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dc.contributor.authorEyeington, Christopher T-
dc.contributor.authorLloyd-Donald, Patryck-
dc.contributor.authorChan, Matthew J-
dc.contributor.authorEastwood, Glenn M-
dc.contributor.authorYoung, Helen-
dc.contributor.authorPeck, Leah-
dc.contributor.authorJones, Daryl A-
dc.contributor.authorBellomo, Rinaldo-
dc.identifier.citationJournal of Critical Care 2019; 49: 187-192-
dc.description.abstractIntensive 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.-
dc.subjectCardiac index-
dc.subjectCardiac output-
dc.subjectHemodynamic monitoring-
dc.subjectMedical emergency team-
dc.subjectRapid response team-
dc.titleRapid response team review of hemodynamically unstable ward patients: The accuracy of cardiac index assessment.-
dc.typeJournal Article-
dc.identifier.journaltitleJournal of Critical Care-
dc.identifier.affiliationMedicine, Monash University, Melbourne, Australiaen
dc.identifier.affiliationDepartment of Intensive Care, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationANZIC Research Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationIntensive Care Research, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationCo-director ANZICS Research Centre, Monash University, Melbourne, Australiaen
dc.identifier.affiliationIntensive Care, The University of Melbourne, Melbourne, Australiaen
dc.type.austinJournal Article-
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