Document Detail


Cardiac output--pulse contour analysis vs. pulmonary artery thermodilution.
MedLine Citation:
PMID:  16987334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aims of this study were to determine the agreement between pulmonary artery thermodilution (PA-TD), transpulmonary thermodilution (TP-TD) and the pulse contour method, and to test the ability of the pulse contour method to track changes in cardiac output. METHODS: Cardiac output was determined twice before cardiac surgery with both PA-TD and TP-TD. The precision (two standard deviations of the difference between repeated measurements) and agreement of the two methods were calculated. Post-operatively, cardiac output was determined with the PA-TD and pulse contour methods, and the bias and limits of agreement were again calculated. Finally, in patients with heart rates below 60 beats/min or a cardiac index of less than 2.5 l/min/m2, atrial pacing was started and the haemodynamic consequences were monitored with the PA-TD and pulse contour methods. RESULTS: Twenty-five patients were included. The precisions of PA-TD and TP-TD were 0.41 l/min [95% confidence interval (CI), +/- 0.07] and 0.48 l/min (95% CI, +/- 0.08), respectively. The bias and limits of agreement between PA-TD and TP-TD were - 0.46 l/min (95% CI, +/- 0.11) and +/- 1.10 l/min (95% CI, +/- 0.19), respectively. Post-operatively, the bias and limits of agreement between the PA-TD and pulse contour methods were 0.07 l/min and +/- 2.20 l/min, respectively. The changes in cardiac output with atrial pacing were in the same direction and of the same magnitude in 15 of the 16 patients. CONCLUSION: The precision of cardiac output measurements with PA-TD and TP-TD was very similar. The transpulmonary method, however, overestimated the cardiac output by 0.46 l/min. Post-operatively, cardiac output measurements with the PA-TD and pulse contour methods did not agree, but the pulse contour method reliably tracked pacing-induced changes in cardiac output.
Authors:
M Ostergaard; J Nielsen; J P Rasmussen; P G Berthelsen
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  50     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-21     Completed Date:  2007-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1044-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Copenhagen University Hospital, Gentofte, Hellerup, Denmark. morten.ostergaard@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / physiology*
Cardiac Output / physiology*
Cardiac Pacing, Artificial
Cardiac Surgical Procedures
Catheterization, Swan-Ganz*
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Postoperative Period
Reproducibility of Results
Thermodilution*

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