Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique
This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous cardiac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a pulmonary artery catheter (COPAC).
Prospective, single-center evaluation.
University Hospital Intensive Care Unit.
Patients (n = 23) receiving liver transplantation.
Pulmonary artery catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system.
Measurements and main results
Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11 lmin–1 and –1.84 to + 2.05 lmin–1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29 lmin–1 and –1.87 to + 2.46 lmin–1 (r = 0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for COPAC vs. COLi and 15.1% for COPAC vs. PulseCOLi for data pairs less than 8 lmin–1, and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin–1.
In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent pulmonary artery thermodilution.
KeywordsContinuous cardiac output Lithium dilution technique Pulmonary artery catheter Pulse waveform analysis
- 10.Band DM, Linton RAF, O'Brien TK, Jonas MM, Linton NW (1997) The shape of indicator dilution curves for cardiac output measurement in man. J Physiol (Lond) 498:225–229Google Scholar
- 13.Linton RA, Young LE, Marlin DJ, Blissitt KJ, Brearley JC, Jonas MM, O'Brien TK, Linton NW, Band DM, Hollingworth C, Jones RS (2000) Cardiac output measured by lithium dilution, thermodilution and transesophageal Doppler echocardiography in anesthetized horses. Am J Vet Res 61:731–737PubMedCrossRefGoogle Scholar
- 20.Rhodes A, Sunderland R (2005) Arterial pulse power analysis: the LiDCO™ Plus System. Functional hemodynamic monitoring. In: Pinsky M, Payen D (eds) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 183–192Google Scholar
- 26.Soni N (1996) Swan song for the Swan-Ganz catheter? The use of pulmonary artery catheter probably needs re-evaluation, but they should not be banned. BMJ 313:173–174Google Scholar
- 28.Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D, Brampton W, Williams D, Young D, Rowan K (2005) Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 366:472–477PubMedCrossRefGoogle Scholar