Validation of a new transpulmonary thermodilution system to assess global end-diastolic volume and extravascular lung water

Abstract

Introduction: A new system has been developed to assess global end-diastolic volume (GEDV), a volumetric marker of cardiac preload, and extravascular lung water (EVLW) from a transpulmonary thermodilution curve. Our goal was to compare this new system with the system currently in clinical use.Methods: Eleven anesthetized and mechanically ventilated pigs were instrumented with a central venous catheter and a right (PulsioCath; Pulsion, Munich, Germany) and a left (VolumeView™; Edwards Lifesciences, Irvine, CA, USA) thermistor-tipped femoral arterial catheter. The right femoral catheter was used to measure GEDV and EVLW using the PiCCO2™ (Pulsion) method (GEDV1and EVLW1, respectively). The left femoral catheter was used to measure the same parameters using the new VolumeView™ (Edwards Lifesciences) method (GEDV2and EVLW2, respectively). Measurements were made during inotropic stimulation (dobutamine), during hypovolemia (bleeding), during hypervolemia (fluid overload), and after inducing acute lung injury (intravenous oleic acid).Results: One hundred and thirty-seven paired measurements were analyzed. GEDV1and GEDV2ranged from 701 to 1,629 ml and from 774 to 1,645 ml, respectively. GEDV1and GEDV2were closely correlated (r2= 0.79), with mean bias of -11 ± 80 ml and percentage error of 14%. EVLW1and EVLW2 ranged from 507 to 2,379 ml and from 495 to 2,222 ml, respectively. EVLW1and EVLW2were closely correlated (r2= 0.97), with mean bias of -5 ± 72 ml and percentage error of 15%.Conclusions: In animals, and over a very wide range of values, a good agreement was found between the new VolumeView™ system and the PiCCO™ system to assess GEDV and EVLW. © 2010 Engvall et al.; licensee BioMed Central Ltd.