Comparison of echocardiographic indices of right ventricular systolic function and ejection fraction obtained with continuous thermodilution in critically ill patients

Critical Care

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[1] 0000 0000 9725 279X, grid.411296.9, Department of Anaesthesia and Critical Care, Lariboisière Hospital, DMU Parabol, APHP.Nord, Paris, France;0000 0000 9725 279X, grid.411296.9, Department of Anaesthesia and Critical Care, Lariboisière Hospital, DMU Parabol, APHP.Nord, Paris, France;0000 0000 9725 279X, grid.411296.9, Réanimation Chirurgical Polyvalente, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France;0000 0000 9725 279X, grid.411296.9, Department of Anaesthesia and Critical Care, Lariboisière Hospital, DMU Parabol, APHP.Nord, Paris, France;0000000121866389, grid.7429.8, Inserm UMR-S942, Mascot, Paris, France;0000 0000 9725 279X, grid.411296.9, Department of Anaesthesia and Critical Care, Lariboisière Hospital, DMU Parabol, APHP.Nord, Paris, France;0000000121866389, grid.7429.8, Inserm UMR-S942, Mascot, Paris, France;0000 0001 2171 2558, grid.5842.b, Université de Paris, Paris, France;

关键词: Critical illness;    Ventricular dysfunction;    Right;    Catheterization;    Swan-Ganz;    Thermodilution;    Echocardiography;    2D;    Echocardiography;    Doppler;   

DOI  :  10.1186/s13054-019-2582-7

来源: publisher

【 摘 要 】

BackgroundThough echocardiographic evaluation assesses the right ventricular systolic function, which of the existing parameters best reflects the right ventricular ejection fraction (RVEF) in the critically ill patients is still uncertain. We aimed to determine the relationship between echocardiographic indices of right ventricular systolic function and RVEF.MethodsProspective observational study was conducted in a mixed Surgical Intensive Care Unit (Hôpital Lariboisière, Paris, France) from November 2017 to November 2018. All critically ill patients monitored with a pulmonary artery catheter were assessed. We collected echocardiographic indices of right ventricular function (tricuspid annular plane systolic excursion, TAPSE; peak systolic velocity of pulsed tissue Doppler at lateral tricuspid annulus, S′; fractional area change, FAC; right ventricular index of myocardial performance, RIMP; isovolumic acceleration, IVA; end-diastolic diameter ratio, EDDr) and compared them with the RVEF obtained from continuous volumetric pulmonary artery catheter.ResultsTwenty-five patients were analyzed. Admission diagnosis was acute heart failure in 11 patients and septic shock in 14 patients. Median age was 70 years [57–80], norepinephrine median dose was 0.29 μg/kg/min [0.14–0.50], median Sequential Organ Failure Assessment score was 12 [10–14], and mortality at day 28 was 56%. When compared to RVEF, TAPSE had the highest correlation coefficient (rho = 0.78, 95% CI 0.52 to 0.89, p < 0.001). S′ was also correlated to RVEF (rho = 0.64, 95% CI 0.60 to 0.80, p = 0.001) whereas FAC, RIMP, IVA, and EDDr did not. TAPSE lower than 16 mm, S′ lower than 11 cm/s, and EDDr higher than 1 were always associated with a reduced RVEF.ConclusionsWe found that amongst indices of right ventricular systolic function, TAPSE and S′ were well correlated with thermodilution-derived RVEF in critically ill patients.

【 授权许可】

CC BY