Web of Science: 12 cites, Scopus: 12 cites, Google Scholar: cites,
Noninvasive Assessment of Acute Dyspnea in the ED
García, Xaime (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Simon, Peter
Guyette, Francis X.
Ramani, Ravi
Alvarez, Rene
Quintero, Jorge
Pinsky, and Michael R.
Universitat Autònoma de Barcelona

Data: 2013
Resum: We compared the ability of noninvasive measurements of cardiac output (CO) and thoracic fluid content (TFC) and their change in response to orthostatic challenges to diagnose acute decompensate heart failure (ADHF) from non-ADHF causes of acute dyspnea in patients in the ED. Forty-five patients > 44 years old presenting in the ED with dyspnea were studied. CO and TFC were monitored with a NICOM bioreactance device. CO and TFC were measured continuously while each patient was sitting, supine, and during a passive leg-raising maneuver (3 min each); the maximal values during each maneuver were reported. Orthostatic challenges were repeated 2 h into treatment. One patient was excluded because of intolerance to the supine position. Diagnoses obtained with the hemodynamic measurements were compared with ED diagnoses and with two expert physicians by chart review (used as gold standard diagnosis); both groups were blinded to CO and TFC values. Patient's treatment, ED disposition, hospital length of stay, and subjective dyspnea (Borg scale) were also recorded. Sixteen of 44 patients received a diagnosis of ADHF and 28 received a diagnosis of non-ADHF by the experts. Baseline TFC was higher in patients with ADHF (P =. 001). Fifteen patients were treated for ADHF, and their Borg scale values decreased at 2 h (P <. 05). TFC threshold of 78. 8 had a receiver operator characteristic area under the curve of 0. 81 (76% sensitivity, 71% specificity) for ADHF. Both ADHF and non-ADHF groups were similar in their increased CO from baseline to PLR and supine. Pre- and posttreatment measurements were similar. Baseline TFC can discriminate patients with ADHF from non-ADHF dyspnea in the ED.
Nota: Altres ajuts: This work was supported in part by National Institutes of Health [Grants HL67181; and HL073198].
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Publicat a: Chest, Vol. 144 (march 2013) , p. 610-615, ISSN 1931-3543

DOI: 10.1378/chest.12-1676
PMID: 23471509

6 p, 548.2 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
Articles > Articles de recerca
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 Registre creat el 2018-01-27, darrera modificació el 2021-08-08

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