Evaluation of Cardiothoracic Parameters: The Clinical Role of Intrathoracic Blood Volume

  • M. Nastasi
  • F. Petrini
  • G. Martinelli
Conference paper


A correct approach to critically ill patients requires invasive haemodynamic monitoring and, even if many non-invasive measurements have been suggested for a good assessment of cardiac output and derived parameters, thermodilution with the use of a pulmonary artery catheter is still the gold standard [1]. An alternative way to measure haemodynamic data is founded on the use of the “double indicator technique”, that requires the injection of two indicators into the right atrium and their detection on the arterial side of circulation. This technique is less invasive than the traditional one, because it does not need the use of pulmonary artery catheter and, moreover, its use lets us measure additional physiological and pathophysiological parameters, as intravascular blood volumes, extravascular lung water and liver perfusion.


Cardiac Output Central Venous Pressure Pulmonary Capillary Wedge Pressure Pulmonary Artery Catheter Central Blood Volume 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hoeft A (1995) Transpulmonary indicator dilution: an alternative approach to hemodynamic monitoring. In: Vincent JL (ed) 1995 Yearbook of Intensive Care and Emergency Medicine. Springer, Berlin Heidelberg New York, pp 593–605CrossRefGoogle Scholar
  2. 2.
    Zierler KL (1962) Theoretical basis of indicator-dilution methods for measuring flow and volume. Circ Res 10:393–407CrossRefGoogle Scholar
  3. 3.
    Hamilton WF, Moore JW, Kinsman JM et al (1932) Studies on the circulation—IV. Further analysis on the injection method, and of changes of the hemodynamics under physiological and pathological conditions. Am J Physiol 99:534–551Google Scholar
  4. 4.
    Harris TR, Newman EV (1970) An analysis of mathematical models of circulatory indicator-dilution curves. J Appl Physiol 28:840–850PubMedGoogle Scholar
  5. 5.
    Shippy CR, Appel RL, Shoemaker WC (1984) Reliability of clinical monitoring to assess blood volume in critically ill patients. Crit Care Med 12:107–112PubMedCrossRefGoogle Scholar
  6. 6.
    Hedenstierna G (1992) What value does the recording of intrathoracic blood volume have in clinical practice? Intensive Care Med 18:137–138PubMedCrossRefGoogle Scholar
  7. 7.
    Lichtwarck-Aschoff M, Zeravik J, Pfeiffer UJ (1992) Intrathoracic blood volume accurately reflects circulatory volume status in critically ill patients with mechanical ventilation. Intensive Care Med 18:142–147PubMedCrossRefGoogle Scholar
  8. 8.
    Nastasi M, Bernardi E, Cattabriga I et al (1994) Correlations between cardiac output and preload parameters in a group of critically ill patients. Clin Intensive Care 5[Suppl]:32Google Scholar
  9. 9.
    Martinelli G, Nastasi M (1995) Recent experiences with the “COLD System” in a group of critically ill patients. In: Braschi A, Chiaranda M, Gattinoni L, Pesenti A, Raimondi F (eds) Atti dello SMART. Springer, Berlin Heidelberg New York, pp 54–56Google Scholar
  10. 10.
    Bindels AJGH, van der Hoeven JG, Meinders AE (1995) Intrathoracic blood volume as indicator of cardiac preload in critically ill patients. Intensive Care Med 21[suppl 1]:S216Google Scholar
  11. 11.
    Piccione R, Bernardi E, Campagna S et al (1996) Trends of intrathoracic blood volume and cardiac output in a group of critically ill patients. Intensive Care Med 22[Suppl 1]:S57CrossRefGoogle Scholar
  12. 12.
    Brock H, Rapf B, Necek S et al (1994) Intrathoracic blood volume as indicator for intravascular volume status. Clin Intensive Care 5[Suppl]:31Google Scholar
  13. 13.
    Ceriani R, Sisillo E, Salvi L et al (1994) Effects of colloid versus crystalloids rapid infusion on thoracic and cardiac fluid volumes in the early postoperative cardiac surgery period. Clin Intensive Care 5[Suppl]:42Google Scholar
  14. 14.
    Hoeft A, Schorn B, Weyland A et al (1994) Bedside assessment of intravascular volume status in patients undergoing coronary bypass surgery. Anesthesiology 81:76–86PubMedCrossRefGoogle Scholar
  15. 15.
    Hachenberg T, Tenling A, Rothen H-U et al (1993) Thoracic intravascular and extravascular fluid volumes in cardiac surgical patients. Anesthesiology 79:976–984PubMedCrossRefGoogle Scholar
  16. 16.
    Godje O, Fischlein T, Mair H et al (1996) Cardiac function index, intrathoracic blood volumes, lung water and liver function—New parameters for earlier diagnosis of organ dysfunction? Intensive Care Med 22[Suppl 1]:S56CrossRefGoogle Scholar
  17. 17.
    Grillone G, Bacchin R, Cattabriga I et al (1995) Impiego del “COLD System” nel trattamento post-operatorio del paziente cardiochirurgico. Arch Chir Torac Cardiovasc 17:85Google Scholar
  18. 18.
    Ceriani R, Bortone F, Zucchetti MC et al (1994) Influence of positive pressure ventilation on intrathoracic fluid volumes in cardiac surgical patients. Clin Intensive Care 5[Suppl]:36Google Scholar
  19. 19.
    Morrone A, Cattabriga I, Nastasi M et al (1995) Valutazione dei volumi ematici nel post-operatorio precoce di pazienti sottoposti a sostituzione valvolare mitralica. Minerva Anestesiol 61[Suppl 2]: 180Google Scholar
  20. 20.
    Cattabriga I, Morrone A, Nastasi M et al (1995) Valutazione dei volumi ematici nel post-operatorio precoce di pazienti sottoposti a trapianto cardiaco. Minerva Anestesiol 61 [Suppl2]:181Google Scholar
  21. 21.
    Borelli M, Benini A, Acciaro CM et al (1995) Valutazione del precarico cardiaco in diverse condizioni di pressione intratoracica. Minerva Anestesiol 61[Suppl 1]:379–381Google Scholar
  22. 22.
    Mullner M, Stuhlinger HG, Roggia M et al (1994) Circulating blood volume and oxygenation in different ventilatory patterns—pressure controlled versus volume cycled ventilation. Clin Intensive Care 5[Suppl]:35Google Scholar
  23. 23.
    Ceriani R, Salvi L, Solinas C et al (1995) Intrathoracic fluid volumes and hemodynamic effects during pressure controlled inverse ratio ventilation in patients with poor left ventricular function. Intensive Care Med 21[Suppl 1]:S108Google Scholar
  24. 24.
    Volpini MJ, Campagna S, Martini R et al (1996) Analisi dei volumi ematici in un gruppo di pazienti affetti da insufficienza respiratoria acuta. In: Atti dell’ XI Congresso Nazionale SITI, Montecatini 24–27 aprile 1966. Società Italiana di Terapia Intensiva, 550Google Scholar

Copyright information

© Springer-Verlag Italia 1997

Authors and Affiliations

  • M. Nastasi
  • F. Petrini
  • G. Martinelli

There are no affiliations available

Personalised recommendations