Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009;13(6):R202.
doi: 10.1186/cc8209. Epub 2009 Dec 14.

Global end-diastolic volume acquired by transpulmonary thermodilution depends on age and gender in awake and spontaneously breathing patients

Stefan Wolf  1 , Alexander Riess, Julia F Landscheidt, Christianto B Lumenta, Patrick Friederich, Ludwig Schürer
Affiliations

Global end-diastolic volume acquired by transpulmonary thermodilution depends on age and gender in awake and spontaneously breathing patients

Stefan Wolf et al. Crit Care. 2009.

Abstract

Introduction: Volumetric parameters acquired by transpulmonary thermodilution had been repeatedly proven superior to filling pressures for estimation of cardiac preload. Up to now, the proposed normal ranges were never studied in detail. We investigated the relationship of the global end-diastolic volume (GEDV) acquired by transpulmonary thermodilution with age and gender in awake and spontaneously breathing patients.

Methods: Patients requiring brain tumor surgery were equipped prospectively with a transpulmonary thermodilution device. On postoperative day one, thermodilution measurements were performed in 101 patients ready for discharge from the ICU. All subjects were awake, spontaneously breathing, hemodynamically stable and free of catecholamines.

Results: Main finding was a dependence of GEDV on age and gender, height and weight of the patient. Age was a highly significant non-linear coefficient for GEDV with large inter-individual variance (p < 0.001). On average, GEDV was 131.1 ml higher in males (p = 0.027). Each cm body height accounted for 13.0 ml additional GEDV (p < 0.001). GEDV increased by 2.90 ml per kg actual body weight (p = 0.043). Each cofactor, including height and weight, remained significant after indexing GEDV to body surface area using predicted body weight.

Conclusions: The volumetric parameter GEDV shows a large inter-individual variance and is dependent on age and gender. These dependencies persist after indexing GEDV to body surface area calculated with predicted body weight. Targeting resuscitation using fixed ranges of preload volumes acquired by transpulmonary thermodilution without concern to an individual patient's age and gender seems not to be appropriate.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow of patient recruitment. ICU = intensive care unit; MRI = magnetic resonance imaging; POD = postoperative day.
Figure 2
Figure 2
(a) Global end-diastolic volume (GEDV) and (b) global end-diastolic volume index (GEDVI) versus age in predefined groups (univariate comparison).
Figure 3
Figure 3
(a) Global end-diastolic volume (GEDV) and (b) global end-diastolic volume index (GEDVI) versus gender (univariate comparison).
Figure 4
Figure 4
(a) Global end-diastolic volume (GEDV) and (b) global end-diastolic volume index (GEDVI) versus age using a generalized additive model. The continuous line represents the highly significant non-linear relationship for all data (P < 0.0001). The dotted and dashed lines show the 95% confidence interval (CI) for females and males. Single data points are shown with male and female symbols.
See this image and copyright information in PMC

References

    1. Michard F, Alaya S, Zarka V, Bahloul M, Richard C, Teboul J. Global end-diastolic volume as an indicator of cardiac preload in patients with septic shock. Chest. 2003;124:1900–1908. doi: 10.1378/chest.124.5.1900. - DOI - PubMed
    1. Sakka SG, Rühl CC, Pfeiffer UJ, Beale R, McLuckie A, Reinhart K, Meier-Hellmann A. Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med. 2000;26:180–187. doi: 10.1007/s001340050043. - DOI - PubMed
    1. Lichtwarck-Aschoff M, Zeravik J, Pfeiffer UJ. Intrathoracic blood volume accurately reflects circulatory volume status in critically ill patients with mechanical ventilation. Intensive Care Med. 1992;18:142–147. doi: 10.1007/BF01709237. - DOI - PubMed
    1. Neumann P. Extravascular lung water and intrathoracic blood volume: double versus single indicator dilution technique. Intensive Care Med. 1999;25:216–219. doi: 10.1007/s001340050819. - DOI - PubMed
    1. Sakka SG, Bredle DL, Reinhart K, Meier-Hellmann A. Comparison between intrathoracic blood volume and cardiac filling pressures in the early phase of hemodynamic instability of patients with sepsis or septic shock. J Crit Care. 1999;14:78–83. doi: 10.1016/S0883-9441(99)90018-7. - DOI - PubMed