Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19917
Title: Rapid response team review of hemodynamically unstable ward patients: The accuracy of cardiac index assessment.
Authors: Eyeington, Christopher T;Lloyd-Donald, Patryck;Chan, Matthew J;Eastwood, Glenn M;Young, Helen;Peck, Leah;Jones, Daryl A;Bellomo, Rinaldo
Affiliation: Medicine, Monash University, Melbourne, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
ANZIC Research Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
Intensive Care Research, Austin Health, Heidelberg, Victoria, Australia
Co-director ANZICS Research Centre, Monash University, Melbourne, Australia
Intensive Care, The University of Melbourne, Melbourne, Australia
Issue Date: Feb-2019
EDate: 2018-10-26
Citation: Journal of critical care 2019; 49: 187-192
Abstract: Intensive care doctors commonly attend rapid response team (RRT) reviews of hospital-ward patients with hemodynamic instability and estimate the patient's likely cardiac index (CI). We aimed to non-invasively measure the CI of such patients and assess the level of agreement between such measurements and clinically estimated CI categories (low <2L/min/m2, normal 2-2.99L/min/m2 or high ≥3L/min/m2). A prospective, observational study of non-invasive measurement and clinical estimation of CI categories in 50 adult hospital-ward patients who activated the RRT for 'hemodynamic instability' (tachycardia > 100BPM or hypotension < 90mmHg or both). The CI was measured in 47/50(94%) patients and the mean CI was 3.5(95% CI 3.2-3.7) L/min/m2. Overall, 30(64%) patients had a high CI, 13(28%) and 4(9%) had a normal and a low CI, respectively. The level of agreement between measured and clinically estimated CI categories was low(19.2%). Sensitivity and positive predictive values of clinical estimation were low(0% and 3.3% for high CI, and 0% and 50% for low CI, respectively). Non-invasive CI measurement was possible in almost all hospital-ward patients triggering RRT review for hemodynamic instability. In such patients, the CI was high, and intensive care clinicians were unable to identify a low or a high CI state.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19917
DOI: 10.1016/j.jcrc.2018.09.002
ORCID: 0000-0002-1650-8939
PubMed URL: 30482613
Type: Journal Article
Subjects: Cardiac index
Cardiac output
Hemodynamic monitoring
Medical emergency team
Non-invasive
Rapid response team
Appears in Collections:Journal articles

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