Cardiac Output Measurement With NICCOMO and PiCCO Devices at Different PEEP Levels

Medical University of Gdansk

Status: Unknown

Conditions: Cardiovascular Diagnostic Techniques

Treatments: Device: PICCO; Device: NICCOMO

Study type: Observational

Funder types: Other

Identifiers

NCT02572739

GUMed-Wu-002

Details and patient eligibility

About

Thermodilution cardiac output measurement is a reliable method, but it is an invasive one. PiCCO device requires cannulation of central vein and peripheral artery. Impedance method requires only attachment of special electrodes. Non-invasive methods are less accurate. Aim of study is to assess accuracy and reliability of impedance method ( using NICCOMO device) in comparison of thermodilution method ( using PiCCO device) at different PEEP levels.

Full description

Echocardiography is performed prior to measurement to exclude patients with heart valve abnormalities.

Patients without spontaneous ventilation ( deeply unconscious, sedated or sedated and paralysed), ventilated with controlled mechanical ventilation mode with tidal volume 6-8 ml/ideal body weight, resulting in EtCO2 35-45 mmHg, with PiCCO catheters implemented have additionally NICCOMO device attached. Fraction of inspired oxygen (FiO2) is set to achieve saturation >96% at positive end expiratory pressure (PEEP) 0 cmH2O.

Measurement of cardiac output are performed on expiration at PEEP 0, 5, 10, 15 20 cmH2O and at optimal PEEP (obtained from P-V curve). Simultaneously CO value from impedance device is noted. Other haemodynamic parameters, calculated by both devices are also noted - stroke volume (SV), stroke volume variation (SVV), Cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI).

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• critically ill patients
• patients on mechanical ventilation
• circulatory insufficiency (present or in the past) monitored with with PiCCO device

Exclusion criteria

• morbid obesity,
• short neck,
• severe pneumonia,
• inability to NICCOMO electrodes attachment,
• massive tissue oedema,
• non-sinus cardiac rhythm,
• tachycardia,
• low cardiac output,
• septic shock,
• heart valve pathologies,
• severe atherosclerosis,
• aortic prosthesis,
• severe hypertension,
• extremes of height and weight,
• intraaortic pump

Trial design

50 participants in 1 patient group

haemodynamics measuring

Description:

those with already implemented PICCO device get impedance device (NICCOMO) attached

Treatment:

Device: PICCO

Device: NICCOMO