• Intensive care medicine · Jul 2012

    Transpulmonary thermodilution measurements are not affected by continuous veno-venous hemofiltration at high blood pump flow.

    • Nicolas Dufour, Marianne Delville, Jean-Louis Teboul, Laurent Camous, Aude Favier du Noyer, Christian Richard, and Xavier Monnet.
    • AP-HP, Hôpital de Bicêtre, service de réanimation médicale, 78, rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France.
    • Intensive Care Med. 2012 Jul 1;38(7):1162-8.

    PurposeTo assess whether continuous veno-venous hemofiltration (CVVH) with high blood pump flow alters the measurements of cardiac index (CI), global end-diastolic volume indexed (GEDVI), and extravascular lung water indexed (EVLWI) performed by transpulmonary thermodilution.MethodsSixty-nine patients were included if they were monitored by a PiCCO2 device and received CVVH through a femoral (n = 62) or an internal jugular (n = 7) dialysis catheter. The blood pump flow was set at 250 mL/min (n = 31) or 350 mL/min (n = 38) and the filtration flow at 6,000 mL/h. A first set of data was collected with a first transpulmonary thermodilution (TD(on)). The blood pump was stopped and the continuous CI derived from pulse contour analysis was recorded (PC(off)). A second data set (TD(off)) was collected before and a last one (TD(on-last)) after restarting the blood pump.Results[Formula: see text], [Formula: see text], [Formula: see text] , and [Formula: see text] were not significantly different in patients with a femoral dialysis catheter (3.49 ± 0.96, 3.51 ± 0.96, 3.51 ± 0.99, and 3.44 ± 1.00 L min(-1) m(-2), respectively). This was observed with a blood pump flow at 350 mL/min and at 250 mL/min. In these patients with a femoral dialysis catheter, GEDVI did not significantly change when the blood pump was stopped. EVLWI significantly decreased when the blood pump was stopped but to a non-clinically relevant extent (-0.3 ± 0.8 mL/kg). No significant changes in CI, GEDVI, and EVLWI were observed in patients with an internal jugular dialysis catheter over the study period.ConclusionsCVVH with a high blood flow pump does not alter the transpulmonary thermodilution measurements of CI, GEDVI, and EVLWI.

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