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BioMed Research International
Volume 2014, Article ID 598029, 7 pages
Research Article

Evaluation of Cardiac Function Index as Measured by Transpulmonary Thermodilution as an Indicator of Left Ventricular Ejection Fraction in Cardiogenic Shock

1CHU Nancy, Service de Reanimation Medicale Brabois, Pole Cardiovasculaire et Reanimation Medicale, Hopital Brabois, 54511 Vandoeuvre-les-Nancy, France
2INSERM, CHU Nancy, Groupe Choc Inserm, U1116, Faculté de Médecine, 54511 Vandoeuvre-les-Nancy, France
3Université de Lorraine, 54000 Nancy, France

Received 27 February 2014; Revised 7 May 2014; Accepted 19 May 2014; Published 11 June 2014

Academic Editor: Karim Bendjelid

Copyright © 2014 Jessica Perny et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. The PiCCO transpulmonary thermodilution technique provides two indices of cardiac systolic function, the cardiac function index (CFI) and the global ejection fraction (GEF). Both appear to be correlated with left ventricular ejection fraction (LVEF) measured by echocardiography in patients with circulatory failure, especially in septic shock. The aim of the present study was to test the reliability of CFI as an indicator of LVEF in patients with cardiogenic shock. Methods. In thirty-five patients with cardiogenic shock, we performed (i) simultaneous measurements of echocardiography LVEF and cardiac function index assessed by transpulmonary thermodilution ( ) and (ii) transpulmonary thermodilution before/after increasing inotropic agents ( ). Results. Mean LVEF was 31% (+/−11.7), CFI 3/min (+/−1), and GEF 14.2% (+/−6). CFI and GEF were both positively correlated with LVEF ( , ). CFI and GEF were significantly increased with inotropic infusion (resp., , ). A cardiac function index <3.47/min predicted a left ventricular ejection fraction ≤35% (sensitivity 81.1% and specificity 63%). In patients with right ventricular dysfunction, CFI was not correlated with LVEF. Conclusion. CFI is correlated with LVEF provided that patient does not present severe right ventricular dysfunction. Thus, the PiCCO transpulmonary thermodilution technique is useful for the monitoring of inotropic therapy during cardiogenic shock.