The effect of head up tilting on bioreactance cardiac output and stroke volume readings using suprasternal transcutaneous Doppler as a control in healthy young adults
Publication in refereed journal


摘要To compare the performance of a bioreactance cardiac output (CO) monitor (NICOM) and transcutaneous Doppler (USCOM) during head up tilting (HUT). Healthy young adult subjects, age 22 +/- 1 years, 7 male and 7 female, were tilted over 3-5 s from supine to 70A degrees HUT, 30A degrees HUT and back to supine. Positions were held for 3 min. Simultaneous readings of NICOM and USCOM were performed 30 s into each new position. Mean blood pressure (MBP), heart rate (HR), CO and stroke volume (SV), and thoracic fluid content (TFC) were recorded. Bland-Altman, percentage changes and analysis of variance for repeated measures were used for statistical analysis. Pre-tilt NICOM CO and SV readings (6.1 +/- 1.0 L/min and 113 +/- 25 ml) were higher than those from USCOM (4.1 +/- 0.6 L/min and 77 +/- 9 ml) (P < 0.001). Bland-Altman limits of agreement for CO were wide with a percentage error of 38 %. HUT increased MBP and HR (P < 0.001). CO and SV readings decreased with HUT. However, the percentage changes in USCOM and NICOM readings did not concur (P < 0.001). Whereas USCOM provided gravitational effect proportional changes in SV readings of 23 +/- 15 % (30A degrees half tilt) and 44 +/- 11 % (70A degrees near full tilt), NICOM changes did not being 28 +/- 10 and 33 +/- 11 %. TFC decreased linearly with HUT. The NICOM does not provide linear changes in SV as predicted by physiology when patients are tilted. Furthermore there is a lack of agreement with USCOM measurements at baseline and during tilting.
著者Zhang J, Critchley LAH, Lee DCW, Khaw KS, Lee SWY
期刊名稱Journal of Clinical Monitoring and Computing
詳細描述DOI 10.1007/s10877-016-9835-7.
頁次519 - 526
關鍵詞Bioreactance; Cardiac output; Doppler; Head up tilting
Web of Science 學科類別Anesthesiology

上次更新時間 2020-01-12 於 00:51