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Initial distribution volume of glucose as noninvasive indicator of cardiac preload: comparison with intrathoracic blood volume

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To analyze the correlation between initial distribution volume of glucose (IDVGI) and intrathoracic blood volume measured by single indicator dilution technique.

Design and setting

Prospective clinical study conducted in the intensive care unit of a university hospital.

Patients and methods

We enrolled 20 consecutive adult patients requiring hemodynamic monitoring with arterial pulse contour analysis system (PiCCO) and without any underlying pathology inducing generalized protein capillary leakage and/or marked peripheral edema. Cardiac output, intrathoracic blood volume, extravascular lung water were recorded. IDVGI was measured once per day for the first 5 days after PiCCO positioning by administering a bolus of 25 ml 20% glucose (5 g) over 30 s through a central venous catheter. The relationship between IDVGI and other variables was studied by regression analysis. Receiver operating characteristic curves were used to study the relationship between changes in IDVGI and changes in cardiac index, intrathoracic blood volume, and central venous pressure.


A good linear correlation was obtained between intrathoracic blood volume and IDVGI (R2=0.79). Receiver operating characteristic curve analysis showed a good ability of initial distribution volume of glucose variations to reflect cardiac index variations.


Our results indicate that IDVGI can serve as noninvasive indicator of cardiac preload.

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  1. 1.

    Sinclair S, James S, Singer M (1997) Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ 315:909–912

  2. 2.

    Shoemaker WC, Parsa MH (1995) Invasive and noninvasive physiologic monitoring. In: Ayres SM, Grenvik A, Holbrook PR, Shoemaker WC (eds) Textbook of critical care, 3rd edn. Harcourt Brace, Philadelphia, pp 252–266

  3. 3.

    Sakka SG, Brendle DL, Reinhart K, Meier-Hellmann A (1999) Comparison between intrathoracic blood volume and cardiac filling pressure in the early phase of haemodynamic instability of patients with sepsis or septic shock. J Crit Care 14:78–83

  4. 4.

    Sorbara C, Amà R, Rossi A (2002) L’ecocardiografia transesofagea (TEE) nel periodo perioperatorio e in terapia intensiva: diagnosi e monitoraggio emodinamico. In Gullo A (ed) Medicina perioperatoria terapia Intensiva emergenza. Springer, Berlin Heidelberg New York, pp 283–308

  5. 5.

    Godje O, Peyerl M, Seebauer T, Lamm P, Mair H, Reichart B (1998) Central venous pressure, pulmonary capillary wedge pressure and intrathoracic blood volumes as preload indicators in cardiac surgery patients. Eur J Cardiotorac Surg 13:533–539

  6. 6.

    Sakka SG, Ruhl CC, Pfeiffer UJ, Beale R, McLuckie A, Reinhart K, Meier-Hellmann A (2000) Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med 26:180–187

  7. 7.

    Iwakawa T, Ishihara H, Takamura K, Sakai I, Suzuki A (1998) Measurements of extracellular fluid volume in highly perfused organs and lung water in hypo and hypervolaemic dogs. Eur J Anaesthesiol 15:414–421

  8. 8.

    Ishihara H, Takamura K, Koh H, Iwakawa T, Tsubo T, Matsuki A (1996) Does the initial distribution volume of glucose reflect the central extracellular fluid volume status in critically ill patients? Infusionsther Transfusionsmed 23:196–201

  9. 9.

    Saccomanni MP, Bonadonna RC, Bier DM, De Fronzao RA, Cobelli C (1996) A model to measure insulin effects on glucose transport and phosphorylation in muscle: a three-tracer study. Am J Physiol 270:E170–E185

  10. 10.

    Youn JH, Kim JK, Steil GM (1995) Assessment of extracellular glucose distribution and glucose transport activity in conscious rats. Am J Physiol 268:E712–E721

  11. 11.

    Pierson RN, Price DC, Wang J, Janis RK (1978) Extracellular water measuremens: organ tracer kinetics of bromide and sucrose in rats and man. Am J Physiol 235:254–264

  12. 12.

    Ishihara H, Matsui A, Muraoka M, Tanabe T, Tsubo T, Matsuki A (2000) Detection of capillary protein leakage by the indocyanine green and glucose dilution in septic patients. Crit Care Med 28:620–626

  13. 13.

    Ishihara H, Suzuki A, Okawa H, Sakai I, Tsubo T, Matsuki A (2000) The initial distribution volume of glucose rather than indocyanine green derived plasma volume is correlated with cardiac output following major surgery. Intensive Care Med 26:1441–1448

  14. 14.

    Ishihara H, Suzuki A, Okawa H, Ebina T, Tsubo T, Matsuki A (2001) Comparison of initial distribution volume of glucose and plasma volume in thoracic fluid-accumulated patients. Crit Care Med 29:1532–1538

  15. 15.

    Le Gall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score based on a European/North American multicenter study. JAMA 24:2957–2962

  16. 16.

    Dubois EF (1936) Basal metabolism in healt and disease. Lea and Febiger, Philadelphia

  17. 17.

    Godje O, Friendl R, Hannekum A (2001) Accuracy of beat to beat cardiac output monitoring by pulse contour analysis in hemodynamical unstable patients. Med Sci Monit 7:1344–1350

  18. 18.

    Hirota K, Ishihara H, Tsubo T, Matsuki A (1999) Estimation of the initial distribution volume of glucose by an incremental plasma glucose level at 3 min after i.v. glucose in humans. Br J Clin Pharmacol 47:361–364

  19. 19.

    Ishihara H, Suzuki A, Takamura K, Yatsu Y, Kimura N, Otomo N, Tsubo T, Matsuki A (1998) Does the initial distribution volume of glucose reflect the shift of the central extracellular fluid volume after major surgical procedures? J Jpn Intensive Care Med 5:203–210

  20. 20.

    Cobelli C, Toffolo G (1984) A model of glucose kinetics and their control by insulin, compartimental and noncompartimental approaches. Math Biosci 72:291–315

  21. 21.

    Bland JM, Altman DG (1995) Calculating correlation coefficients with repeated observations. II. Correlation between subjects. BMJ 310:633

  22. 22.

    Donati A, Loggi S, Coltrinari R, Pelaia P (2004) Intrathoracic blood volume as index of cardiac output variations. Acta Anaesthesiol Scand 48:384–390

  23. 23.

    Van Den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Buillon R (2001) Intensive insulin therapy in critically ill patients. N Engl J Med 345:1359–1367

  24. 24.

    Diaz-Parejo P, Stahl N, Xu W, Reinstrup P, Ungerstedt U, Nordstrom CH (2003) Cerbral energy metabolism during transient hyperglycaemia in patients with severe brain trauma. Intensive Care Med 29:544–550

  25. 25.

    Allaria B, Faustini M, Resta M (2003) Evoluzione e scelta del monitoraggio emodinamico: importanza dei mezzi non invasivi. In Gullo A (ed) Medicina perioperatoria terapia intensiva emergenza. Springer, Berlin Heidelberg New York, pp 263–266

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Correspondence to Vincenzo Gabbanelli.

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Gabbanelli, V., Pantanetti, S., Donati, A. et al. Initial distribution volume of glucose as noninvasive indicator of cardiac preload: comparison with intrathoracic blood volume. Intensive Care Med 30, 2067–2073 (2004). https://doi.org/10.1007/s00134-004-2421-3

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  • Measurement technique
  • Plasma volume
  • Distribution volume
  • Cardiac preload
  • Intrathoracic blood volume