STUDY: Comparative, prospective and controlled study. SETTING: Intensive Care Units of two university hospitals. METHODS: Cardiac output was measured by thermodilution and partial carbon dioxide rebreathing. Twenty patients with acute lung failure (PaO2/FiO2 < 300) who were under mechanical ventilation and from whom 294 measurements were taken: 164 measurements in group A (n = 11) and 130 in group B (n = 9), ranging from 14 to 15 determinations per patient. RESULTS: There was a poor positive correlation between the methods studied for the patients from groups A (r = 0.52, p < 0.001) and B (r = 0.47, p < 0.001). The application of the Bland-Altman test made it possible to expose the lack of agreement between the methods (group A: -0.9 ± 2.71 l/min; 95% CI = -1.14 to -0.48; and group B: -1.75 ± 2.05 l/min; 95% CI = -2.11 to -1.4). The comparison of the results (Student t and Mann-Whitney tests) within each group and between the groups showed significant difference (p = 0.000, p < 0.05). DISCUSSION: Errors in estimating CaCO2 (arterial CO2 content) from ETCO2 (end-tidal CO2) and situations of hyperdynamic circulation associated with dead space and/or increased shunt possibly explain our results. CONCLUSION: Under the conditions of this study, the results obtained allow us to conclude that, in patients with acute lung injury, the cardiac output determined by partial rebreathing of CO2 differs from the measurements obtained by thermodilution. This difference becomes greater, the more critical the lung injury is.