Effect of thermodilution injectate volume and temperature on the accuracy and precision of cardiac output measurements for healthy anesthetized horses

2021 ◽  
Vol 82 (10) ◽  
pp. 818-822
Author(s):  
Jesse C. A. Jenny ◽  
Klaus Hopster ◽  
Samuel D. Hurcombe
Author(s):  
Wenshen Wu ◽  
Sulian Lin ◽  
Caixuan Xie ◽  
Jianbo Li ◽  
Jingen Lie ◽  
...  

Abstract Objective The aim of this study was to validate impedance technique (IT) by investigating the agreement in cardiac output measurements performed by IT and echocardiography (ECHO). Study design This is a prospective observational study, including a total of 30 neonates who underwent hemodynamic measurements by IT and ECHO. To determine the agreement between both methods, we performed IT to measure stroke volume (SV-IT) and cardiac output (CO-IT) immediately before or after ECHO to measure SV (SV-ECHO) and CO (CO-ECHO). The precision and accuracy of the IT relative to ECHO were assessed. Results SV-ECHO and SV-IT were (4.45 ± 0.78) and (4.54 ± 0.81) mL, respectively. The bias and limits of agreement of SV-IT were 0.09 mL and ( –1.92 to 1.73) mL, respectively. The true precision of SV-IT was 27.3%. Furthermore, CO-ECHO and CO-IT were (0.62 ± 0.12) and (0.61 ± 0.12) L/min, respectively. The bias and LoA of CO-IT were 0.01L/min and (–0.33 to 0.31) L/min, respectively. The true precision of CO-IT was 28.3%. Conclusion Agreement between the IT and ECHO in the cardiac output measurement appeared acceptable. However, the accuracy and precision of the IT approach should be further investigated using a larger sample.


2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Geert Koster ◽  
Thomas Kaufmann ◽  
Bart Hiemstra ◽  
Renske Wiersema ◽  
Madelon E. Vos ◽  
...  

Abstract Background Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts necessary for novices to attain images of sufficient quality. There is no data on medical students performing CCUS for the measurement of cardiac output (CO), a hemodynamic variable of importance for daily critical care. Objective The aim of this study was to explore the agreement of cardiac output measurements as well as the quality of images obtained by medical students in critically ill patients compared to the measurements obtained by experts in these images. Methods In a prospective observational cohort study, all acutely admitted adults with an expected ICU stay over 24 h were included. CCUS was performed by students within 24 h of admission. CCUS included the images required to measure the CO, i.e., the left ventricular outflow tract (LVOT) diameter and the velocity time integral (VTI) in the LVOT. Echocardiography experts were involved in the evaluation of the quality of images obtained and the quality of the CO measurements. Results There was an opportunity for a CCUS attempt in 1155 of the 1212 eligible patients (95%) and in 1075 of the 1212 patients (89%) CCUS examination was performed by medical students. In 871 out of 1075 patients (81%) medical students measured CO. Experts measured CO in 783 patients (73%). In 760 patients (71%) CO was measured by both which allowed for comparison; bias of CO was 0.0 L min−1 with limits of agreement of − 2.6 L min−1 to 2.7 L min−1. The percentage error was 50%, reflecting poor agreement of the CO measurement by students compared with the experts CO measurement. Conclusions Medical students seem capable of obtaining sufficient quality CCUS images for CO measurement in the majority of critically ill patients. Measurements of CO by medical students, however, had poor agreement with expert measurements. Experts remain indispensable for reliable CO measurements. Trial registration Clinicaltrials.gov; http://www.clinicaltrials.gov; registration number NCT02912624


CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 297A
Author(s):  
Irene Ma ◽  
Joshua Caplin ◽  
Aftab Azad ◽  
Christina Wilson ◽  
Michael Fifer ◽  
...  

2021 ◽  
Vol 48 (6) ◽  
pp. S997
Author(s):  
V. Paranjape ◽  
N. Henao-Guerrero ◽  
G. Menciotti ◽  
F. Garcia-Pereira ◽  
C. Ricco-Pereira

1983 ◽  
Vol 245 (4) ◽  
pp. H690-H692 ◽  
Author(s):  
A. van Grondelle ◽  
R. V. Ditchey ◽  
B. M. Groves ◽  
W. W. Wagner ◽  
J. T. Reeves

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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