A Pilot Feasibility Study of Hypotensive Hematopoietic Malignancy Patients’ USCOM Readings
Year: 2014
Type: article
Study design: Observational Study
Abstract: Patients with hematopoietic malignancies are at risk for cardiopulmonary toxicities secondary to high-dose chemotherapy, radiation, and sepsis. Hemodynamic monitoring may offer insight into symptom recognition and management, but has not been studied in this population due to the invasive equipment available. Recently, noninvasive technology has become available, but conclusions about the inter-rater reliability of this cardiac output monitoring are mixed. Two independent USCOM users scanned patients to measure stroke volume (SV) and peak velocity (Vpk). Inter-rater reliability was assessed using the Intraclass Correlation Coefficient (ICC) for USCOM users scanning separate groups: (Aim 1) hemodynamically stable patients (patients with systolic blood pressures > 95mmHg and mean arterial pressures > 65mmHg) and (Aim 2) hypotensive patients (patients with systolic blood pressures < 95mmHg and mean arterial pressures < 65mmHg). Confidence intervals (CIs) were calculated for Aim 1 SV, Aim1 Vpk, Aim 2 SV, and Aim 2 Vpk. For the hemodynamically stable group, the inter-rater reliability CI for Aim 1 SV (n=41) was 0.913 and for aim 1 Vpk (n=41) was 0.857. The hypotensive group inter-rater reliability CI for Aim 2 SV (n=40) was 0.978 and for Aim 2 Vpk (n=40) was 0.961. Two nurses taking USCOM readings of SV and Vpk can consistently achieve inter-rater agreement to establish the reliability of the USCOM in hemodynamically stable and hypotensive patients with hematopoietic malignancies. Insight into the cardiovascular function of this population will improve outcomes, decrease sequelae of overshooting fluid resuscitation, and encourage early intervention.
Institutions: Barnes-Jewish Hospital, Washington University in St. Louis
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
OpenAlex ID: W2322764558