The Correlation Analysis Between Non-invasive Hemodynamic Monitor Of Thoracic Electrical Bioimpedance And PiCCO

Objective Through the detection of CSM3000 Non-invasive hemodynamic monitor of Thoracic Electrical Bioimpedance and PiCCO (pulse indicator Continous Cadiac output) in patients with septic shock, expound the correlation of the two methods, evaluating the accuracy and clinical application value of CSM3000 Non-invasive hemodynamic monitor of TEB.Methods Patients in the intensive care unit were selected from February 2015 to March 2016,and register the name, sex, age, height and weight of each patient.PiCCO and TEB were continuously performed in all patients, and Sixty-nine groups of hemodynamic datas were collected by the two methods.PiCCO needs one central venous catheterization and one femoral artery catheter, single cardiac output was obtained using thermodilution method,then calculate global end-diastolic volume(GEDV)、intrathoracic blood volume (ITBV)、extravascular lung water(EVLW).In addition,pulse contour cardiac output(PCCO)and stroke volume (SV) were obtained by analyzing the area under the curve of the arterial pressure waveform.Noninvasive hemodynamic monitoring used thoracic electrical bioimpedance technology, pasted disposable heart special detection electrode slice on the body face, and observed the synchronously showed ECG and impedance cardiography(ICG), freezed the waveform graph,obtained the hemodynamic data of SV、SI,CO、CI, pre-ejection period (PEP), left ventricular ejection time(LVET), systolic time ratio (STR), thoracic fluid capacity(TFC) and systemic vascular resistance (SVR) etc..Using medcalc software for statistical analysis. Measurement data are expressed as x± s.CO、CI、SV、SI and SVR are compared by t-test, count data using chi-square test. Bland-Altman method analysis the correlation among two methods. The difference is statistically significant when P<0.05.Results1.The hemodynamic data measured by t-test:two kinds of detection methods of CO and CI were not statistically different (P>0.05), but SV, SI and SVR were statistically significant (P<0.05).2.Bland Altman analysis the consistency of two methods:The difference between and CO and CI measured by TEB and PiCCO is 20% to 31%,that can be accepted in clinical,indicating that the consistency of TEB and PiCCO is good; In terms of the maximum value of the absolute value of the SV and SI are difficult to accept in clinical, and the difference between SVR measured by TEB and PiCCO is 20% to 31%, that can be accepted in clinical difficultly,so that the the consistency of SV、SI and SVR is ordinary.3.TFC detected by TEB and the capacity detected by PiCCO are used as the basis of liquid management:the P value was significantly greater than 0.05 (P=0.8289), which showed that there was no significant difference between the two methods.Conclusion1. In the monitoring of CO and CI, PiCCO can be replaced by CSM3000 Non-invasive hemodynamic monitor.2. CSM3000 Non-invasive hemodynamic monitor can effectively guide the management of liquid as PiCCO.3. CSM3000 Non-invasive hemodynamic monitor can monitor SV, SI and SVR, but which needs to be combined with other indicators to guide clinical treatment.