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Signa vitae : journal for intesive care and emergency medicine, Vol. 2 No. 1, 2007.

Original scientific paper

First measured intrathoracic blood volume in icu patients indicates the appropriateness of circulatory volume management

Jasminka Kopic ; Department of Anaesthesiology and Intensive Care, «Dr. Josip Benčević» General Hospital, Kraljice Jelene 1, 35000 Slavonski Brod, Croatia
Ivan Mirkovic ; Department of Anaesthesiology and Intensive Care, «Dr. Josip Benčević» General Hospital, Kraljice Jelene 1, 35000 Slavonski Brod, Croatia
Ivan Lucic ; Department of Anaesthesiology and Intensive Care, «Dr. Josip Benčević» General Hospital, Kraljice Jelene 1, 35000 Slavonski Brod, Croatia
Asja Ajdinovic ; Department of Anaesthesiology and Intensive Care, «Dr. Josip Benčević» General Hospital, Kraljice Jelene 1, 35000 Slavonski Brod, Croatia
Matija Jurjevic ; Department of Anaesthesiology and Intensive Care, «Dr. Josip Benčević» General Hospital, Kraljice Jelene 1, 35000 Slavonski Brod, Croatia

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Abstract

Hemodynamic monitoring in Intensive Care Unit (ICU) settings is usually introduced when a patient becomes hemodynamically unstable. We analyzed how empirically guided volume management relates to first measured intrathoracic blood volume (ITBV), at the moment of the beginning of Puls Contour Cardiac Output (PiCCO) hemodynamic monitoring.
Data and measurements from 37 ICU patients, divided into four groups according to diagnosis of primary condition, were retrospectively studied. The first group consisted of polytrauma patients, second group of patients with pancreatitis and/or peritonitis, third group were postoperative patients, and fourth group were patients with various medical diagnosis: sepsis, acute respiratory distress syndrome (ARDS), acute lung failure (ALF), and acute heart failure (AHF). PiCCO monitor was introduced when the signs of hemodynamic instability were observed. First measured ITBV was recorded and analyzed according to deviation from reference values.
First measured ITBV was in reference range in 14 (37.8%) patients. Volume overloading was observed in 16 (43.2%) and hypovolemia in 7 (18.9%) patients.
The observed inappropriate blood volume in patients of all studied groups suggests that there is the need for defining indications and earlier application of hemodynamic monitoring, as well as reassessment of usual empirically guided infusion therapy in ICU setting.

Keywords

hemodynamic process; intensive care; hypovolemia; monitoring

Hrčak ID:

11965

URI

https://hrcak.srce.hr/11965

Publication date:

1.4.2007.

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