Thermodilution cardiac output: A critical analysis and review of the literature

Levett, James M.; Replogle, Robert L.

doi:10.1016/0022-4804(79)90159-8

Cited by 229 publications

(83 citation statements)

References 39 publications

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“…52 This can be attained by injecting into the right atrium and detection in the PA. 52 The change in temperature of blood in the PA causes a change in the thermistor (Wheatstone bridge) resistance which allows calculation of the area under the thermodilution curve (Figure 1). 48,49,53,54 Cardiac output (CO) is determined from the following equation: f7 CO = Vi (TB -TI)KIK2/ ~TB(t)dt where V~ is injectate volume; TB is blood temperature; T l injectate temperature; K t is a density factor which is defined as the specific heat multiplied by the specific gravity of the injectate divided by the product of the specific heat and gravity of blood; K2 is a compuation constant taking into account the catheter dead space, the heat exchange in transit, and injection rate. The denominator of the equation (the change of blood temperature as a function of time) corresponds to the area under the thermodilution curve.…”

Section: Principle Of Measurementmentioning

confidence: 99%

“…48,49 The injection of a known amount of a cold solution as an indicator into the right atrium through the proximal port of a PA catheter is detected distally by a thermistor located 4 cm from the end of the PA catheter. Although there is some controversy regarding the extravascular distribution of thermal indicator in the pulmonary vascular bed, s~ the distance between injection and detection site should be as short as possible to reduce indicator loss due to radial heat exchange.…”

Section: Principle Of Measurementmentioning

confidence: 99%

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Errors in the measurement of cardiac output by thermodilution

1993

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Section: Principle Of Measurementmentioning

confidence: 99%

Section: Principle Of Measurementmentioning

confidence: 99%

Errors in the measurement of cardiac output by thermodilution

1993

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“…and accepted as correct if the shape of the curve fulfilled the criteria of Levett and Replogle [12] and if the injectate temperature was <10°C.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of Continuous Central Venous Oxygen Saturation Monitoring in Patients Undergoing Cardiac Surgery

Baulig

Dullenkopf

Kobler

et al. 2008

J Clin Monit Comput

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“…Injections were distributed randomly throughout the respiratory cycle. Thermodilution curves were displayed on a recorder and accepted as correct if the shape of the curve fulfilled the criteria of Levett and Replogle and if the injectate temperature was < 10°C [19]. Between three and five thermodilution cardiac output measurements were carried out for every patient, and the mean cardiac output value was used for comparison.…”

Section: Methodsmentioning

confidence: 99%

Cardiac output measurement by pulse dye densitometry in cardiac surgery

Baulig¹,

Bernhard²,

Béttex³

et al. 2005

Anaesthesia

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SummaryThe aim of this study was to compare the accuracy of pulse dye densitometry with that of bolus thermodilution cardiac output measurement in patients before and after elective coronary artery bypass grafting. Twenty-eight patients were studied. Agreement between mean thermodilution and pulse dye densitometry cardiac output values was assessed by Bland-Altman analysis. [2.0-7.2] l.min )1 for pulse dye densitometry using indocyanine green 20 mg. Mean bias was + 0.566 l.min )1 , the limits of agreement were ± 2.51 l.min )1 and mean error was 60.9%. Postoperative cardiac output data were not analysed because pulse dye densitometry signals were low or absent in > 50% of the patients. We conclude that pulse dye densitometry using indocyanine green 5 mg or 20 mg is inaccurate in anaesthetised patients before coronary artery bypass surgery and cannot be used after surgery because of a high incidence of low pulse dye densitometry signal amplitudes. Pulse dye densitometry is based on the principle of indocyanine green dye dilution, whereby indocyanine green is injected through a central [7] or peripheral [8] venous line and the changes in dye concentration over time are detected by pulse spectrophotometry using a finger probe [7,9] or a nose probe [10,11]. Only a few investigators [7,[12][13][14] have compared pulse dye densitometry with standard methods of cardiac output determination, and the accuracy of pulse dye densitometry is therefore in dispute.Our primary aim was to validate pulse dye densitometry in patients before and after elective coronary artery bypass graft surgery (CABG). Our secondary aim was to investigate whether different concentrations of indocyanine green would affect the accuracy of pulse dye densitometry. The accuracy of cardiac output determination by pulmonary thermodilution has been assessed and confirmed at our institution [15]. MethodsWith the approval of the Local Research Ethics Committee and written, informed consent, 28 patients who were scheduled for elective CABG were enrolled in the study. Exclusion criteria comprised: allergy to iodine, presence of an aortic counterpulsation device, severe renal disease or liver dysfunction and intake of drugs with a Anaesthesia, 2005, 60, pages 968-973

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Thermodilution cardiac output: A critical analysis and review of the literature

Cited by 229 publications

References 39 publications

Errors in the measurement of cardiac output by thermodilution

Errors in the measurement of cardiac output by thermodilution

Accuracy of Continuous Central Venous Oxygen Saturation Monitoring in Patients Undergoing Cardiac Surgery

Cardiac output measurement by pulse dye densitometry in cardiac surgery

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