Prediction and monitoring of fluid responsiveness after coronary bypass surgery using the Initial Systolic Time Interval: Preliminary results

Abstract

The objective of the study is to develop a non-invasive method to optimize the assessment of cardiac preload and therapeutic fluid administration after coronary artery bypass surgery. Previous studies have reported that the pre-ejection period (PEP), obtained from the electro-cardiogram (ECG) and from the invasively measured arterial pressure Pa, can be used for this assessment as it is dependent on the cardiac preload. The Initial Systolic Time Interval (ISTI), obtained non-invasively by simultaneous measurement of the Electro-CardioGram (ECG) and Impedance CardioGram (ICG), is expected to depend on the cardiac preload as well. 16 patients, admitted to the Intensive Care Unit after coronary artery bypass surgery and presumably hypovolaemic, were measured during administration of 2×250 ml of an isosmotic colloidal fluid solution. The parameters PEP and ISTI were determined before and after the administrations and compared with the change in cardiac output (CO), obtained by a thermodilution technique. Preliminary results show significant relationships between ISTI and CO and between changes in both of these variables before and after fluid administration.