Intensive Care Medicine

, Volume 28, Issue 10, pp 1470–1474

Evaluation of a noninvasive method for cardiac output measurement in critical care patients

  • Gastón E. Murias
  • Ana Villagrá
  • Sara Vatua
  • Maria del Mar Fernandez
  • Héctor Solar
  • Ana Ochagavía
  • Rafael Fernández
  • Josefina Aguilar
  • Pablo V. Romero
  • Lluis Blanch
Original

DOI: 10.1007/s00134-002-1477-1

Cite this article as:
Murias, G.E., Villagrá, A., Vatua, S. et al. Intensive Care Med (2002) 28: 1470. doi:10.1007/s00134-002-1477-1

Abstract

Objective. Thermodilution (TD) is the gold standard to monitor cardiac output (CO) in critical care. However, there is concern about the safety of right-ventricular catheterization. The CO2 rebreathing technique allows noninvasive CO determination by means of the indirect Fick principle. Our objectives were: (a) to assess the accuracy of a new system of CO measurement using the CO2 partial rebreathing method (PRCO); (b) to evaluate whether the PRCO itself may induce changes in CO.

Design and setting. Prospective study in the intensive care department in a university-affiliated hospital.

Patients. Twenty-two mechanically ventilated critically ill patients.

Interventions. CO measured simultaneously by PRCO and TDCO.

Measurements and results. PRCO and TDCO values were compared by concordance analysis. Stability of cardiac output during PRCO was evaluated by comparing the TDCO measurements before, during, and after the partial rebreathing period using analysis of variance. From a total of 79 valid sets of measurements, bias and precision was calculated at –0.18±1.39 l/min. The concordance analysis of lower and intermediate CO values (<7 l/min) yielded a bias and precision calculation of –0.07±0.91 l/min. No changes in hemodynamics were observed during the partial rebreathing period.

Conclusions. The noninvasive partial CO2 rebreathing technique may be an alternative method for CO determination in mechanically ventilated critically ill patients. The rebreathing maneuver alone does not induce changes in CO.

Cardiac output Carbon dioxide rebreathing Thermodilution Monitoring Hemodynamics Critical care 

Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Gastón E. Murias
    • 1
  • Ana Villagrá
    • 2
  • Sara Vatua
    • 2
  • Maria del Mar Fernandez
    • 2
  • Héctor Solar
    • 1
  • Ana Ochagavía
    • 2
  • Rafael Fernández
    • 2
  • Josefina Aguilar
    • 2
  • Pablo V. Romero
    • 3
  • Lluis Blanch
    • 2
  1. 1.Critical Care Center, Hospital San Martín, La Plata, Argentina
  2. 2.Critical Care Center, Hospital de Sabadell, Corporacio Parc Tauli, Parc Taulí s/n, 08208 Sabadell, Spain
  3. 3.Respiratory Department, Hospital de Bellvitge, Barcelona, Spain