S G Sakka1, K Reinhart, A Meier-Hellmann. 1. Department of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Bachstrasse 18, D-07 740 Jena, Germany.
Abstract
OBJECTIVE: We studied the agreement between cardiac output measurements via pulmonary artery thermodilution [CO(PA)], regarded as the current clinical gold standard, and aortic transpulmonary thermodilution [CO(AORTA)]. DESIGN: Prospective clinical study. SETTING: Surgical intensive care unit of a university hospital. PATIENTS: 37 patients with sepsis or septic shock (n = 34) and subarachnoid haemorrhage (n = 3). MEASUREMENTS AND RESULTS: We analysed 449 simultaneous cardiac output measurements. All patients were deeply sedated and mechanically ventilated in a pressure controlled mode. Each patient received a 7.5-F five-lumen pulmonary artery catheter and a 4-F aortic catheter with an integrated thermistor. The thermistors of the two different catheters were connected to one computer system (COLD-Z021, Pulsion Medical Systems, Munich, Germany). Linear regression analysis revealed: CO(AORTA) = 0.96. CO(PA) + 1.02 (l/min) (r = 0.97, p < 0.0001). CO(AORTA) was consistently higher than CO(PA) with a bias of 0.68 (l/min) and a standard deviation of 0.62 (l/min). CONCLUSION: Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.
OBJECTIVE: We studied the agreement between cardiac output measurements via pulmonary artery thermodilution [CO(PA)], regarded as the current clinical gold standard, and aortic transpulmonary thermodilution [CO(AORTA)]. DESIGN: Prospective clinical study. SETTING: Surgical intensive care unit of a university hospital. PATIENTS: 37 patients with sepsis or septic shock (n = 34) and subarachnoid haemorrhage (n = 3). MEASUREMENTS AND RESULTS: We analysed 449 simultaneous cardiac output measurements. All patients were deeply sedated and mechanically ventilated in a pressure controlled mode. Each patient received a 7.5-F five-lumen pulmonary artery catheter and a 4-F aortic catheter with an integrated thermistor. The thermistors of the two different catheters were connected to one computer system (COLD-Z021, Pulsion Medical Systems, Munich, Germany). Linear regression analysis revealed: CO(AORTA) = 0.96. CO(PA) + 1.02 (l/min) (r = 0.97, p < 0.0001). CO(AORTA) was consistently higher than CO(PA) with a bias of 0.68 (l/min) and a standard deviation of 0.62 (l/min). CONCLUSION: Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.
Authors: Martin Boehne; Florian Schmidt; Lars Witt; Harald Köditz; Michael Sasse; Robert Sümpelmann; Harald Bertram; Armin Wessel; Wilhelm Alexander Osthaus Journal: Pediatr Cardiol Date: 2012-02-14 Impact factor: 1.655