Informations générales (source: ClinicalTrials.gov)
Assessment of Cardiac Output With End-tidal Carbon Monoxide (COCO2)
Observational
Centre Hospitalier Universitaire de Besancon (Voir sur ClinicalTrials)
janvier 2020
décembre 2020
29 juin 2024
Hemodynamic monitoring, especially cardiac output assessment, is a key feature for the
management of critically ill patients. Although the use of invasive methods, such as
thermodilution with a pulmonary artery catheter, remains the GOLD standard for the
evaluation of the cardiac output, several non-invasive techniques are currently used in
practice. An acceptable estimation of the cardiac output can be made by standard
transthoracic echocardiography. Cardiac output can be calculated from subaortic velocity
time integral (VTI). However, this technique requires a trained operator and depends on
the echogenicity of the patient. The best method for assessing cardiac output depends on
the patient's needs, the clinical scenario and the physician's experience with the
monitoring device itself. No simple and rapid tool currently exist for assessing cardiac
output in critically ill patients.
The measurement of end-tidal carbon dioxide (EtCO2) used in routine in critically ill
patients requiring mechanical ventilation could be an interesting alternative. Indeed,
the amount of carbon dioxide (CO2) exhaled depends on the production of CO2 by the body,
the pulmonary blood flow (corresponding to cardiac output) and its elimination by
alveolar ventilation. In controlled ventilation, ie for constant alveolar ventilation,
EtCO2 should therefore depend only on cardiac output. It has been shown in a porcine
model that EtCO2 and cardiac output are strongly related under stable respiratory and
metabolic conditions. In humans, only the variation of EtCO2 after volume expansion has
been studied and EtCO2 seems to reflect changes in cardiac output. Nevertheless, the
usefulness of EtCO2 in assessing cardiac output has never been evaluated.
The objective of this study is therefore to determine the relationship between EtCO2 and
cardiac output evaluated by the measurement of subaortic VTI in critically ill patients.
Etablissements
| Les établissements sans correspondance certaine dans le répertoire FINESS dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Intensive care unit, University hospital of Besançon - 25000 - Besançon - France | Thibaud Soumagne, MD, PhD | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- patients intubated and ventilated in the control assisted mode with no inspiratory
effort
- requiring vasopressors
- patients intubated and ventilated in the control assisted mode with no inspiratory
effort
- requiring vasopressors
- less than 18 years
- refuse to participate
- situation in which health condition, medication or procedure could significantly
interfere with the interpretation of EtCO2 or cardiac output (extracorporeal life
support, pneumothorax with persistant air leak)
(be increased without correlation to an infectious process (poly-traumatised patients,