Cardiothoracic Anesthesia, Respiration and Airway Cardiac output by PulseCO™ is not interchangeable with thermodilution in patients undergoing OPCAB

Abstract

P Pu ur rp po os se e: : To investigate the reliability of cardiac output assessed by arterial pressure waveform (PulseCO™) in comparison with bolus thermodilution measurements in patients undergoing off-pump coronary artery bypass grafting (OPCAB).M Me et th ho od ds s: : 23 patients who underwent OPCAB were enrolled in this study. After premedication with oral diazepam 10 mg, anesthesia was induced with midazolam, fentanyl and vecuronium. After induction, radial artery and pulmonary artery catheters were inserted. Cardiac output was measured simultaneously by the PulseCO™ and the bolus thermodilution method using the Vigilance™ monitor: 1) after sternotomy, 2) after opening the mediastinum, and 3) at the end of surgery. The PulseCO™ was calibrated initially with cardiac output determined by the thermodilution method after induction of anesthesia.

The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery: findings in six cases

“…[14][15][16][17] The readings obtained when lithium calibration has not been performed merely serve to identify hemodynamic trends. When calibration by lithium dilution is not performed (in our practice we do not usually calibrate the system with lithium), estimation of the stroke volume (and hence CO) requires knowledge of the static compliance curve of the aorta, which the PulseCO system estimates based on the patient's age, height and weight.…”

Like methylene blue, indigo carmine might counteract vasoplegia: hemodynamic evidence obtained with pulse contour analysis

“…It is true that PulseCO pulse contour analysis, performed without lithium calibration, gives only trends in hemodynamic values, and it is also true that the method is imperfect during periods of hemodynamic instability [9]. Nevertheless, the technique is valuable for detecting rapid and possibly significant changes such as those shown in this example.…”

FloTrac for monitoring arterial pressure and cardiac output during phaeochromocytoma surgery

“…The use of the PAC has been increasingly criticized because it is an invasive technique and because of its unclear risk-benefit ratio [1][2][3]. Several haemodynamic devices have been developed using calculation of CI based on peripheral arterial pressure waveform analysis [4,5]. These devices need to be initially calibrated by either transpulmonary thermodilution or pulmonary artery thermodilution to correct for arterial compliance in the calculation.…”