Thoracic Fluid Content Measurement: Diagnostic Value of Suspected Pulmonary Oedema in Acute Decompensate Heart Failure

Abstract

Aim:One of the non-invasive methods of monitoring changes in cardiovascular haemodynamics is the measurement of transthoracic impedance (TTI). The most important features of this method are that it does not require catheterisation, it carries no risk of complications and it is both cost-effective and easily applicable. The aim of this study was to determine the diagnostic value of thoracic fluid content (TFC), which is one the parameters obtained from TTI measurement in patients who present to the emergency department (ED) with dyspnoea and are suspected of pulmonary oedema (PO) due to acute decompensate heart failure (ADHF).Materials and Methods:This single-centre, prospective, cohort clinical study was conducted on patients aged >18 years who presented to the tertiary care university ED with acute dyspnoea and were suspected of PO due to ADHF. The primary outcome measure was to determine the diagnostic value of TFC measurement in patients who presented to the ED with dyspnoea and were suspected of PO due to ADHF.Results:A total of 113 patients were included in the study. The Brain Natriuretic Peptide (BNP) value was accepted as the gold standard in the diagnosis of PO due to ADHF. The sensitivity/specificity of PO associated with ADHF was 64.3/31.4%, 14.3/88.4% and 60.5/83.7% for TFC, cardiac index (CI) and stroke index, respectively. Among these, only TFC was statistically significant in the diagnosis of PO (p<0.001).Conclusion:TFC measured by TTI in patients suspected of PO due to ADHF could be a better alternative for exclusion tests.

Keywords

• thoracic fluid content
• transthoracic impedance
• pulmonary oedema
• emergency
• stroke index
• cardiac index