Indirect Fick and Thermodilution Cardiac Output Measurements Have Significant Variance Compared to Direct Fick in LVAD Patients

BACKGROUND: Few complete studies have been published to validate the agreement between continuous cardiac output and intermittent thermodilution cardiac output. OBJECTIVE: To analyze the agreement between cardiac output measurements by the continuous thermodilution method and the intermittent bolus thermodilution method, using a continuous cardiac output catheter in postoperative cardiothoracic surgery patients. METHODS: A convenience sample of 14 adult cardiothoracic surgical patients with thermodilution pulmonary artery catheters placed preoperatively was used. A total of 214 comparison measurements of cardiac output by both the continuous and intermittent thermodilution methods were taken on patient admission to the critical care unit, every 4 hours, and with any change greater than 10% from baseline readings. RESULTS: The intraclass correlation between continuous cardiac output and intermittent cardiac output was .89. The limits of agreement were -1.34 to 1.18 L/min, indicating that in 95% of readings the difference between continuous cardiac output and intermittent cardiac output were within this range. CONCLUSIONS: The continuous cardiac output monitoring method shows clinically acceptable agreement with the intermittent cardiac output method.

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Cardiac Output Determination

AACN Advanced Critical Care ◽

10.4037/15597768-1993-1008 ◽

1993 ◽

Vol 4 (1) ◽

pp. 81-97 ◽

Cited By ~ 1

Author(s):

Susan L. Woods ◽

Susan Osguthorpe

Keyword(s):

Cardiac Output ◽

Critical Care Nurses ◽

Cardiac Output Measurement ◽

Nursing Management ◽

Output Measurement ◽

Thermodilution Cardiac Output ◽

Cardiac Output Determination ◽

Output System ◽

Cardiac Output Measurements ◽

Management Issues

Critical care nurses frequently are involved in obtaining cardiac output measurements and in using these data to assess and to plan therapy. This article reviews the physiologic determinants of cardiac output and the clinical factors that influence these determinants. Principles and techniques of common methods of cardiac output measurement are discussed. A thorough presentation of guidelines for troubleshooting problems with thermodilution cardiac output measurement is provided in a table. Nursing management issues are discussed using relevant nursing research. Future considerations in cardiac output measurement are discussed, and suggestions of an ideal cardiac output system are provided

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Room-temperature thermodilution cardiac output: proximal injectate lumen vs proximal infusion lumen

American Journal of Critical Care ◽

10.4037/ajcc1993.2.2.132 ◽

1993 ◽

Vol 2 (2) ◽

pp. 132-133

Author(s):

GR Pesola ◽

B Ayala ◽

L Plante

Keyword(s):

Cardiac Output ◽

Room Temperature ◽

Central Venous ◽

Right Heart ◽

Thermodilution Cardiac Output ◽

Central Venous Port ◽

Venous Port ◽

Port Design ◽

Venous Infusion ◽

Cardiac Output Measurements

OBJECTIVE: To assess the accuracy of room-temperature thermodilution cardiac output measurements from the venous infusion port. DESIGN: Central venous port cardiac output measurements were compared with venous infusion port measurements in 48 right-heart catheters. INTERVENTION: Three 10-mL injections of 5% dextrose in water were made through each port. The order of port injection was random. RESULTS: The cardiac outputs were 5.8 +/- 1.8 L/min from both ports, with no difference between ports (paired t test). CONCLUSION: Room-temperature thermodilution cardiac output determinations from the venous infusion port can be used in place of central venous port cardiac outputs if the central venous port becomes nonfunctional.

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