Document Detail

Can a NICO monitor substitute for thermodilution to measure cardiac output in patients with coexisting tricuspid regurgitation?
MedLine Citation:
PMID:  20490574     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The validity of measuring cardiac output (CO) using thermodilution via pulmonary artery catheterization in the presence of tricuspid regurgitation (TR) remains controversial.
METHODS: We compared the accuracy and precision of a non-invasive cardiac output (NICO) monitor and of thermodilution with those of transesophageal echocardiography (TEE) to measure CO in 50 patients who underwent elective valvoplasty to treat TR (26 mild and 24 moderate-to-severe) and in 25 normal controls (without TR). We used TEE as a reference method to measure CO and to intraoperatively grade TR.
RESULTS: The differences between NICO monitor and TEE measurements in patients without TR and in those with mild and with moderate-to-severe TR were -0.17 +/- 0.88 (n = 150, r (2) = 0.75), -0.16 +/- 0.82 (n = 158, r (2) = 0.78), and 0.17 +/- 0.91 L/min (n = 155, r (2) = 0.78), respectively. The differences between bolus thermodilution cardiac output and TEE measurements in patients without TR and in those with mild and with moderate-to-severe TR were -0.08 +/- 0.55 (r (2) = 0.88), 0.05 +/- 0.61 (r (2) = 0.86), and 0.43 +/- 1.37 L/min (r (2) = 0.58), respectively.
CONCLUSION: These findings demonstrate that measuring CO using the thermodilution technique is less accurate in patients with moderate-to-severe TR and that the NICO monitor is more accurate for such patients. We postulate that the NICO monitor measures CO more accurately and reproducibly than thermodilution in patients with coexisting TR.
Naka Imakiire; Takeshi Omae; Akira Matsunaga; Ryuzo Sakata; Yuichi Kanmura
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Publication Detail:
Type:  Journal Article     Date:  2010-05-19
Journal Detail:
Title:  Journal of anesthesia     Volume:  24     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-05     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  511-7     Citation Subset:  IM    
Department of Anesthesiology and Critical Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
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MeSH Terms
Cardiac Output*
Echocardiography, Transesophageal
Middle Aged
Monitoring, Physiologic / instrumentation*
Tricuspid Valve Insufficiency / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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