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Transpulmonary thermodilution (TPTD)-derived global end-diastolic volume index (GEDVI) is a static marker of preload which better predicted volume responsiveness compared to filling pressures in several studies. GEDVI can be generated with at least two devices: PiCCO and EV-1000. Several studies showed that uncorrected indicator injection into a  femoral  central venous catheter (CVC) results in a significant overestimation of GEDVI by the PiCCO-device. Therefore, the most recent PiCCO-algorithm corrects for femoral indicator injection. However, there are no systematic data on the impact of  femoral  indicator injection for the EV-1000 device. Furthermore, the correction algorithm of the PiCCO is poorly validated. Therefore, we prospectively analyzed 14 datasets from 10 patients with TPTD-monitoring undergoing central venous catheter (CVC)- and arterial line exchange. PiCCO was replaced by EV-1000,  femoral  CVCs were replaced by  jugular / subclavian  CVCs and vice-versa. For PiCCO,  jugular  and  femoral  indicator injection derived GEDVI was comparable when the correct information about  femoral  catheter site was given ( p  = 0.251). By contrast, GEDVI derived from  femoral  indicator injection using the EV-1000 was obviously not corrected and was substantially higher than  jugular  GEDVI measured by the EV-1000 (846 ± 250 vs. 712 ± 227 ml/m 2 ;  p  = 0.001). Furthermore, measurements of GEDVI were not comparable between PiCCO and EV-1000 even in case of  jugular  indicator injection ( p  = 0.003). This is most probably due to different indexations of the raw value GEDV. EV-1000 could not be recommended to measure GEDVI in case of a  femoral  CVC. Furthermore, different indexations used by EV-1000 and PiCCO should be considered even in case of a jugular CVC when comparing GEDVI derived from PiCCO and EV-1000.

scientific reports

Comparison of global end-diastolic volume index derived from jugular and femoral indicator injection: a prospective observational study in patients equipped with both a PiCCO-2 and an EV-1000-device