| Lack of agreement between thermodilution and electrical velocimetry cardiac output measurements. | |
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MedLine Citation:
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PMID: 17690864 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The modified algorithm for the non-invasive determination of cardiac output (CO) by electrical bioimpedance-electrical velocimetry (EV)-has been reported to give reliable results in comparison with echocardiography and pulmonary arterial thermodilution (PA-TD) in patients either before or after cardiac surgery. The present study was designed to determine whether EV-CO measurements reflect intraindividual changes in CO during cardiac surgery. DESIGN: Prospective, observational study. SETTING: Operating room (OR) and intensive care unit (ICU) of a university hospital. PATIENTS: Twenty-nine patients undergoing elective cardiac surgery. INTERVENTIONS: None. MEASUREMENTS: CO was determined simultaneously by PA-TD and EV after induction of anesthesia (t1) and 4.9+/-3.5 h after ICU admission (t2). RESULTS: TD-CO was 3.9+/-1.4 and 5.4+/-1.1 l/min at t1 and t2 (p < 0.0001). EV-CO was 4.3+/-1.1 and 4.9+/-1.5 l/min at t1 and t2 (p = 0.013). Bland-Altman analysis showed a bias of -0.4 l/min and 0.4 l/min and a precision of 3.2 and 3.6 l/min (34.3% and 67.4%) at t1 and t2, respectively. Analysis of the individual pre- to postoperative changes in CO with both methods revealed bidirectional changes in n = 12 patients and unidirectional changes with a difference greater than 50% and less than 50% in n = 9 and n = 8 patients, respectively. CONCLUSIONS: The disagreement between PA-TD and EV-CO measurements after anesthesia induction and after ICU admission, as well as the fact that thoracic bioimpedance did not adequately reflect pre- to postoperative changes in CO, questions the reliability of EV-CO measurements in cardiac surgery patients and contrasts sharply with previous studies. |
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Authors:
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Matthias Heringlake; Ulrich Handke; Thorsten Hanke; Frank Eberhardt; Jan Schumacher; Hartmut Gehring; Hermann Heinze |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-08-10 |
Journal Detail:
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Title: Intensive care medicine Volume: 33 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-23 Completed Date: 2008-05-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2168-72 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. heringlake@t-online.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Algorithms Anesthesia, General Blood Flow Velocity* / physiology Cardiac Output / physiology* Catheterization, Swan-Ganz Female Germany Humans Intensive Care Units Male Middle Aged Observation Operating Rooms Prospective Studies Reproducibility of Results Thermodilution / methods* Thoracic Surgery |
| Comments/Corrections | |
Comment In:
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Intensive Care Med. 2007 Dec;33(12):2226; author reply 2227
[PMID:
17932653
]
Intensive Care Med. 2007 Dec;33(12):2220; author reply 2221-2 [PMID: 17938881 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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