Cardiac Output Measurement Using a Modified Carbon Dioxide Fick Method: A Validation Study in Ventilated Lambs

Boode, Willem P. de; Hopman, J.C.W.; Daniëls, Otto; Hoeven, Hans G. van der; Liem, Kian D.

doi:10.1203/pdr.0b013e318030d0c6

Cited by 14 publications

(11 citation statements)

References 34 publications

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“…The bias and precision found in this study during a closed aortopulmonary shunt are consistent with the result of our former study [4] , when sampling venous blood from the right atrium. This implies a good reproducibility of cardiac output measurements with the mCO 2 F method.…”

Section: Discussionsupporting

confidence: 91%

“…In a former study, we validated the mCO 2 F method for measurement of cardiac output in newborn lambs [4] . In that study, the ductus arteriosus was ligated on purpose to exclude any influence of a ductal shunt on the measurements.…”

Section: Discussionmentioning

confidence: 99%

“…In search of a reliable, easily applicable, (semi)continuous method of objective cardiac output measurement in critically ill newborns, we previously validated the modified carbon dioxide Fick (mCO 2 F) method [4] . In general, the direct oxygen Fick method is regarded as the gold standard in cardiac output measurement.…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Output Measurement in Ventilated Lambs with a Significant Left-to-Right Shunt Using the Modified Carbon Dioxide Fick Method

Boode

Hopman²,

Wijnen³

et al. 2009

Neonatology

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Background: It remains a great challenge to measure systemic blood flow in critically ill newborns. In a former study we validated the modified carbon dioxide Fick (mCO₂F) method for measurement of cardiac output in a newborn lamb model. In this new study we studied the influence of a left-to-right shunt on the accuracy of the mCO₂F method. Objective: To analyze the influence of a left-to-right shunt on the agreement between cardiac output measurement with the mCO₂F method and ultrasonic transit time pulmonary blood flow in a lamb model. Methods: The study was approved by the Ethical Committee on Animal Research of the Radboud University Nijmegen and performed in 8 random-bred lambs. A Gore-Tex® shunt was placed between the left pulmonary artery and the descending aorta. This aortopulmonary shunt was intermittently opened and closed, while cardiac output was manipulated by creating hemorrhagic hypotension. Cardiac output measurement with the mCO₂F method (Q^mCO2F) was compared with pulmonary blood flow obtained by a transit time ultrasonic flow probe positioned around the common pulmonary artery (Q^APC). Results: Bias, defined as Q^mCO2F – Q^APC, was calculated for each measurement. With an open shunt there was a significant left-to-right shunt (mean Qp/Qs ratio 2.26; range 1.56–3.69). Mean bias (SD) was –12.3 (50.4) ml·kg^–1·min^–1 and –12.3 (42.7) ml·kg^–1·min^–1 for measurements with a closed and open shunt, respectively (no statistical significant difference). Conclusions: Cardiac output measurement with the mCO₂F method is reliable and easily applicable in ventilated newborn lambs, also in the presence of a significant left-to-right shunt.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Cardiac Output Measurement in Ventilated Lambs with a Significant Left-to-Right Shunt Using the Modified Carbon Dioxide Fick Method

Boode

Hopman²,

Wijnen³

et al. 2009

Neonatology

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“…To further investigate the feasibility of the proposed composite PA indicator dilution method for a clinical situation, we've performed in-vivo experiments with live piglets. In this experiment, the CO of the piglets was controlled by applying a hemorrhagic shock method [19], and the commercially available transpulmonary thermo-dilution device named PiCCO TM was used for CO references [20]. In order to measure composite PA indicator dilution curves, a PA sensing system was prototyped by using two 905 nm pulsed laser diodes (OSI Laser Diode Inc.: CVN 5S63) and a 3.5 MHz flat ultrasound transducer (Blatek, 3.5MHz, −6dB bandwidth 82%).…”

Section: Experimental Results With Discussionmentioning

confidence: 99%

Noninvasive photoacoustic measurement of the composite indicator dilution curve for cardiac output estimation

Kang

Huang²,

Li³

2015

Biomed. Opt. Express

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Abstract:Recently, the measurement of indicator dilution curves using a photoacoustic (PA) technology was reported, which showed promising results on the noninvasive estimation of cardiac output (CO) that is an important hemodynamic parameter useful in various clinical situations. However, in clinical practice, measuring PA indicator dilution curves from an arterial blood vessel requires an ultrasound transducer array capable of focusing on the targeted artery. This causes several challenges on the clinical translation of the PA indicator dilution method, such as high sensor cost and complexity. In this paper, we theoretically derived that a composite PA indicator dilution curve simultaneously measured from both arterial and venous blood vessels can be used to estimate CO correctly. The ex-vivo and in-vivo experimental results with a flat ultrasound transducer verified the developed theory. We believe this new concept would overcome the main challenges on the clinical translation of the noninvasive PA indicator dilution technology.

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“…CO Fick was determined by simultaneous arterial and mixed venous blood gas measurements and calculations of CO 2 content (ml dl À1 ) in whole blood 12 and CO 2 elimination (VCO 2 , ml min À1 ) recorded with the ventilator. 13 CO Fick was then determined as described in Eq. 2.…”

Section: Co Fickmentioning

confidence: 99%

Capnodynamic determination of cardiac output in hypoxia-induced pulmonary hypertension in pigs

Karlsson

Wallin

Hallbäck

et al. 2019

British Journal of Anaesthesia

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Background: Effective pulmonary blood flow (CO EPBF) has recently been validated for its ability to measure cardiac output (CO) in children and animals. This study compared CO EPBF with the Fick method (CO Fick) and CO measurements using an invasive pulmonary artery flow probe (CO TS). The aim of the study was to validate CO EPBF against these reference methods in a porcine model of hypoxia-induced selective pulmonary hypertension. Methods: Ten anaesthetised mechanically ventilated piglets (median weight 23.9 kg) were exposed to a hypoxic gas mixture inducing selective pulmonary hypertension. Pulmonary hypertension was subsequently reversed with inhaled nitric oxide. Simultaneous recordings of CO EPBF , CO Fick , and CO TS were performed throughout the protocol and examined for agreement and trending ability. Results: Overall bias (Bland-Altman) between CO EPBF and CO TS was 0.2 L min À1 (limits of agreement À0.5 and þ0.9 L min À1) with a mean percentage error of 25%. Overall bias between CO EPBF and CO Fick was À0.1 L min À1 (limits of agreement À0.9 and þ0.6 L min À1) and a mean percentage error of 25%. The concordance rate was 86% for CO EPBF when compared with CO TS using a 10% exclusion zone. Conclusions: Estimation of CO with CO EPBF results in values very close to the gold standard reference methods CO Fick and CO TS. CO EPBF appears to be an accurate tool for monitoring absolute values and changes in CO during hypoxia-induced pulmonary hypertension and inhaled nitric oxide treatment.

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Cardiac Output Measurement Using a Modified Carbon Dioxide Fick Method: A Validation Study in Ventilated Lambs

Cited by 14 publications

References 34 publications

Cardiac Output Measurement in Ventilated Lambs with a Significant Left-to-Right Shunt Using the Modified Carbon Dioxide Fick Method

Cardiac Output Measurement in Ventilated Lambs with a Significant Left-to-Right Shunt Using the Modified Carbon Dioxide Fick Method

Noninvasive photoacoustic measurement of the composite indicator dilution curve for cardiac output estimation

Capnodynamic determination of cardiac output in hypoxia-induced pulmonary hypertension in pigs

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