Right ventricular volumes by thermodilution in the adult respiratory distress syndrome. A comparative study using two-dimensional echocardiography as a reference method.
Measurements of right ventricular ejection fraction and volumes were obtained at bedside by the thermodilution method performed with a fast-response balloon-tipped thermistor in a group of 18 patients undergoing respiratory therapy for the adult respiratory distress syndrome (ARDS). These measurements were compared with right ventricular dimensions simultaneously obtained with two-dimensional echocardiography. A significant correlation was found between right ventricular ejection fraction by thermodilution and two-dimensional echocardiographic fractional area contraction (r = 0.74; p less than 0.001), between right ventricular end-diastolic volume by thermodilution and two-dimensional echocardiographic end-diastolic area (r = 0.70; p less than 0.001), and between right ventricular end-systolic volume by thermodilution and two-dimensional echocardiographic end-systolic area (r = 0.78; p less than 0.001). Right ventricular end-diastolic pressure, a commonly used index of right ventricular preload, did not correlate with two-dimensional echocardiographic end-diastolic area. In conclusion, the thermodilution method allowed reliable measurements of right ventricular ejection fraction and volumes at bedside in critically ill patients. Appraisal of right ventricular end-diastolic volume by this method appeared to be a better predictor of right ventricular preload than were the measurements of pressure.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001810:Blood Volume; D004452:Echocardiography / Q000379:methods*; D005069:Evaluation Studies as Topic; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D012016:Reference Values; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D013318:Stroke Volume; D013815:Thermodilution