ORIGINAL ARTICLE

Correlation Between the End-Tidal CO2 (EtCO2) and Decreased Cardiac Output Measured by Ultrasonic Cardiac Output Monitor (USCOM) for Intubated Patients in ICU

Tjokorda Gde Agung Senopathi, Made Wiryana, Ketut Sinardja, I Made Widnyana, Putu Agus Surya Panji, Warsito Warsito

Tjokorda Gde Agung Senopathi
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia

Made Wiryana
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia

Ketut Sinardja
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia

I Made Widnyana
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia

Putu Agus Surya Panji
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia

Warsito Warsito
Anesthesiology and Intensive Care Department, Udayana University, Sanglah General Hospital, Denpasar, Bali Indonesia. Email: [email protected]
Online First: January 02, 2017 | Cite this Article
Senopathi, T., Wiryana, M., Sinardja, K., Widnyana, I., Panji, P., Warsito, W. 2017. Correlation Between the End-Tidal CO2 (EtCO2) and Decreased Cardiac Output Measured by Ultrasonic Cardiac Output Monitor (USCOM) for Intubated Patients in ICU. Bali Medical Journal 6(1): 12-16. DOI:10.15562/bmj.v6i1.372


Background: assessment of cardiac output is crucial in management of critical ill patients. Various types of tool are available to measure cardiac output. However, most has limitations such as invasive, expensive, and require special skill. Assessment of End-tidal Carbon Dioxide (EtCO2) is expected to be used as an alternative estimation of cardiac output. It is based on the condition that when cardiac output is decreased, it decreased pulmonary blood flow and diffusion of CO2 into the alveolar, thereby increasing alveolar dead space and lowering EtCO2. Objective: to find a correlation between EtCO2 and decreased cardiac output measured by Ultrasonic Cardiac Output Monitor (USCOM) for intubated patients in ICU of Sanglah General Hospital, Denpasar, Bali. Methods: This is a cross-sectional study, the correlation test conducted from June to August 2016 in ICU of Sanglah Hospital. The study involved 75 patients who eligible with a total population sampling technique. Intubated patients admitted to the ICU were evaluated for EtCO2 and USCOM in the first 24 hours by the researchers simultaneously. Shapiro-Francia test was used for normality and Pearson’s correlation tests was used to measure the correlations between variables. Results: The EtCO2 value obtained was positively correlated with cardiac output values (r = 0.373; p 0.001). Conclusion: there is a correlation between EtCO2 and decreased cardiac output measured by USCOM for intubated patients in ICU of Sanglah General Hospital, Denpasar

References

REFERENCES

Cecconi, Maurizio., Backer, D.D., Antonelli, Massimo., Beale, Richard., Bakker, Jan., Hofer, Christoph., Jaeschke, Roman., Mebazaa, Alexandre., Pinsky, M. R., Teboul, J.L. Vincent, Jean, J.L., Rhodes, Andrew. 2014. Consensus on circulatory shock and hemodynamic monitoring. Task Force of the European Sociaety of Intensive Care Medicine. Intensive Care Med., 40:1795-1815.

Alhashemi, J.A., Cecconi, Maurizio., Hofel, C.H. 2011. Cardiac Output Monitoring: an Integrative Perspective. Critical Care., p1-9.

Hiller, S. C., Mazurek, M.S. 2009. Monitored anesthesia care. In: Barash, P. G. Cullen, B.F., Stoelting, R.K., Cahalan, M.K., Stock, M.C., editors. Clinical Anesthesia. Seventh edition. Philadelphia: Lippincott William & Wilkins. p697-714.

Porhomayon, J., Sadei, G., Congello, S., Nader, N., 2012. Applications of minimally invasive cardiac output monitors. International Journal of Emergency Medicine. 5:1-9.

Saugel, B., Cecconi, M., Wagner, J.Y., Reuter, D.A. 2015. Noninvasive continous cardiac output monitoring in perioperative and intensive care medicine. Bristish Journal of Anaesthesia., p1-14.

