Document Detail

Transpulmonary versus continuous thermodilution cardiac output after valvular and coronary artery surgery.
MedLine Citation:
PMID:  19383638     Owner:  NLM     Status:  MEDLINE    
Residual left-sided valvular insufficiencies after valvular surgery may confound transpulmonary thermodilution cardiac output (COtp). We compared the technique with the continuous right-sided thermodilution technique (CCO) after valvular surgery (n=8) and coronary artery surgery (n=8). Patients with pulmonary and femoral artery catheters in the intensive care unit (ICU) were included. After valvular surgery, there was minimal aortic insufficiency in four patients and minimal to moderate mitral valve insufficiency in six. Five fluid loading steps (250 ml) were done in each patient. CCO and COtp were measured prior to and 15 min after each step. The cardiac output was lower after valvular than coronary artery surgery but responses to fluid loading steps were similar among surgery types and techniques. After valvular and coronary artery surgery, cardiac output was lower prior to responses than in non-responses to fluids, by either technique. After valvular surgery, COtp and CCO correlated (r=0.64, P<0.001, n=48) but fluid-induced changes did not. After coronary artery surgery, COtp and CCO correlated (r=0.81, P<0.001) and changes also did (r=0.55, P<0.001). At fluid-induced CCO increases <20%, the r for changes in cardiac output measured by both techniques was similar after valvular and coronary artery surgery. Thus, COtp and CCO were of similar value in predicting and monitoring fluid responses after both surgery types. This argues against left-sided valvular insufficiencies confounding COtp.
Rose-Marieke B G E Breukers; A B Johan Groeneveld; Rob B P de Wilde; Jos R C Jansen
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-04-21
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-23     Completed Date:  2009-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  4-8     Citation Subset:  IM    
Department of Intensive Care and Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Cardiac Output*
Cardiac Surgical Procedures* / adverse effects
Catheterization, Swan-Ganz*
Coronary Artery Disease / physiopathology,  surgery*
Heart Valve Diseases / physiopathology,  surgery*
Intensive Care
Middle Aged
Monitoring, Physiologic / methods*
Postoperative Period
Predictive Value of Tests
Pulmonary Artery / physiopathology*
Thermodilution / methods*

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

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