Respiratory change in ECG-wave amplitude is a reliable parameter to estimate intravascular volume status

Electrocardiogram (ECG) is a standard type of monitoring in intensive care medicine. Several studies suggest that changes in ECG morphology may reflect changes in volume status. The “Brody effect”, a theoretical analysis of left ventricular (LV) chamber size influence on QRS-wave amplitude, is the k...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2013-04, Vol.27 (2), p.107-111
Main Authors: Giraud, Raphaël, Siegenthaler, Nils, Morel, Denis R., Romand, Jacques-A, Brochard, Laurent, Bendjelid, Karim
Format: Article
Language:English
Subjects:
Amplitudes
Anesthesiology
Animals
Arterial Pressure
Blood Pressure
Correlation
Critical Care Medicine
Electrocardiography - instrumentation
Electrocardiography - methods
Electrodes
Estimates
Health Sciences
Heart Rate
Hemodynamics
Intensive
Mathematical analysis
Medicine
Medicine & Public Health
Monitoring
Original Research
Recording
Respiration
Respiration, Artificial
Signal Processing, Computer-Assisted
Statistics for Life Sciences
Swine
Tidal Volume
Ventricular Function, Left - physiology
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Summary:Electrocardiogram (ECG) is a standard type of monitoring in intensive care medicine. Several studies suggest that changes in ECG morphology may reflect changes in volume status. The “Brody effect”, a theoretical analysis of left ventricular (LV) chamber size influence on QRS-wave amplitude, is the key element of this phenomenon. It is characterised by an increase in QRS-wave amplitude that is induced by an increase in ventricular preload. This study investigated the influence of changes in intravascular volume status on respiratory variations of QRS-wave amplitudes (ΔECG) compared with respiratory pulse pressure variations (ΔPP), considered as a reference standard. In 17 pigs, ECG and arterial pressure were recorded. QRS-wave amplitude was measured from the Biopac recording to ensure that in all animals ECG electrodes were always at the same location. Maximal QRS amplitude (ECGmax) and minimal QRS amplitude (ECGmin) were determined over one respiratory cycle. ΔECG was calculated as 100 × [(ECGmax − ECGmin)/(ECGmax + ECGmin)/2]. ΔECG and ΔPP were simultaneously recorded. Measurements were performed at different time points: during normovolemic conditions, after haemorrhage (25 mL/kg), and following re-transfusion (25 mL/kg) with constant tidal volume (10 mL/kg) and respiration rate (15 breath/min). At baseline, ΔPP and ΔECG were both
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-012-9405-6