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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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| Published in: | Intensive care medicine 2006-06, Vol.32 (6), p.919-922 |
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| creator | BENDJELID, Karim SCHUTZ, Nicolas SUTER, Peter M ROMAND, Jacques-Andre |
| description | 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 |
| doi_str_mv | 10.1007/s00134-006-0161-2 |
| format | article |
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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<0.01). The Bland-Altman analysis demonstrated an objective mean bias of 0.33+/-0.6 l min(-1) (confidence interval of -0.87-1.58) with 34% of measured values falling outside of the clinically acceptable limits.
Our results suggest that, in the first 6 h after CPB, continuous and bolus CO determinations are not interchangeable; one third of the values obtained by continuous CO fell outside the strict limits of clinically useful precision.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-006-0161-2</identifier><identifier>PMID: 16601960</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>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</subject><ispartof>Intensive care medicine, 2006-06, Vol.32 (6), p.919-922</ispartof><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2006 Springer</rights><rights>Springer-Verlag 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-2d5bb252a5e61c92c7b2852a18dc37fb8497396a8278f0917fb9e7638ae38c143</citedby><cites>FETCH-LOGICAL-c461t-2d5bb252a5e61c92c7b2852a18dc37fb8497396a8278f0917fb9e7638ae38c143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17838473$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16601960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BENDJELID, Karim</creatorcontrib><creatorcontrib>SCHUTZ, Nicolas</creatorcontrib><creatorcontrib>SUTER, Peter M</creatorcontrib><creatorcontrib>ROMAND, Jacques-Andre</creatorcontrib><title>Continuous cardiac output monitoring after cardiopulmonary bypass : a comparison with bolus thermodilution measurement</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>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<0.01). The Bland-Altman analysis demonstrated an objective mean bias of 0.33+/-0.6 l min(-1) (confidence interval of -0.87-1.58) with 34% of measured values falling outside of the clinically acceptable limits.
Our results suggest that, in the first 6 h after CPB, continuous and bolus CO determinations are not interchangeable; one third of the values obtained by continuous CO fell outside the strict limits of clinically useful precision.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output - physiology</subject><subject>Cardiopulmonary Bypass</subject><subject>Cardiovascular system</subject><subject>Catheterization, Swan-Ganz</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Humans</subject><subject>Hypothermia</subject><subject>Intensive care medicine</subject><subject>Investigative techniques of hemodynamics</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Patient outcomes</subject><subject>Prospective Studies</subject><subject>Thermodilution</subject><subject>Thoracic Surgery</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNptkk2LFDEQhoMo7rj6A7xIUPTWaz66k_TelsEvWPCi55BOp2ezdCdtPpT999bQA4sy5BBS9dRLVeVF6DUlV5QQ-TETQnnbECIaQgVt2BO0oy1nDWVcPUU7wlvWtKJlF-hFzvdAS9HR5-iCCkFoL8gO_d7HUHyosWZsTRq9sTjWstaClxh8icmHAzZTcWnLx7XOkDHpAQ8Pq8kZX2ODbVxWk3yOAf_x5Q4PcQbBcufSEkc_1-IhsziTa3KLC-UlejaZObtXp_sS_fz86cf-a3P7_cu3_c1tY1tBS8PGbhhYx0znBLU9s3JgCp5UjZbLaVBtL3kvjGJSTaSnEOqdFFwZx5WFVVyiD5vumuKv6nLRi8_WzbMJDkbWQvZ9ywgH8O1_4H2sKUBvmsFq-44oBtC7DTqY2WkfpliSsUdFfUM73sGmRQdUc4Y6uOCSmWNwk4fwP_zVGR7O6BZvzxbQrcCmmHNyk16TX-BHNCX6aAy9GUODMfTRGPrY-pvTfHVY3PhYcXICAO9PgMnWzFMywfr8yEnFVSs5_wvOu8Ab</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>BENDJELID, Karim</creator><creator>SCHUTZ, Nicolas</creator><creator>SUTER, Peter M</creator><creator>ROMAND, Jacques-Andre</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20060601</creationdate><title>Continuous cardiac output monitoring after cardiopulmonary bypass : a comparison with bolus thermodilution measurement</title><author>BENDJELID, Karim ; SCHUTZ, Nicolas ; SUTER, Peter M ; ROMAND, Jacques-Andre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-2d5bb252a5e61c92c7b2852a18dc37fb8497396a8278f0917fb9e7638ae38c143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Output - physiology</topic><topic>Cardiopulmonary Bypass</topic><topic>Cardiovascular system</topic><topic>Catheterization, Swan-Ganz</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Humans</topic><topic>Hypothermia</topic><topic>Intensive care medicine</topic><topic>Investigative techniques of hemodynamics</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Patient outcomes</topic><topic>Prospective Studies</topic><topic>Thermodilution</topic><topic>Thoracic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BENDJELID, Karim</creatorcontrib><creatorcontrib>SCHUTZ, Nicolas</creatorcontrib><creatorcontrib>SUTER, Peter M</creatorcontrib><creatorcontrib>ROMAND, Jacques-Andre</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BENDJELID, Karim</au><au>SCHUTZ, Nicolas</au><au>SUTER, Peter M</au><au>ROMAND, Jacques-Andre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Continuous cardiac output monitoring after cardiopulmonary bypass : a comparison with bolus thermodilution measurement</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>32</volume><issue>6</issue><spage>919</spage><epage>922</epage><pages>919-922</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>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<0.01). The Bland-Altman analysis demonstrated an objective mean bias of 0.33+/-0.6 l min(-1) (confidence interval of -0.87-1.58) with 34% of measured values falling outside of the clinically acceptable limits.
Our results suggest that, in the first 6 h after CPB, continuous and bolus CO determinations are not interchangeable; one third of the values obtained by continuous CO fell outside the strict limits of clinically useful precision.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>16601960</pmid><doi>10.1007/s00134-006-0161-2</doi><tpages>4</tpages></addata></record> |
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| 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 |
| title | Continuous cardiac output monitoring after cardiopulmonary bypass : a comparison with bolus thermodilution measurement |
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