Monitoring of intrathoracic blood volume in early septic patients: its correlation with survival
© Biomed central limited 2001
Published: 1 March 2002
Early goal directed therapy improves survival in sepsis, trough optimisation of contractility, oxygen balance and correction of fluids deficit . Aim of the study is to investigate whether optimisation of ITBV (intrathoracic blood volume) an index of preload, could be a therapeutic end point in early sepsis, as previously demonstrated in burns patients .
Sixty septic patients (Bone criteria) were monitored with a central vein catheter and an artery femoral catheter connected to a fiberoptic system (Cold Z-02; Pulsion Medizintechnic) Patients were submitted to a fluid management protocol to obtain MAP = 75 mm/Hg, maintaining ITBVI 800-1000 ml/m2 and EVLWI <7.5 ml/kg. At T0 (basal) and after 24 (T1), 48 (T2) 72 (T3) and 96 hours (T4) main volumetric, hemodynamic data were studied. ANOVA test was used to compare changes over time. A Fisher test was used to compare categorical data.
(1) ITBVI improves earlier in survivors then non survivors during a reanimation period. (2) This improvement has a predictive value. (3) Optimisation of ITBVI during early sepsis should be evaluated in further trials.
ITBVI > 800 ml/m2
Positive predictive value
Negative predictive value