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Accuracy of a Novel Approach to Measuring Arterial Thermodilution Cardiac Output During Intra-Aortic Counterpulsation

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Abstract

Objective

To assess the agreement between a novel approach of arterial and the pulmonary artery bolus thermodilution for measuring cardiac output in critically ill patients during aortic counterpulsation.

Methods

Eighteen male patients aged 37–80 years, undergoing preoperative insertion of an intra-aortic balloon pump (IABP) and elective coronary artery bypass grafting. A thin 1.3FG thermistor was introduced through the pressure lumen to the tip of an 8FG IABP catheter, and the pump rate was set at 1:1. After arrival in the intensive care unit cardiac output (CO) was measured under haemodynamic steady-state conditions hourly for 8–11 h, and arterial bolus thermodilution (BCOiabp) and pulmonary artery bolus thermodilution (BCOpulm) were determined after the patients’ admission to the intensive care unit.

Results

A total of 198 data pairs were obtained: 177 with aortic counterpulsation and 21 without. During aortic counterpulsation, median CO was 6.8 l/min for BCOiabp and 6.1 l/min for BCOpulm, without aortic counterpulsation; corresponding values were 7.1 l/min for BCOiabp and 6.5 l/min for BCOpulm with aortic counterpulsation. Mean bias was +0.77 l/min, limits of agreement ( ± 2 SD) were –1.27/+2.81 l/min, and mean error (2 SD/[(BCOiabp + BCOpulm)/2] was 31.4%. Without aortic counterpulsation, corresponding values were +0.43 l/min, –1.03/+1.87 l/min, and 22.4%.

Conclusions

Agreement between BCOiabp and BCOpulm was satisfactory for CO values between 2.0 and 10 l/min only without aortic counterpulsation. BCOiabp CO measurements during aortic counterpulsation after coronary artery bypass grafting cannot be recommended at the present time.

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Acknowledgements

There were no financial or non-financial competing interests in the accomplishment of this study.

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Authors and Affiliations

  1. Division of Cardiac Anaesthesia, University Hospital of Zurich, Raemistrasse 100, Zurich, 8091, Switzerland

    Werner Baulig MD & Edith R. Schmid MD

  2. Department of Anaesthesia, Klinik im Park, Seestrasse 220, Zurich, 8027, Switzerland

    Philipp Schuett MD

  3. Pulsion Medical Systems AG, Stahlgruberring 28, München, 81829, Germany

    Oliver Goedje MD

Authors
  1. Werner Baulig MD
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  2. Philipp Schuett MD
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  3. Oliver Goedje MD
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  4. Edith R. Schmid MD
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Corresponding author

Correspondence to Werner Baulig MD.

Additional information

Baulig W, Schuett P, Goedje O, Schmid ER. Accuracy of a novel approach to measuring arterial thermodilution cardiac output during intra-aortic counterpulsation

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Baulig, W., Schuett, P., Goedje, O. et al. Accuracy of a Novel Approach to Measuring Arterial Thermodilution Cardiac Output During Intra-Aortic Counterpulsation. J Clin Monit Comput 21, 147–153 (2007). https://doi.org/10.1007/s10877-007-9068-x

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  • DOI: https://doi.org/10.1007/s10877-007-9068-x

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