Document Detail


A comparative evaluation of thermodilution and partial CO2 rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation.
MedLine Citation:
PMID:  14652718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the reliability and clinical value of partial noninvasive CO2 (NICO2) rebreathing technique for measuring cardiac output compared with standard thermodilution in a group of intensive care nonpostoperative patients. DESIGN AND SETTING: Clinical investigation in a university hospital ICU. PATIENTS: Twelve mechanically ventilated patients with high (n=6) and low (n=6) pulmonary shunt fractions. MEASUREMENTS AND RESULTS: Thirty-six paired measurements of cardiac output were carried out with NICO2 and thermodilution in patients ventilated in pressure-support mode and sedated with a sufentanil continuous infusion to obtain a Ramsay score value of 2. The mean cardiac output was: thermodilution 7.27+/-2.42 l/min; NICO2 6.10+/-1.66 l/min; r2 was 0.62 and bias -1.2 l/min+/-1.5. Mean values of cardiac output were similar in the low shunt group (Qs/Qt < 20), with r2=0.90 and a bias of 0.01 l/min+/-0.4; conversely, in the high pulmonary shunt group (Qs/Q > 35%) the mean was 9.32+/-1.23 l/min with thermodilution and a mean NICO2CO value was 6.97+/-1.53 l/min, with r2 of 0.38 and a bias of -2.3 l+/-1.2 min. CONCLUSIONS: The partial CO2 rebreathing technique is reliable in measuring cardiac output in nonpostoperative critically ill patients affected by diseases causing low levels of pulmonary shunt, but underestimates it in patients with shunt higher than 35%.
Authors:
Monica Rocco; Gustavo Spadetta; Andrea Morelli; Donatella Dell'Utri; Patrizia Porzi; Giorgio Conti; Paolo Pietropaoli
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2003-12-03
Journal Detail:
Title:  Intensive care medicine     Volume:  30     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-12     Completed Date:  2004-03-26     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  82-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, University of Rome La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy. monica.rocco@uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Intravenous / therapeutic use
Bias (Epidemiology)
Breath Tests / methods*
Carbon Dioxide / diagnostic use*
Cardiac Output*
Conscious Sedation / methods
Critical Care / methods,  standards
Critical Illness / therapy
Hospitals, University
Humans
Linear Models
Monitoring, Physiologic / methods,  standards
Oximetry / methods*,  standards
Patient Selection
Positive-Pressure Respiration* / methods
Pulmonary Circulation
Pulmonary Gas Exchange
Sufentanil / therapeutic use
Thermodilution / methods*,  standards
Tidal Volume
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 124-38-9/Carbon Dioxide; 56030-54-7/Sufentanil

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


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