Der Einfluss von kontinuierlichen Nierenersatzverfahren auf die Bestimmung des Herzzeitvolumens mittels Thermodilutions-Technik

by Michael Faulstich
Doctoral thesis
Date of Examination:2025-12-01
Date of issue:2025-11-20
Advisor:PD Dr. Daniel Heise
Referee:PD Dr. Daniel Heise
Referee:Dr. Björn Tampe
Persistent Address: http://dx.doi.org/10.53846/goediss-11640

 

 

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Abstract

English

This study examines the effects of continuous renal replacement therapy (CRRT) on cardiac output (CO) measurement using both transpulmonary and pulmonary artery thermodilution techniques. As CRRT is commonly applied continuously in critically ill patients, understanding its potential impact on hemodynamic monitoring is of clinical relevance. At the initiation of this research, it was uncertain whether CRRT needed to be paused to obtain accurate CO values. Our findings indicate that CO measurements are significantly elevated during CRRT interruption, consistent with previous results. Any modification in CRRT operation particularly the cessation or resumption of filtration results in immediate and pronounced fluctuations in CO readings, most likely due to rapid temperature changes within the extracorporeal circuit. Even during stable CRRT operation, a modest but statistically significant temperature-related effect persists, though its clinical relevance appears limited. A novel aspect of this study is the assessment of return-flow temperature, which offers additional mechanistic insight. From a clinical standpoint, CO measurements should only be performed after thermal equilibrium has been re-established following any change in CRRT operation.
Keywords: cardiac output measurement; renal replacement therapy