title: [Effect of Paroxysmal Atrial Fibrillation on Parameters Monitored by Transpulmonary Thermodilution Method].
abstract: OBJECTIVE
  To investigate the effect of atrial fibrillation on the accuracy of parameters monitored by transpulmonary thermodilution method.
  
  
  METHODS
  Totally 12 patients from emergency intensive care unit with paroxysmal atrial fibrillation were enrolled. The hemodynamic parameters such as heart rate, mean arterial pressure, cardiac index, systemic vascular resistance index, intrathoracic blood volume index, and extravascular lung water index were monitored by transpulmonary thermodilution method before paroxysmal atrial fibrillation and during atrial fibrillation, the number of B-lines was detected by lung ultrasonography before and during paroxysmal atrial fibrillation. The changes of all the parameters were analyzed.
  
  
  RESULTS
  When the paroxysmal atrial fibrillation happened, the heart rate increased significantly [(123.3±20.0) beat/min vs. (98.9±12.3) beat/min, P=0.006]; the mean arterial pressure [(86.9±10.2) mmHg vs. (93.0±12.5) mmHg, P=0.058], cardiac index [(2.82±0.62) L/(min·m(2)) vs. (3.31±1.02) L/(min·m(2)), P=0.058] and systemic vascular resistance index [(2254±947) dyn·s·cm(-5)·m(2) vs. (2302±828) dyn·s·cm(-5)·m(2), P=0.351] had no obvious change; however, the intrathoracic blood volume index significantly increased [(1333±90) ml/m(2) vs. (937±111) ml/m(2), P<0.001]; extravascular lung water index also increased significantly [(16.1±1.1) ml/kg vs. (6.5±1.9) ml/kg, P<0.001]. No significant difference was found in the number of B-lines detected by lung ultrasonography before and during atrial fibrillation (10.0±4.2 vs. 9.4±4.4, P=0.180).
  
  
  CONCLUSIONS
  Both intrathoracic blood volume and extravascular lung water monitored by transpulmonary thermodilution method were overvalued during paroxysmal atrial fibrillation, which may mislead the clinical judgment and decision-making.
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Hua-dong
authors.initials: HD
authors.lastname: Zhu
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Liang-liang
authors.initials: LL
authors.lastname: Zheng
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Dong-qi
authors.initials: DQ
authors.lastname: Yao
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Ji-hai
authors.initials: JH
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Tie-kuan
authors.initials: TK
authors.lastname: Du
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Xue-zhong
authors.initials: XZ
authors.lastname: Yu
authors.affiliation: Department of Emergency Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology*; D001794:Blood Pressure; D001810:Blood Volume; D002302:Cardiac Output; D015633:Extravascular Lung Water; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D013815:Thermodilution; D014655:Vascular Resistance