Validation of Electrical Cardiometry Measurements Compared to Transthoracic Echocardiography in Fluid Responsiveness in Sepsis

Abstract

Background: Severe sepsis and septic shock patients have a broad range of hemodynamic characteristics. A better understanding of the hemodynamic profile and response to therapy can lead to more effective treatment and consequently a lower mortality and morbidity. The current research work was designed to investigate the non-invasive diagnostic accuracy and agreement of electrical cardiometry (EC) with transthoracic echocardiography (TTE) for fluid responsiveness in sepsis. Methods: This prospective cohort study was assessed on 25 patients showing clinical criteria of sepsis and developed hypotension. All patients were subjected to simultaneous measurement by EC and TTE. Fluid was administered if stroke volume (SV) measured by TTE increased by > 10% after the fluid challenge up to 30 mL/kg else vasopressor infusion was initiated. Results: Electrical cardiometry significantly predicted fluid responsiveness in sepsis compared to TTE with 81.4% sensitivity and 90% specificity. There was an insignificant difference between SV index (SVI), cardiac index (CI), SV, and cardiac output (CO) estimated by TTE and by EC. The mean bias between SV measured by TTE and by EC was 0.25 ± 3.4 ml. The mean bias between TTE and by EC was 0.10 ± 1.78 mL/m2 in SVI, 0.01 ± 0.35 L/min in CO and 0.009 ± 0.18 L/min/m2 in CI. Conclusions: Electrical cardiometry significantly predicted fluid responsiveness in sepsis compared to TTE with good agreement between measurements of EC and TTE.