Abstract
The purpose of the study was to compare cardiac output (CO) measurement by continuous (CTD) with that by conventional thermodilution (TD) in critically ill patients. In 19 of 20 critically ill patients requiring a pulmonary artery catheterism, 105 paired CO measurements were performed by both CTD and TD. Regression analysis showed that: CTD CO = 1.18 TD CO − 0.47. Correlation coefficient was 0.96. Bias and limit of agreement were — 0.8 and 2.4 L · min−1, respectively. When a Bland and Altman diagram was constructed according to cardiac index ranges, biases were −0.2 and −0.3 and −0.8 L · min−1 · m−2 and limits of agreement were 0.3, 0.7 and 1.6 L · min−1 · m−2 for low (<2.5 L · min−1 · m−2), normal (between 2.5 and 4.5 L · min−1 · m−2) and high (> 4.5 L · min−1 · m−2) cardiac indexes, respectively. It is concluded that CTD, compared with TD, is a reliable method of measuring CO, especially when cardiac index is ≤4.5 L · min−1 · m−2.
Résumé
Cette étude avait pour but de comparer les mesures du débit cardiaque réalisées par thermodilution continue (CTD) par rapport à la thermodilution classique (TD) chez des patients de réanimation. Cent cinq paires de mesures du débit cardiaque ont été comparées chez 19 des 20 patients de réanimation inclus dans l’étude. L’équation de la droite de régression est CTD CO = 1,18 TD CO − 0,47. Le coefficient de corrélation s’élève à 0,96. L’erreur moyenne et l’intervalle de confiance sont respectivement de −0,8 et 2,4 L · min−1. En réalisant un diagramme de Bland and Altman selon le niveau d’index cardiaque, les erreurs moyennes s’élèvent à −0,2, −0,3 et −0,8 L · min−1 · m−2 et les intervalles de confiance à 0,3, 0,7 et 1,6 L · min−1 · m−2, respectivement pour les index cardiaques bas (<2,5 L · min−1 · m−2), normaux (entre 2,5 et 4,5 L · min−1 · m−2) et hauts (> 4,5 L · min−1 · m−2). La thermodilution continue, comparée à la thermodilution classique, est une méthode fiable pour le monitorage du débit cardiaque surtout pour les index cardiaque ≤4,5 L · min−1 · m−2.
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Lefrant, JY., Bruelle, P., Ripart, J. et al. Cardiac output measurement in critically ill patients: comparison of continuous and conventional thermodilution techniques. Can J Anaesth 42, 972–976 (1995). https://doi.org/10.1007/BF03011067
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DOI: https://doi.org/10.1007/BF03011067