Evaluation of thoracic fluid states and hemodynamic parameters with thoracic electric bioimpedance method and pulmonary artery catheter in patients with acute myocardial infarction with normal pulmonary capillary wedge pressure

DOI 24 References
  • Okawa Hirobumi
    Department of Emergency and Disaster Medicine, Hirosaki University Graduate School of Medicine
  • Tose Ryuji
    Department of Anesthesia, Hirosaki University Graduate School of Medicine
  • Hashiba Eiji
    Intensive Care Unit, Hirosaki University Hospital
  • Tsubo Toshihito
    Intensive Care Unit, Hirosaki University Hospital
  • Ishihara Hironori
    Department of Anesthesia, Hirosaki University Graduate School of Medicine
  • Hirota Kazuyoshi
    Department of Anesthesia, Hirosaki University Graduate School of Medicine

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  • 肺毛細管楔入圧が正常な急性心筋梗塞患者における胸郭インピーダンス法と肺動脈カテーテルを用いた肺内水分状態および血行動態の検討

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Objectives: To evaluate the usefulness of a thoracic electric bioimpedance (TEB) method as a monitor in patients with acute myocardial infarction whose pulmonary capillary wedge pressure (PCWP) was normal. Methods: Thirty-six patients with a diagnosis of acute myocardial infarction were included. Thoracic fluid content (TFC) and PCWP were measured with a TEB method and a pulmonary artery catheter, respectively. Cardiac index (CI) was also measured with a TEB method and a conventional thermodilution (TD) method simultaneously. The correlation between TFC and PCWP, CI measured with both methods, TFC and CI, PCWP and CI, were examined. Results: TFC was correlated with PCWP (r = 0.45, P = 0.0036). CI measured with both methods had a positive correlation (r = 0.68, P = 0.000057) and Bland-Altman plot yielded a mean ±2SD of the difference of CIs, that was −0.10±1.26 l·min−1·m−2. TFC had no significant correlation with CI. PCWP was inversely correlated with CI (r =−0.49, P = 0.0067 with CI measured with a TEB method and r =−0.47, P = 0.0096 with CI measured with a TD method). Conclusions: It was suggested that the TEB method could reflect pulmonary fluid states and cardiac output in patients with acute myocardial infarction whose PCWP was normal. This method could be a choice as a monitor in this group of patients.

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