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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: "Computed tomography to estimate cardiac preload and extravascular lung water. A retrospective analysis in critically ill patients | Saugel et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 31 http www.sjtrem.eom content 19 1 31 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access Computed tomography to estimate cardiac preload and extravascular lung water. A retrospective analysis in critically ill patients 1 2 3 4 1 1 Bernd Saugel Konstantin Holzapfel Jens Stollfuss Tibor Schuster Veit Phillip Caroline Schultheiss Roland M Schmid1 and Wolfgang Huber1 Abstract Background In critically ill patients intravascular volume status and pulmonary edema need to be quantified as soon as possible. Many critically ill patients undergo a computed tomography CT -scan of the thorax after admission to the intensive care unit ICU . This study investigates whether CT-based estimation of cardiac preload and pulmonary hydration can accurately assess volume status and can contribute to an early estimation of hemodynamics. Methods Thirty medical ICU patients. Global end-diastolic volume index GEDVI and extravascular lung water index EVLWI were assessed using transpulmonary thermodilution TPTD serving as reference method with established GEDVI EVLWI normal values . Central venous pressure CVP was determined. CT-based estimation of GEDVI EVLWI CVP by two different radiologists R1 R2 without analyzing software. Primary endpoint predictive capabilities of CT-based estimation of GEDVI EVLWI CVP compared to TPTD and measured CVP. Secondary endpoint interobserver correlation and agreement between R1 and R2. Results Accuracy of CT-estimation of GEDVI 680 680-800 800 mL m2 was 33 R1 27 R2 . For R1 and R2 sensitivity for diagnosis of low GEDVI 680 mL m2 was 0 specificity 100 . Sensitivity for prediction of elevated GEDVI 800 mL m2 was 86 R1 57 R2 with a specificity of 57 R1 39 R2 positive predictive value 38 R1 22 R2 negative predictive value 93 R1 75 R2 . Estimated CT-GEDVI and TPTD-GEDVI were significantly different showing an overestimation of GEDVI by the .
