Continuous cardiac output measurements in intensive care patients after cardiac surgery

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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Comparison of cardiac output and cardiac index values measured by critical care echocardiography with the values measured by pulse index continuous cardiac output (PiCCO) in the pediatric intensive care unit:a preliminary study

Italian Journal of Pediatrics ◽

10.1186/s13052-020-0803-y ◽

2020 ◽

Vol 46 (1) ◽

Author(s):

Nagehan Aslan ◽

Dincer Yildizdas ◽

Ozden Ozgur Horoz ◽

Yasemin Coban ◽

Fadli Demir ◽

...

Keyword(s):

Cardiac Output ◽

Critical Care ◽

Intensive Care ◽

Cardiac Index ◽

Pediatric Intensive Care ◽

Continuous Cardiac Output ◽

Critical Care Echocardiography ◽

Preliminary Study

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EFFECTS OF BODY TEMPERATURE ON ACCURACY OF CONTINUOUS CARDIAC OUTPUT MEASUREMENTS

Critical Care Medicine ◽

10.1097/00003246-199501001-00227 ◽

1995 ◽

Vol 23 (Supplement) ◽

pp. A137 ◽

Cited By ~ 1

Author(s):

Fred Luchette ◽

Jay Johannigman ◽

Richard Branson ◽

David Porembka ◽

Kenneth Davis

Keyword(s):

Cardiac Output ◽

Body Temperature ◽

Continuous Cardiac Output ◽

Cardiac Output Measurements

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Extracorporeal Arteriovenous Ultrasound Measurement of Cardiac Output in Small Children

Anesthesiology ◽

10.1097/aln.0000000000002582 ◽

2019 ◽

Vol 130 (5) ◽

pp. 712-718 ◽

Cited By ~ 8

Author(s):

Theodor S. Sigurdsson ◽

Anders Aronsson ◽

Lars Lindberg

Keyword(s):

Cardiac Output ◽

Cardiac Surgery ◽

Reference Method ◽

Ultrasound Measurement ◽

Good Precision ◽

Flow Probe ◽

Small Children ◽

Blood Dilution ◽

The Mean ◽

Cardiac Output Measurements

Abstract Editor’s Perspective What We Already Know about This Topic To date, there are not clinically practical, accurate, and precise noninvasive methods for measuring cardiac output in small children What This Article Tells Us That Is New This study describes a noninvasive method by which ultrasound can be used in small children to determine cardiac output with good precision After surgery in 43 small children for repair of atrial or ventricular septal defects, cardiac output measurements performed using saline bolus injections and ultrasound detection of the expected blood dilution showed similar precision for measuring cardiac output as a cardiac outputs measured using periaortic flow probe Background Technology for cardiac output (CO) and blood volume measurements has been developed based on blood dilution with a small bolus of physiologic body temperature saline, which, after transcardiopulmonary mixing, is detected with ultrasound sensors attached to an extracorporeal arteriovenous loop using existing central venous and peripheral arterial catheters. This study aims to compare the precision and agreement of this technology to measure cardiac output with a reference method, a perivascular flow probe placed around the aorta, in young children. The null hypothesis is that the methods are equivalent in precision, and there is no bias in the cardiac output measurements. Methods Forty-three children scheduled for cardiac surgery were included in this prospective single-center comparison study. After corrective cardiac surgery, five consecutive repeated cardiac output measurements were performed simultaneously by both methods. Results A total of 215 cardiac output measurements were compared in 43 children. The mean age of the children was 354 days (range, 30 to 1,303 days), and the mean weight was 7.1 kg (range, 2.7 to 13.6 kg). The precision assessed as two times the coefficient of error was 3.6% for the ultrasound method and 5.0% for the flow probe. Bias (mean COultrasound 1.28 l/min − mean COflow probe 1.20 l/min) was 0.08 l/min, limits of agreement was ±0.32 l/min, and the percentage error was 26.6%. Conclusions The technology to measure cardiac output with ultrasound detection of blood dilution after a bolus injection of saline yields comparable precision as cardiac output measurements by a periaortic flow probe. The difference in accuracy in the measured cardiac output between the methods can be explained by the coronary blood flow, which is excluded in the cardiac output measurements by the periaortic flow probe.

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