Comparison of pulmonary arterial thermodilution and arterial pulse contour analysis: evaluation of a new algorithm

• Published in: Journal of clinical anesthesia 2002-06, Vol.14 (4), p.296-301
• Main Authors: Felbinger, Thomas W, Reuter, Daniel A, Eltzschig, Holger K, Moerstedt, Karl, Goedje, Oliver, Goetz, Alwin E
• Format: Article
• Language: English
• Subjects: Algorithms; Aorta - physiology; Biological and medical sciences; Cardiac index; Cardiac Output; Cardiac Surgical Procedures; Cardiovascular system; Female; Heart Function Tests; Humans; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Postoperative Period; Prospective Studies; Pulmonary Artery; Pulse; pulse contour analysis; Thermodilution
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/S0952-8180(02)00363-X

Study Objective: To compare cardiac index (CI) measurement by arterial pulse contour analysis using two different algorithms (CI PC , CI PCnew ) with pulmonary arterial thermodilution values (CI PA ) so as to evaluate the difference between the conventional algorithm, CI PC , and a new algorithm, CI PCnew , that accounts for patients’ individual aortic compliance. Design: Prospective, clinical study. Setting: Intensive care unit of a university hospital. Patients: 20 ASA physical status II and III patients following elective cardiac surgery. Measurements and Main Results: 360 parallel triplicate determinations of CI (CI PA , CI PC , CI PCnew ) were performed within a 90-minute period during the immediate postoperative period. Prior to the start of the study period, CI PC as well as CI PCnew were calibrated by triplicate femoral arterial thermodilution measurements. Regression analysis of CI PA and CI PC , as well as CI PA and CI PCnew , revealed r = 0.89, p < 0.001, and r = 0.93, p < 0.001, respectively. Bland-Altman analysis was used for determining the accuracy and precision of CI PC and CI PCnew compared with CI PA . The mean differences (m) and standard deviation (SD) between CI PA and CI PC, as well as CI PA and CI PCnew , resulted in m = − 0.312 L/min/m 2 , SD = 0.456 L/min/m 2 , and m = − 0.140 L/min/m 2 , SD = 0.328 L/min/m 2 , respectively. Conclusion: Arterial pulse contour analysis measurement of CI using either algorithm correlates well with CI values derived by pulmonary arterial thermodilution. However, the algorithm introduced in this study proved to be a more accurate predictor of values as derived by pulmonary artery catheter.