title: Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO.
abstract: USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring). The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points) on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (n = 70). Seventy paired left-sided CO measurements (transaortic access = CO(US-A)) were obtained. The mean CO(US-A) were 6.55 l/min (±2.19) versus CO(PiCCO) 6.5 l/min (±2.18). The correlation coefficient was r = 0.89. Comparison by Bland-Altman analysis revealed a bias of -0.36 l/min (±0.99 l/min) leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO). It seems to be appropriate in situations where CO measurements are most pertinent to patient management.
authors.affiliation: Medical Department II, Ludwig Maximilian University of Munich, Campus Großhadern, Marchioninistraße 15, 81377 Munich, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Horster
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: Nina
authors.initials: N
authors.lastname: Strecker
authors.forename: Florian
authors.initials: F
authors.lastname: Brettner
authors.forename: Andreas
authors.initials: A
authors.lastname: Hausmann
authors.forename: Jitske
authors.initials: J
authors.lastname: Cnossen
authors.forename: Klaus G
authors.initials: KG
authors.lastname: Parhofer
authors.forename: Thomas
authors.initials: T
authors.lastname: Nickel
authors.forename: Sandra
authors.initials: S
authors.lastname: Geiger