Continuous cardiac output monitoring after cardiopulmonary bypass : a comparison with bolus thermodilution measurement

The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. Prospective observational clinical study. A 20-bed surgical ICU at a university hospital. Fourteen deeply sedated, ventilated, post-c...

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Bibliographic Details
Published in:Intensive care medicine 2006-06, Vol.32 (6), p.919-922
Main Authors: BENDJELID, Karim, SCHUTZ, Nicolas, SUTER, Peter M, ROMAND, Jacques-Andre
Format: Article
Language:English
Subjects:
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiac Output - physiology
Cardiopulmonary Bypass
Cardiovascular system
Catheterization, Swan-Ganz
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Female
Humans
Hypothermia
Intensive care medicine
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Linear Models
Male
Medical sciences
Methods
Middle Aged
Monitoring, Physiologic
Patient outcomes
Prospective Studies
Thermodilution
Thoracic Surgery
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Summary:The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain. Prospective observational clinical study. A 20-bed surgical ICU at a university hospital. Fourteen deeply sedated, ventilated, post-cardiac surgery patients, all equipped with a pulmonary artery catheter. Six hours after the end of the CPB, 56 simultaneous bolus and continuous measurements were compared by a linear regression analysis and Bland-Altman analysis. Bolus CO was estimated by averaging triplicate injections of 10 ml room-temperature NaCl 0.9%, delivered randomly during the respiratory cycle. A stringent maximum difference of 0.55 l min(-1) (about 10% of the mean bolus measured) was considered as a clinically acceptable agreement between the two types of measurements. To be interchangeable the limits of agreement (+/-2 SD of the mean difference between the two methods) should not exceed the chosen acceptable difference. Continuous was correlated with bolus CO, with a correlation coefficient of r(2)=0.68. (p
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-006-0161-2