Noninvasive Cardiac Output Measurement Using Partial Carbon Dioxide Rebreathing Is Less Accurate at Settings of Reduced Minute Ventilation and when Spontaneous Breathing Is Present

Tachibana, Kunihide; Imanaka, Hideaki; Takeuchi, Muneyuki; Takauchi, Yuji; Miyano, Hiroshi; Nishimura, Masaji

doi:10.1097/00000542-200304000-00007

Cited by 62 publications

(33 citation statements)

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“…While some investigators found close agreement with thermodilution [13, 28], others could not confirm these data [10, 14, 29]. Tachibana et al [11] found only poor agreement in spontaneously breathing patients and proposed to restrict this technique to mechanically ventilated patients. …”

Section: Discussionmentioning

confidence: 99%

“…Until recently, only a partial CO 2 rebreathing system, whose reliability and accuracy are controversial even under stable hemodynamic and respiratory conditions, was commercially available [10]. Changes in the ventilatory setting [11, 12] and high intrapulmonary shunt fractions [13, 14] impacted on the accuracy of the measurements as well. Overall, the value of partial CO 2 rebreathing seems to be at least limited under various clinical conditions [13].…”

Section: Introductionmentioning

confidence: 99%

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Noninvasive Determination of Cardiac Output by the Inert-Gas-Rebreathing Method – Comparison with Cardiovascular Magnetic Resonance Imaging

Saur¹,

Fluechter²,

Trinkmann³

et al. 2009

Cardiology

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Background: An easy, noninvasive and accurate technique for measuring cardiac output (CO) would be desirable for the diagnosis and therapy of cardiac diseases. Innocor, a novel inert-gas-rebreathing (IGR) system, has shown promising results in smaller studies. An extensive evaluation in a larger, less homogeneous patient collective is lacking. Methods: We prospectively assessed the accuracy and reproducibility of CO measurements obtained by IGR in 305 consecutive patients as compared to the noninvasive gold standard, cardiovascular magnetic resonance (CMR) imaging. Results: Bland-Altman analysis showed a good correspondence of the two methods for CO measurement with an average deviation of 0.2 ± 1.0 liters/min (mean ± SD) and a good reproducibility with a mean bias of 0.2 ± 0.5 liters/min. The accuracy of the present measurements at rest was significantly better in the physiological range than in higher or lower CO ranges. The error levels set forth by current recommendations were exceeded. Conclusion: The data show that IGR measurements are easy to perform and show good agreement with CMR; however, the technique appears to be less accurate in extreme CO ranges at rest. The clinical importance of the IGR method remains to be proven by further studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Noninvasive Determination of Cardiac Output by the Inert-Gas-Rebreathing Method – Comparison with Cardiovascular Magnetic Resonance Imaging

Saur¹,

Fluechter²,

Trinkmann³

et al. 2009

Cardiology

View full text Add to dashboard Cite

show abstract

“…Th ere are several limitations to this device including the need for intubation and mechanical ventilation with fi xed ventilator settings and minimal gas exchange abnor malities [27]. Variations in ventilator settings, mechanicallyassisted spontaneous breathing, the presence of increased pulmonary shunt fraction, and hemodynamic instability have been associated with decreased accuracy [28]. Th us, this technique may be applied in a precisely defi ned clinical setting to mechanically ventilated patients only.…”

Section: Applied Fick Principlementioning

confidence: 99%

Cardiac Output Monitoring: An Integrative Perspective

Alhashemi¹,

Cecconi²,

Hofer³

2011

Annual Update in Intensive Care and Emergency Medicine 2011

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“…There are several limitations to this device, including the need for intubation and mechanical ventilation with fixed ventilator settings and minimal gas exchange abnormalities [30]. Variations in ventilator settings, mechanically assisted spontaneous breathing, the presence of increased pulmonary shunt fraction, and hemodynamic instability have been associated with decreased precision of the device [31,32]. In addition, validation studies have shown poor agreement between the NICO device and PAC [33,34].…”

Section: Applied Fick's Principlementioning

confidence: 99%

Minimally Invasive Monitoring of Cardiac Output in the Cardiac Surgery Intensive Care Unit

Alhashemi

Cecconi

Rocca

et al. 2010

Curr Heart Fail Rep

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Cardiac output monitoring in the cardiac surgery patient is standard practice that is traditionally performed using the pulmonary artery catheter. However, over the past 20 years, the value of pulmonary artery catheters has been challenged, with some authors suggesting that its use might be not only unnecessary but also harmful. New minimally invasive devices that measure cardiac output have become available. In this paper, we review their operative principles, limitations, and utility in an integrated approach that could potentially change patients' outcome. However, it is now clear that it is how the monitor is used (ie, the protocol or therapy associated with its use, or its lack thereof), and not the monitor per se, that should be questioned when a patient's outcome is being evaluated.

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Noninvasive Cardiac Output Measurement Using Partial Carbon Dioxide Rebreathing Is Less Accurate at Settings of Reduced Minute Ventilation and when Spontaneous Breathing Is Present

Cited by 62 publications

References 0 publications

Noninvasive Determination of Cardiac Output by the Inert-Gas-Rebreathing Method – Comparison with Cardiovascular Magnetic Resonance Imaging

Noninvasive Determination of Cardiac Output by the Inert-Gas-Rebreathing Method – Comparison with Cardiovascular Magnetic Resonance Imaging

Cardiac Output Monitoring: An Integrative Perspective

Minimally Invasive Monitoring of Cardiac Output in the Cardiac Surgery Intensive Care Unit

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