Thesis (M.Sc.) - Cairo University - Faculty of Medicine- Department of Critical Care Medicine

Background: Management of decompensated heart failure represents a daily challenge to critical care physicians, the outcomes of which remains very variable depending on patients co-morbidities and the accurate diagnosis with rapid initiation of optimum treatment, Daily updates of lines of diagnosis and management improve the outcome of cases, and impedence cardiography is one of the rapidly evolving technique of diagnosis and prediction of mortality. Patients and methods: 60 patients who fullfilled the inclusion and exclusion criteria of our study had full examination, laboratory and radiologically investigation. Then connected to the electrical cardiometry on admission and 72 h later and we get full data analysis for our patients for assessment the accuracy of diagnosis and prognosis. Results: We found that corrected flow rate has 84% sensitivity and 89.6% specificity in diagnosis of cardiogenic shock with cut off value 625, AUC 0.857 and P value < 0.001. As for thoracic fluid content it has 75% sensitivity and 93% specificity in diagnosis diastolic heart failure with cut off value 46.5, AUC 0.899 and P value < 0.001. Corrected flow time has 96% sensitivity and 98 % specificity with cut off value 410 msec.AUC 1.000 and P value < 0.001. There is significant correlation between EF below 50 % and TFC (p value <0.001 R: - 0.676). Also with CI (p value <0.001 R: 0.747). TFC has 70% sensitivity and 84% specificity in prediction of in-hospital mortality with cut off value 54.5, AUC 0.770 with P value 0.007. While corrected flow time has 96% sensitivity and 94% specificity in prediction of in hospital mortality with cut off value 635 msec , AUC 0.969 with P value <0.001

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