Document Detail

[Cardiac output determination by thermodilution and arterial pulse waveform analysis in patients undergoing aortic valve replacement]
MedLine Citation:
PMID:  18166744     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare the accuracy of cardiac output (CO) measurement by arterial pulse waveform analysis (CO(PW)) to thermodilution assessments in patients with aortic stenosis, a high-risk patient group who may benefit from extended hemodynamic monitoring. METHODS: In 30 patients with aortic stenosis, CO was assessed in triplicate by thermodilution via pulmonary artery catheterization (CO(PAC)), and by arterial pulse waveform analysis (CO(PW)), before and after valve replacement. The techniques were compared by assessing the repeatability coefficient of each method and by calculating the percentage error, bias, and the limits of agreement between methods. RESULTS: The repeatability coefficients of CO(PAC) and CO(PW) were 0.89 L.min(-1) and 1.04 L.min(-1) respectively after induction of anesthesia, which corresponded to 24% of CO(PAC) and 26% of CO(PW), and increased to 33% of CO(PAC) and 32% of CO(PW) immediately after extracorporeal circulation. A systematic error between methods was not observed. The limits of agreement were bias +/- 1.42 L.min(-1) after anesthesia induction, corresponding to a 36% percentage error. The scattering of differences between methods increased markedly after termination of extracorporeal circulation (percentage error 56%). CONCLUSION: The repeatability of CO(PAC), as well as of CO(PW), is reduced in patients with aortic stenosis. The repeatability of both methods, as well as the agreement between methods, decreased markedly immediately after termination of cardiopulmonary bypass.
Klaus Staier; Christoph Wiesenack; Ludwig Günkel; Cornelius Keyl
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  55     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-01     Completed Date:  2008-03-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  22-8     Citation Subset:  IM    
Department of Anesthesiology, Heart Centre Bad Krozingen, Suedring 15, 79189 Bad Krozingen, Germany.
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MeSH Terms
Aged, 80 and over
Aortic Valve / surgery*
Aortic Valve Stenosis / surgery
Blood Pressure
Cardiac Output*
Cardiopulmonary Bypass
Catheterization / methods
Extracorporeal Circulation
Heart Rate
Middle Aged
Monitoring, Intraoperative / methods*,  statistics & numerical data*
Pulmonary Artery / physiopathology
Pulse / methods*,  statistics & numerical data*
Reproducibility of Results
Risk Factors
Thermodilution / methods,  statistics & numerical data

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

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