Volumetric assessment of left heart preload by thermodilution: comparing the PiCCO-VoLEF® system with transoesophageal echocardiography.

The new Volumetric Ejection Fraction monitoring system (VoLEF®), when combined with the Pulse Contour Cardiac Output monitoring system (PiCCO®) system, allows measurement of left and right heart end-diastolic volumes by thermodilution. The aim of this study was to evaluate whether the left heart end-diastolic volume index determined by the VoLEF system (LHEDI) better reflects left ventricular end-diastolic area index (LVEDAI) measured by transoesophageal echocardiography than does global end-diastolic volume index (GEDI) measured by the PiCCO system alone. Following induction of anaesthesia, PiCCO, VoLEF and transoesophageal echocardiography measurements were performed before and after a fluid challenge in 20 patients scheduled for elective cardiac surgery. Both left ventricular end-diastolic area index and global end-diastolic volume index, but not left heart end-diastolic volume index, significantly increased after fluid administration. Mean bias ± 2 SD for ΔLHEDI–ΔLVEDAI was − 2.2 ± 32.0% and for ΔGEDI–ΔLVEDAI − 0.6 ± 16.8%. In contrast to global end-diastolic volume index, the use of left heart end-diastolic volume index determined by the VoLEF system cannot be recommended as an estimate of left ventricular preload. [ABSTRACT FROM AUTHOR]