Key result
Right ventricular end-diastolic volume index (RVEDVI) correlated better with cardiac index (r=0.61) than pulmonary artery wedge pressure (r=0.42) and accurately predicted fluid responsiveness.
Why the study?
Does RVEDVI predict preload recruitable increases in cardiac output better than PAWP in critically ill patients?
Observational (n=29)
Does RVEDVI predict preload recruitable increases in cardiac output better than PAWP in critically ill patients?
RVEDVI is a more accurate predictor of preload recruitable increases in cardiac output than PAWP in critically ill patients.
RVEDVI may better predict fluid responsiveness than PAWP in critical illness; hypothesis-generating and requires randomized confirmation before practice change.
The relative value of pulmonary artery wedge pressure (PAWP) and right ventricular end-diastolic volume index (RVEDVI) as a reflection of the preload status of the critically ill was determined in 29 patients. Regression analysis of 131 hemodynamic studies demonstrated that cardiac index (CI) correlated better with RVEDVI (r = .61) than did PAWP (r = .42). Comparisons of PAWP and RVEDVI showed that possible misleading information concerning filling volume was provided by the PAWP at some time in 15 (52%) of these patients. In 15 patients given 22 fluid challenges, patients with a high PAWP (greater than or equal to 18 mm Hg) "responded" with a rise in CI more frequently than did patients with a low PAWP (less than 12 mm Hg). However, all eight patients with a RVEDVI less than 90 mL/m2 responded with a rise in CI, but all seven patients with a RVEDVI greater than or equal to 139 mL/m2 failed to respond. Thus, RVEDVI more accurately predicted preload recruitable increases in cardiac output.
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Lawrence N. Diebel (1992) conducted an observational in Critically ill (n=29). Right ventricular end-diastolic volume index (RVEDVI) vs. Pulmonary artery wedge pressure (PAWP) was evaluated on Correlation with cardiac index (CI). Right ventricular end-diastolic volume index (RVEDVI) correlated better with cardiac index (r=0.61) than pulmonary artery wedge pressure (r=0.42) and accurately predicted fluid responsiveness.