Document Detail

An Uncalibrated Pulse Contour Method to Measure Cardiac Output During Aortic Counterpulsation.
MedLine Citation:
PMID:  22003226     Owner:  NLM     Status:  Publisher    
Background:Less-invasive monitoring systems, such as pulse contour methods, are increasingly being used to estimate cardiac output (CO). However, alterations in the arterial waveform caused by intraaortic balloon pump counterpulsation may affect the ability of pulse contour algorithms to determine CO. We investigated the reliability of an uncalibrated pulse contour method, the MostCare system, in patients with cardiac failure receiving intraaortic balloon pump counterpulsation by comparing its measurements of CO with those determined by an intermittent thermodilution method.Methods:The study included 15 patients requiring hemodynamic support with an intraaortic balloon pump after coronary artery bypass graft surgery. A pulmonary artery catheter was inserted and CO was determined by bolus thermodilution (ThD-CO). The MostCare device was directly connected to the standard monitoring system for analysis of the radial artery pressure wave and computation of CO (MostCare-CO). Data were collected at 3 different intraaortic balloon pump rates (1:1, 1:2, 1:4) and after intraaortic balloon pump removal.Results:One hundred six pairs of ThD-CO and MostCare-CO measurements were analyzed. There was a good correlation between ThD-CO and MostCare-CO (r = 0.90, 95% confidence interval [CI] = 0.86-0.93; P < 0.001). The mean bias of all CO measurements corrected for repeated measures was -0.2 L/min with limits of agreements of -1.31 to 0.91 L/min (lower 95% CI, -1.72 to -0.90; upper 95% CI, 0.50-1.32) and a relative percentage error of 24. There were close agreements between ThD-CO and MostCare-CO at the different intraaortic balloon pump rate settings. Changes in CO were calculated separately for the 2 methods and data comparison showed a correlation of 0.82 (95% CI = 0.76-0.87; P < 0.001) and a mean bias of 0.14 L/min with limits of agreement of -1.31 to 1.59 L/min (lower 95% CI, -1.62 to -1.00; upper 95% CI, 1.28-1.90).Conclusion:The MostCare system provided measurements of CO that were comparable to ThD-CO in patients assisted with an intraaortic balloon pump. The reliability of the MostCare system is not significantly affected by changes in arterial waveform morphology caused by inflation and deflation of the intraaortic balloon pump.
Sabino Scolletta; Federico Franchi; Fabio Silvio Taccone; Katia Donadello; Bonizella Biagioli; Jean-Louis Vincent
Related Documents :
16607046 - Is single or double aortic clamping safer in terms of cerebral outcome during coronary ...
16159836 - Hemodynamic and vascular effects of ventricular sourcing by stent-based ventricle to co...
8402846 - Rapid development of left main disease after coronary artery bypass grafting for failed...
15296886 - The effect of leucodepletion on leucocyte activation, pulmonary inflammation and respir...
25216766 - Incremental value of coronary flow velocity reserve, measured by transthoracic echocard...
21667016 - Decellularized bovine reinforced vessels for small-diameter tissue-engineered vascular ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-14
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  -     ISSN:  1526-7598     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the *Department of Anaesthesia and Intensive Care, University of Siena, Siena, Italy; and.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  What's New in Obstetric Anesthesia? The 2011 Gerard W. Ostheimer Lecture.
Next Document:  Chromosome 1p21.3 microdeletions comprising DPYD and MIR137 are associated with intellectual disabil...