H R Pesola1, G R Pesola. 1. Department of Critical Care Medicine and Nursing, Hospital for Joint Diseases, New York.
Abstract
OBJECTIVE: To assess the accuracy of room-temperature thermodilution cardiac output measurements from the side port (SP) of the introducer catheter through which the pulmonary artery flotation catheter is inserted. DESIGN:Central venous port (CVP) cardiac output measurements were compared with SP cardiac output measurements using the same right-heart catheter. SETTING: The general intensive care unit of the Hospital for Joint Diseases, Orthopedic Institute, New York. PATIENTS: Thirty one orthopedic patients with 31 different right-heart catheters placed in the right internal jugular or right subclavian position were evaluated. INTERVENTION: Four injections of 10 ml of normal saline solution at room temperature were made through each port; the results of the last three injections were averaged. Cardiac output determinations from both ports were completed in less than 10 min. The order of port injection was random. RESULTS: A significant difference was noted between cardiac output determinations from the two ports (p < 0.001, paired Student's t test) with the SP slightly overestimating thermodilution cardiac outputs by 6.34 +/- 8.38 percent compared to the CVP. A significant correlation was noted between both ports (r = 0.97, p < 0.001) with the linear regression line starting at the origin (y intercept not significantly different from zero) with a slope (1.07) significantly greater than 1. CONCLUSION: If the proximal CVP becomes nonfunctional, room-temperature thermodilution cardiac outputs from the SP can be used with the understanding that a slight overestimation of cardiac output will occur.
RCT Entities:
OBJECTIVE: To assess the accuracy of room-temperature thermodilution cardiac output measurements from the side port (SP) of the introducer catheter through which the pulmonary artery flotation catheter is inserted. DESIGN: Central venous port (CVP) cardiac output measurements were compared with SP cardiac output measurements using the same right-heart catheter. SETTING: The general intensive care unit of the Hospital for Joint Diseases, Orthopedic Institute, New York. PATIENTS: Thirty one orthopedic patients with 31 different right-heart catheters placed in the right internal jugular or right subclavian position were evaluated. INTERVENTION: Four injections of 10 ml of normal saline solution at room temperature were made through each port; the results of the last three injections were averaged. Cardiac output determinations from both ports were completed in less than 10 min. The order of port injection was random. RESULTS: A significant difference was noted between cardiac output determinations from the two ports (p < 0.001, paired Student's t test) with the SP slightly overestimating thermodilution cardiac outputs by 6.34 +/- 8.38 percent compared to the CVP. A significant correlation was noted between both ports (r = 0.97, p < 0.001) with the linear regression line starting at the origin (y intercept not significantly different from zero) with a slope (1.07) significantly greater than 1. CONCLUSION: If the proximal CVP becomes nonfunctional, room-temperature thermodilution cardiac outputs from the SP can be used with the understanding that a slight overestimation of cardiac output will occur.