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• W2334689018 abstract "Introduction: Monitoring continuous cardiac index (CCI) with pulmonary artery catheter (PAC) is valuable for postoperative management after cardiac surgery. However, some reports have shown that intermittent pneumatic compression (IPC) devices, which are used to prevent deep venous thrombosis and pulmonary embolism, may affect the accuracy of the measurement. We have experienced and previously reported the novel phenomena which displayed the rhythmic fluctuation of CCI during IPC working. They seemed like sine wave curves, and we called them CCI oscillations. It has been already proven that IPC stop tests diminish these CCI oscillations and IPC is the main cause of the phenomena. We had used Venostream® (Terumo) for IPC devices, which compress both lower legs at the same time periodically. Now we are changing IPC devices to Kendall SCD 700 Series® (Covidien), which compress each leg discretely, at non-periodic timing. This change seems to diminish oscillations, which results in more accurate measurement of cardiac index (CI). Methods: We reviewed ICU records of consecutive 36 patients from June 2013 to July 2013 retrospectively, who were admitted to the ICU with PAC after cardiac surgery. Soon after admission to the ICU, we monitored CCI and started IPC for all the patients. We measured an amplitude of the CCI oscillation, which means a difference between CImax and CImin, of each patient during only the period in which his or her heart rate, blood pressure, and mixed venous oxygen saturation were all stable and any procedure was not performed. Then we compared the amplitudes between Venostream group and Kendall group. All data shown below are mean±SD, and we used Student t tests for comparison between the groups. All p values < 0.05 were considered statistically significant. Results: Of 36 patients, 21 patients were received IPC by Venostream, and 15 patients by Kendall. Between both groups patients’ backgrounds and clinical characteristics were not significantly different. Mean amplitudes of CCI oscillations of patients in Venostream group were significantly higher than those of patients in Kendall group (0.91 ± 0.48 vs 0.48 ± 0.14, P=0.002). Conclusions: Changing devices of IPC significantly reduced the amplitudes of CCI oscillations. The oscillations often confuse us because we can’t know the true value of CI. Changing IPC devices may help us resolve this problem." @default.
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• W2334689018 date "2013-12-01" @default.
• W2334689018 modified "2023-09-25" @default.
• W2334689018 title "284" @default.
• W2334689018 doi "https://doi.org/10.1097/01.ccm.0000439430.56202.bd" @default.
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