Thermodilution versus inert gas rebreathing for estimation of effective pulmonary blood flow

Christensen, Peter; Clemensen, Peter; Andersen, P. K.; Henneberg, Steen Winther

doi:10.1097/00003246-200001000-00008

Cited by 46 publications

(35 citation statements)

References 15 publications

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“…Recent studies have demonstrated that IGR measurements can be easily performed at rest and during exercise and therefore could add important information for optimizing the treatment of various cardiac disorders [17]. The previous results indicate good agreement of the IGR measurements with the clinically well-accepted thermodilution method as well as with Direct Fick calculations in smaller patient collectives [16,18,19,20,21]. However, thermodilution itself suffers from inaccuracies and is limited in clinical practice because of its invasiveness, cost and complexity [22, 23].…”

Section: Introductionmentioning

confidence: 91%

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: Introductionmentioning

confidence: 91%

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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“…Rückatmungsmethoden werden bereits seit langem zur nichtinvasiven Messung des Herzzeitvolumens sowohl bei spontan atmenden [26,29] als auch bei maschinell beatmeten Patienten benutzt [5,24].Ihre Verwendung in der klinischen Routine wurde jedoch bislang vor allem durch die Notwendigkeit einer akkuraten Gaskonzentrationsmessung erschwert.In der Vergangenheit wurde hierfür häufig die Massenspektrometrie herangezogen, die jedoch ein teures und zudem unhandliches Verfahren darstellt,das für den Routineeinsatz am Patientenbett wenig geeignet ist.…”

Section: Diskussionunclassified

“…Inhomogenitäten von Ventilation und Lungenperfusion sowie individuelle Unterschiede des Lungengewebsvolumens oder gar intraindividuelle Än-derungen des Lungengewebevolumens können jedoch zu methodischen Fehlern führen [13]. Von diesen Faktoren scheint insbesondere der Größe des Lungengewebevolumens eine entscheidende Bedeutung für die Messgenauigkeit von Rückatmungsverfahren zuzukommen [5], da das gut lösliche Lachgas nicht nur vom Kapillarblut, sondern auch vom Lungengewebe aufgenommen wird. Eine Über-schätzung des Lungengewebevolumens führt dabei zu einer Überschätzung der effektiven Lungendurchblutung durch die Rückatmungsmethode und umgekehrt.…”

Section: Limitierungen Der Studieunclassified

Nichtinvasive Bestimmung des Herzzeitvolumens bei beatmeten Patienten

et al. 2003

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“…Short measurement cycles may lead to inaccuracies in beat-based methods such as CMR. IGR proved promising in previous investigations [4,5,6,7,8,9,10]. Measurement of CO over a range of consecutive heart beats may provide a realistic representation of the patient’s cardiac function in AF.…”

Section: Introductionmentioning

confidence: 93%

“…AF leads to a decrease in stroke volume and cardiac output (CO) according to Frank and Starling’s law of the heart [3]. The novel inert gas rebreathing (IGR) device (Innocor; Innovision, Odense, Denmark) based on the Fick principle obtained promising results when compared to other invasive [4,5,6,7,8] and non-invasive techniques [9,10,11]. The Fick principle is based on the observation that the total uptake of a substance by the peripheral tissues is equal to the product of blood flow to the peripheral tissues and the arterial-venous concentration difference in the substance.…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Measurement of Cardiac Output during Atrial Fibrillation: Comparison between Cardiac Magnetic Resonance Imaging and Inert Gas Rebreathing

Saur¹,

Doesch²,

Weissmann³

et al. 2010

Cardiology

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Objectives: Atrial fibrillation (AF) is one of the most frequent heart rhythm disorders. It potentially influences cardiac function and its measurement. Cardiac magnetic resonance imaging (CMR) has become the new gold standard for non-invasive assessment of cardiac output (CO). A novel inert gas rebreathing (IGR) device based on the Fick Principle also proved promising in patients in sinus rhythm (SR). The aim of our study was to compare the agreement of non-invasive CO measurements between CMR and IGR in AF patients. Methods: A total of 68 patients, 34 with AF and 34 pair-matched controls in SR, were included. Results: Bland-Altman analysis showed good agreement between both methods, with an average deviation of 0.2 ±1.2 l/min in the AF group versus 0.3 ±1.0 l/min in the SR group (p = 0.77). IGR demonstrated good agreement for CO between 2.0 and 5.4 l/min. However, in hyperdynamic circulatory conditions (CO >5.5 l/min), the increasing disagreement of IGR and CMR measurements reached statistical significance. Conclusions: Non-invasive CO measurements using CMR and IGR are feasible in patients suffering from AF. Good agreement was found between the two methods in an unselected cohort. Hyperdynamic circulatory conditions can lead to significant measurement differences which, however, do not affect the reproducibility of IGR.

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Thermodilution versus inert gas rebreathing for estimation of effective pulmonary blood flow

Cited by 46 publications

References 15 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

Nichtinvasive Bestimmung des Herzzeitvolumens bei beatmeten Patienten

Non-Invasive Measurement of Cardiac Output during Atrial Fibrillation: Comparison between Cardiac Magnetic Resonance Imaging and Inert Gas Rebreathing

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