Thorac Cardiovasc Surg 2014; 62 - p6
DOI: 10.1055/s-0034-1394029

Ultrasound dilution technique provides assessment of new preload parameters: Central blood volume and total end-diastolic volume

M. Boehne 1, M. Baustert 1, V. Paetzel 1, H. Köditz 1, H. Bertram 1, M. Sasse 1, P. Beerbaum 1
  • 1Pädiatrische Kardiologie und Intensivmedizin, Medizinische Hochschule Hannover

Background: We previously validated cardiac output measurement by novel ultrasound dilution technique (UDT) and found favorably agree-ment with Fick principle. UDT also determines volumetric parameters such as central blood volume index (CBVI; blood volume of heart, lungs and major vessels) and total end-diastolic volume (TEDVI; sum of all end-diastolic volumes of the atria and ventricles). We evaluated CBVI and TEDVI as cardiac preload parameter.

Methods: In a prospective observational study UDT measurements were performed in triplicate in mechanically ventilated children after corrective biventricular cardiac surgery. Central venous pressure (CVP), CBVI and TEDVI were compared with cardiac index (CI) applying linear regression analysis.

Results: 56 children with a median (range) weight of 6.9 (3.3 to 66.0) kg were included in preliminary analysis. Mean CI by UDT was 3.2 ± 1.2 L/m2, mean CVP 11.2 ± 3.0 mmHg, mean CBVI 15.9 ± 4.2 ml/kg and TEDVI 200 ± 62 ml/m2. A strong correlation was found for CI versus CBVI (r= 0.68; P< 0.05) and TEDVI (r= 0.81; P< 0.05), whereas no correlation was observed for CI and CVP (r= 0.16; P=0.14).

Conclusions: After cardiac surgery CBVI and TEDVI are superior to CVP as preload parameters. UDT is a suitable method to assess CO and volumetric parameters in critically ill patients. Thereby it may help to optimize hemodynamic management and guide volume therapy.