ArticleCritical care medicine2009
Association of physical examination with pulmonary artery catheter parameters in acute lung injury.
Article in Critical care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 53 citations in OpenAlex.
- The relationship between positive end-expiratory pressure and cardiac index in patients with acute respiratory distress syndrome.Journal of critical care · 2013Trial
- The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients: the Simple Intensive Care Studies-I.Intensive care medicine · 2019Observational
- Cardiac output monitoring: throw it out… or keep it?Critical care (London, England) · 2018Article
- The crashing patient: hemodynamic collapse.Current opinion in critical care · 2017Review
- Clinical examination for diagnosing circulatory shock.Current opinion in critical care · 2017Review
- Early Liberal Fluid Therapy for Sepsis Patients Is Not Harmful: Hydrophobia Is Unwarranted but Drink Responsibly.Critical care medicine · 2016Review
- Experts' recommendations for the management of cardiogenic shock in children.Annals of intensive care · 2016Article
- The effects of advanced monitoring on hemodynamic management in critically ill patients: a pre and post questionnaire study.Journal of clinical monitoring and computing · 2016Article
- Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE.Critical care (London, England) · 2016Review
- Intradialytic Hypoxemia in Chronic Hemodialysis Patients.Blood purification · 2016Review
- Is there a role for invasive hemodynamic monitoring in acute heart failure management?Current heart failure reports · 2015Review
- Incidence and impact of skin mottling over the knee and its duration on outcome in critically ill patients.Intensive care medicine · 2015Observational
- Fluid management with a simplified conservative protocol for the acute respiratory distress syndrome*.Critical care medicine · 2015Article
- Focused critical care echocardiography.Critical care medicine · 2013Review
- Update on acute lung injury and critical care medicine 2009.American journal of respiratory and critical care medicine · 2010Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo correlate physical examination findings, central venous pressure, fluid output, and central venous oxygen saturation with pulmonary artery catheter parameters.
designRetrospective study.
settingData from the multicenter Fluid and Catheter Treatment Trial of the National Institutes of Health Acute Respiratory Distress Syndrome Network. PATIENTS: Five hundred thirteen patients with acute lung injury randomized to treatment with a pulmonary artery catheter.
interventionsCorrelation of physical examination findings (capillary refill time >2 secs, knee mottling, or cool extremities), central venous pressure, fluid output, and central venous oxygen saturation with parameters from a pulmonary artery catheter. MEASUREMENTS: We determined association of baseline physical examination findings and on-study parameters of central venous pressure and central venous oxygen saturation with cardiac index <2.5 L/min/m2 and mixed venous oxygen saturation <60%. We determined correlation of baseline central venous oxygen saturation and mixed venous oxygen saturation and predictive value of a low central venous oxygen saturation for a low mixed venous oxygen saturation. MEASUREMENTS AND MAIN
resultsPrevalence of cardiac index <2.5 and mixed venous oxygen saturation <60% was 8.1% and 15.5%, respectively. Baseline presence of all three physical examination findings had low sensitivity (12% and 8%), high specificity (98% and 99%), low positive predictive value (40% and 56%), but high negative predictive value (93% and 86%) for cardiac index <2.5 and mixed venous oxygen saturation <60%, respectively. Central venous oxygen saturation <70% predicted a mixed venous oxygen saturation <60% with a sensitivity 84%,specificity 70%, positive predictive value 31%, and negative predictive value of 96%. Low cardiac index correlated with cool extremities, high central venous pressure, and low 24-hr fluid output; and low mixed venous oxygen saturation correlated with knee mottling and high central venous pressure, but these correlations were not found to be clinically useful.
conclusionsIn this subset of patients with acute lung injury, there is a high prior probability that cardiac index and mixed venous oxygen saturation are normal and physical examination findings of ineffective circulation are not useful for predicting low cardiac index or mixed venous oxygen saturation. Central venous oxygen saturation <70% does not accurately predict mixed venous oxygen saturation <60%, but a central venous oxygen saturation >or=70% may be useful to exclude mixed venous oxygen saturation <60%.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.