COMPARISON BETWEEN MEASUREMENTS OF CARDIAC OUTPUT BY THERMODILUTION METHOD AND PULSE DYE DENSITOMETRY USING INDOCYANINE GREEN

Background A new method for determining cardiac output (CO, l/min) using dye dilution combined with pulse dye densitometry (PDD), based on the principle of pulse oximetry, has been developed. The aim of the study was to determine the accuracy and precision of PDD by comparing it with the thermodilution method. Methods A prospective study was performed in 22 patients having surgery who were monitored using a pulmonary arterial catheter. In addition to the catheter, a specially designed photodetector was placed on the nasal wing. Ten milliliters of ice-cold indocyanine green dissolved in a 5% glucose solution (0.5 mg/ml) was injected. The dye and thermal dilution curves were simultaneously measured to calculate CO. Three to six injections were performed before and after surgery. Paired data were assessed in absolute terms, and the percentage errors were calculated by the degree of agreement and compared at three levels of CO (low < or = 3.5 < medium < or = 6 < high) by analysis of variance. Results The mean and SDs of the differences between dye and thermodilution CO were 0.16 +/- 0.80 l/min or 4.5 +/- 19.6% for 191 paired data. Measurement after surgery failed in one patient. The percentage error with low CO (9.3 +/- 19.3%) was greater (P < 0.05) than those obtained with other CO. Conclusions Pulse dye densitometry could measure CO repeatedly in patients having major surgery with the same degree of accuracy as the thermodilution method; however, a considerable degree of error was observed in some patients.

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Thermodilution method overestimates low cardiac output in humans

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1983.245.4.h690 ◽

1983 ◽

Vol 245 (4) ◽

pp. H690-H692 ◽

Cited By ~ 11

Author(s):

A. van Grondelle ◽

R. V. Ditchey ◽

B. M. Groves ◽

W. W. Wagner ◽

J. T. Reeves

Keyword(s):

Cardiac Output ◽

Heat Loss ◽

Low Flow ◽

Clinical Implications ◽

Low Cardiac Output ◽

Dye Dilution ◽

Thermodilution Method ◽

Cardiac Output Measurements

We compared 57 cardiac output measurements by the thermodilution and Fick methods in 26 patients and found that thermodilution values were higher in all 16 cases in which Fick outputs were less than 3.5 l/min. In 10 cases where Fick values were less than or equal to 2.5 l/min, thermodilution and Fick measurements differed by an average of 35%. When combined with the results of previous studies comparing the thermodilution, dye dilution, and Fick techniques, these findings suggest that the thermodilution method overestimates true cardiac output in the low output range. This overestimation probably is due to heat loss under conditions of low flow. Because the thermodilution method is used widely in patients with low output states, these findings have potentially important clinical implications.

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Reliability of cardiac output measured by thermodilution method in small animals

Comparative Biochemistry and Physiology ◽

10.1016/0010-406x(70)90073-3 ◽

1970 ◽

Vol 34 (1) ◽

pp. 245-250 ◽

Cited By ~ 15

Author(s):

Yu-Chong Lin ◽

Christopher A Dawson ◽

Ethan R Nadel ◽

Steven M Horvath

Keyword(s):

Cardiac Output ◽

Small Animals ◽

Thermodilution Method

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Continuous measurement of cardiac output by the Fick principle in infants and children: Comparison with the thermodilution method

Intensive Care Medicine ◽

10.1007/bf01712169 ◽

1996 ◽

Vol 22 (5) ◽

pp. 467-471 ◽

Cited By ~ 25

Author(s):

C. -F. Wippermann ◽

R. G. Huth ◽

F. X. Schmidt ◽

J. Thul ◽

M. Betancor ◽

...

Keyword(s):

Cardiac Output ◽

Continuous Measurement ◽

Infants And Children ◽

Fick Principle ◽

Thermodilution Method ◽

In Infants And Children

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Comparison of continuous with intermittent bolus thermodilution cardiac output measurements

American Journal of Critical Care ◽

10.4037/ajcc1995.4.6.460 ◽

1995 ◽

Vol 4 (6) ◽

pp. 460-465 ◽

Cited By ~ 16

Author(s):

CE Ditmyer ◽

M Shively ◽

DB Burns ◽

RT Reichman

Keyword(s):

Cardiac Output ◽

Intraclass Correlation ◽

Continuous Cardiac Output ◽

Cardiac Output Monitoring ◽

Monitoring Method ◽

Convenience Sample ◽

Thermodilution Cardiac Output ◽

Intermittent Bolus ◽

Thermodilution Method ◽

Cardiac Output Measurements

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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