Cardiac output – pulse contour analysis vs. pulmonary artery thermodilution

Abstract

Background: The aims of this study were to determine the agreement between pulmonary artery thermodilution (PA-TD), transpulmonary thermodilution (TP-TD) and the pulse contour method, and to test the ability of the pulse contour method to track changes in cardiac output. Methods: Cardiac output was determined twice before cardiac surgery with both PA-TD and TP-TD. The precision (two standard deviations of the difference between repeated measurements) and agreement of the two methods were calculated. Post-operatively, cardiac output was determined with the PA-TD and pulse contour methods, and the bias and limits of agreement were again calculated. Finally, in patients with heart rates below 60 beats/min or a cardiac index of less than 2.5 l/min/m

Accuracy of cardiac output measurements with pulse contour analysis (PulseCOTM) and Doppler echocardiography during off-pump coronary artery bypass grafting

“…PCA analysis from a peripheral arterial pressure signal is traditionally considered less accurate because curve damping and wave reflection can induce important errors. Nevertheless, data from the present study compare well to published data on accuracy with the PiCCO system and suggest that the PulseCo algorithm may be relatively insensitive to such artifacts [7,17,18]. We need to emphasize that our results were obtained in patients undergoing OPCAB surgery, a peculiar type of cardiac surgery for which extracorporeal circulation is not used.…”

“…The clinical value of a CO monitoring system also depends on its ability to monitor trends and to correctly quantify changes in CO. Only few studies have addressed this issue [18,[22][23][24]. We administered low-dose dobutamine to a small number of patients after complete revascularization.…”

Precision of transpulmonary thermodilution: how many measurements are necessary?

“…It has been shown that a threemeasurement set gives good reproducibility for cardiac output in different patients using the double-indicator dilution technique [4,16]. However, there is no unambiguous agreement on the minimum injection number in the measurement of cardiac output by pulmonary artery catheter [3,17] despite this technique being held as a 'clinical gold standard' in several ICUs.…”

Emerging trends in minimally invasive haemodynamic monitoring and optimization of fluid therapy

“…Numerous studies have examined the correlation between APWA-derived and PAC-derived CO measurements in cardiac surgical patients, both intra-operatively [32,41,52,53] and postoperatively [54][55][56][57][58]. In a series of 24 postoperative cardiac surgical patients, Goedje et al…”