Document Detail


Lack of agreement between thermodilution and electrical velocimetry cardiac output measurements.
MedLine Citation:
PMID:  17690864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Matthias Heringlake; Ulrich Handke; Thorsten Hanke; Frank Eberhardt; Jan Schumacher; Hartmut Gehring; Hermann Heinze
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-10
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2008-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2168-72     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. heringlake@t-online.de
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MeSH Terms
Descriptor/Qualifier:
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:
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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