402 A SIMPLIFIED ECHOCARDIOGRAPHIC FORMULA TO ESTIMATE CARDIAC INDEX IN THE INTENSIVE CARE UNIT. (15th December 2022)

• Record Type: Journal Article
• Authors: Gaspardone, Carlo; Romagnolo, Davide; Baldetti, Luca; Fasolino, Alessandro; Peveri, Beatrice; Calvo, Francesco; Gramegna, Mario; Pazzanese, Vittorio; Sacchi, Stefania; Beneduce, Alessandro; Falasconi, Giulio; Fiore, Giorgio; Rampa, Lorenzo; Ajello, Silvia; Mara Scandroglio, Anna
• Is Part Of: European heart journal supplements. Volume 24(2022)Supplement K
• Publication Date: 2022-12-15
• Subjects: Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartjsupp/suac121.008
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Background and aim: Measurement of cardiac index (CI) is crucial in the hemodynamic assessment of critically ill patients in the intensive care unit (ICU). The most reliable trans-thoracic echocardiography (TTE) technique for CI estimation is the left ventricular outflow tract (LVOT) Doppler method that requires, among other parameters, the LVOT cross-sectional area (CSA) measurement. However, geometrical assumptions inherent limitations and practical disadvantages related to the ICU setting, hamper LVOT-CSA assessment. In this study, we aimed to validate a simplified formula, leveraging only on LVOT-velocity time integral (VTI) and heart rate (HR) variables, for the non-invasive estimation of CI in ICU patients. Methods and Results: We prospectively enrolled 50 consecutive patients admitted to our ICU requiring PAC over a one-year period. For each patient we measured the CI by PAC (CIPAC ) and TTE. The latter was obtained both with the "traditional formula" (traditional CITTE ), requiring LVOT-CSA assessment, and our new "simplified formula" (simplified CITTE ). The correlation between the simplified CITTE and CIPAC was strong (r = 0.81) and resulted significantly greater than the traditional CITTE and CIPAC correlation (r = 0.70; p < 0.05 for Pearson r coefficients comparison). Both TTE-based CI showed an acceptable agreement (+0.19±0.48 L/min/m 2 for simplified CITTE and -0.18±0.58 L/min/m 2 for traditional CITTE ) with the reference CIPAC . Conclusion: In this study, we propose an easy-to-use and practical approach, leveraging on TTE LVOT-VTI and HR only, for non-invasive estimation of CI in ICU patients.