Continuous intraoperative noninvasive cardiac output monitoring using a new thoracic bioimpedance device

• Published in: Journal of cardiothoracic and vascular anesthesia 1997-06, Vol.11 (4), p.440-444
• Main Authors: Thangathurai, Duraiyah, Charbonnet, Christopher, Roessler, Peter, Wo, Charles C.J., Mikhail, Maged, Yoshida, Roland, Shoemaker, William C.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bias; Biological and medical sciences; Carcinoma - surgery; Cardiac Output; Cardiovascular system; continuous hemodynamic monitoring; Electric Impedance; Female; high-risk surgery; Humans; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Male; measurement of cardiac output; Medical sciences; Middle Aged; Monitoring, Intraoperative; noninvasive cardiac output measurement; Postoperative Care; Prospective Studies; pulmonary artery catheterization; Reproducibility of Results; Retrospective Studies; Safety; Signal Processing, Computer-Assisted; Software; Thermodilution; thermodilution cardiac output; thoracic bioimpedance
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1016/S1053-0770(97)90052-5

Objectives: To compare a new noninvasive bioimpedance device with the standard thermodilution method during the intraoperative period in high-risk patients undergoing oncological surgery. Design: Prospectively collected data with retrospective analysis. Setting: The study was undertaken at a university hospital, single institution. Participants: Twenty-three selected adults undergoing extensive, ablative oncological surgery. Interventions: Simultaneous measurements of cardiac output by a new bioimpedance method and the standard thermodilution method during the intraoperative and immediate postoperative periods. Measurements and Main Results: The correlation coefficient between the two methods was r = 0.89, p < 0.001. Bias and precision analysis between the two techniques showed a mean bias of 0.1 L/min and SD of the bias (precision) of 1.0 L/min (95% level of agreement +2.1 L/min to −1.9 L/min). After software enhancement, data from the last 11 monitored patients showed improved correlation between the two methods; r = 0.93, mean bias −0.1 L/min, and precision 0.8 L/min. Electrical and motion-induced interference only transiently impaired the performance of the new impedance method. Conclusion: This new impedance device is a safe, reliable, clinically acceptable alternative to the invasive thermodilution method in the operating room environment.