The effects of differential injection sites of cold saline on transpulmonary thermodilution parameter values

Abstract

Wanjie Yang,1 Qingguo Feng,1 Youzhong An,2 Xuefeng Zhao,1 Kai Wei,1 Chang Li,1 Wei Wang,1 Hongyun Teng1 1Department of Critical Care, The Fifth Central Hospital of Tianjin, Tianjin, People’s Republic of China; 2Department of Critical Care, The People’s Hospital, Peking University, Beijing, People’s Republic of China Aim: To investigate the effects of differential sites for cold saline injection on transpulmonary thermodilution parameter values.Methods: This was a prospective study. Twelve patients were recruited for the following examinations: control condition (injection site at proximal injection end of the Swan-Ganz catheter), proximal end condition (injection site at sheath of the Swan-Ganz catheter), and distal end condition (injection site at PA end of the Swan-Ganz catheter). Sixty measurements were performed for each condition. The cardiac index, global end diastolic volume index (GEDI), and extravascular lung water index for the three different injection sites were recorded from each patient. In addition, the mean transmission time (MTt), downslope time, and area under the curve obtained from PiCCO-VoLEF-Win software were compared among different groups.Results: There were no differences in cardiac index and extravascular lung water index values among the three conditions (P>0.05). There were no differences in GEDI between the proximal end condition and control condition (P>0.05), while the GEDI was significantly lower for the distal end condition (493.33±254.65 mL/m2) than for the control condition (645.53±234.46 mL/m2) (P<0.05) and proximal end condition (717.96±321.63 mL/m2) (P<0.01). There were no differences in downslope time and area under the curve among the three conditions (P>0.05). There were no differences in MTt between the proximal end condition and control condition (P>0.05), while the MTt was significantly lower for distal end condition (40.22±16.37 seconds) than for the control condition (42.91±17.93 seconds) (P<0.05) and proximal end condition (47.16±16.64 seconds) (P<0.01).Conclusion: The differential sites for cold saline injection impacted transpulmonary thermodilution parameter values. Keywords: pulmonary artery catheter, global end diastolic volume index, extravascular lung water index