Sangkum, L., Liu, G., Yu, L., Yan, H. 2016. Minimally invasive or noninvasive cardiac output measurement: an update. Journal of Anaesthesia Springer. 1:1-20

Anonim. 2007. USCOM: Ultrasound Cardiac Output Monitor for Patient Requiring Haemodynamic Monitoring. Australia.: AHTA.

Smith, B.E. 2013. The USCOM and Haemodynamics. Learn Hemodynamics. Revisi 5: 1-20.

Marik, Paul E. 2012. Noninvasive cardiac output monitor: a state of the art review. Journal of cardiothoracic and Vascular Anesthesia., 10:1-14.

Mathews, L., Singh, K., 2007. Cardiac Output Monitoring. Annals of Cardiac Anaesthesia.,11:56-68.

Hoster, Sophia., Stemmler, H.J., Strecker, Nina., Brettner, F., Hausmann, A., Cnossen, Jitske., Parhofer, K.G., Nickel, T., Geiger, Sandra. 2012. Cardiac output measurement in sepsis patient: comparing the accuracy of USCOM to PICCO. Critical Care Research and Practice.2012.

Wong, L.G., Yong, Boon-HunH., Lau, Lee-Sung, Young, K.K., Cheng, King-lik., Man, J.S., Irwin, M.G. 2008. Comparison of the USCOM cardiac monitor with pulmonary artery catheter thermodilution in patients undergoing liver transplantation. American Association for the Study of Liver Disease., 14:1038-1043.

Dunham, C Michael., Chirichella, T.J., gruber, B.S., Ferrari, J.P., Martin, J.A., Luchs, B.A., Hileman, B.M., Merrell, R. 2013. In emergently ventilated trauma patients, low end tidal CO2 and low cardiac output are associated and correlate with hemodynamic instability, hemorrhage, abnormal pupils, and death. BMC Anesthesiology., 13: 1-8.

Bauman, Mark., Cosgrove, Cindy. 2012. Understanding end-tidal CO2 monitoring. American Nurse Today. 7: p12-17.

Eisenkraft, J.B. 2011. Respiratory gas Monitoring. In: Reich, David L., editor. Monitoring in Anesthesia and Perioperative care. New York: Cambridge. p150-170.

Spiegel Joan. 2013. End tidal cardon dioxide: the Most Vital Of vital signs. Anesthesiology News Spesial Edition. P21-27.

Way, Megan., Hill, Garry E. 2011. Intraoperative end-tidal carbon dioxide concentrations: what Is the target. Anesthesiology Research and Practice., 2011 :1-3.

Yosefy, C., Nasri, Y., Magen, E., Reisin, L. 2004. End tidal carbon dioxide as predictor of the arterial PCO2 in the emergency department setting. Emerg Med J., 21:557-559.

Kartal, Mutlu., Eray O., Rinnert, S., Goksu, E., Bektas, F., Eken, C. 2011. EtCo2: a predictive tool for excluding metabolic disturbances in nonintubated patients. American journal of Emergency., 29:65-69.

Singla, M.K., Sodhi, K., Shrivastava, A., Salooja, M. S., Mukherjee, K.C., Saini, S. 2014. End-tidal CO2 should not be parameter for ventilatory adjusment during low cardiac output Stated like off-pump coronary artery bypass grafting. Journal of General Practice., 2:1-4.

Kheng, Cheah P dan Raahman, Nik H. 2012. The Use of End-Tidal Carbon Dioxide Monitoring in Patient with Hypotension in Emergency Department. International Journal of Emergency Medicine.

Kodali, B., Urman, R., 2014. Capnography during cardiopulmonary resuscitation: Current evidence and future directions. Journal of Emergency, Trauma, and Shock 7:332-340.

McGillicuddy, D.C., Tang, Aimee., Cataldo, L., Gusev, J. Shapiro, N.L. 2009. Evaluation of End Tidal Carbon Dioxide Role in Predicting Elevated SOFA Scores and Lactic Acidosis. Intern Emerg. Med., 4:41-44.

Ochiai, M.O., Cardoso, J.N., Vieira, K.R., Lima, M.V., Brancalhao, E.C., Barretto, A.C. 2011. Predictors of low cardiac output in decompensated severe heart failure. Clinic Science. 66:239-244.


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