Abstract
Purpose
To investigate the reliability of cardiac output assessed by arterial pressure waveform (PulseCO™) in comparison with bolus thermodilution measurements in patients undergoing off-pump coronary artery bypass grafting (OPCAB).
Methods
23 patients who underwent OPCAB were enrolled in this study. After premedication with oral diazepam 10 mg, anesthesia was induced with midazolam, fentanyl and vecuronium. After induction, radial artery and pulmonary artery catheters were inserted. Cardiac output was measured simultaneously by the PulseCO™ and the bolus thermodilution method using the Vigilance™ monitor: 1) after sternotomy, 2) after opening the mediastinum, and 3) at the end of surgery. The PulseCO™ was calibrated initially with cardiac output determined by the thermodilution method after induction of anesthesia.
Results
The correlation coefficients between the two techniques at the three measurement periods were: 1) R2 = 0.49, 2) R2 = 0.52, 3) R2 = 0.55. The limits of agreement (bias ± 2 SD of bias) were: 1) 0.71 ± 2.66, 2) 0.30 ± 1.97, 3) 0.76 ± 3.85 L·min-1. Conclusions: Cardiac output by PulseCO™ is not interchangeable with cardiac output measured by thermodilution in patients undergoing OPCAB.
Résumé
Objectif
Vérifier la fiabilité de l’évaluation du débit cardiaque par ondes de tension artérielle (PulseCO™) comparées à la thermodilution de bolus chez des patients devant subir un pontage aortocoronarien à coeur battant (PACCB).
Méthode
L’étude a porté sur 23 patients devant subir un PACCB. Une prémédication orale de 10 mg de diazépam a été administrée, puis l’anesthésie a été induite avec du midazolam, du fentanyl et du vécuronium. Après l’induction, des cathéters ont été insérés dans les artères radiale et pulmonaire. Le débit cardiaque a été mesuré simultanément par PulseCO™ et par la méthode de thermodilution de bolus en utilisant le moniteur Vigilance™ : 1) après la sternotomie 2) après l’ouverture du médiastin et 3) à la fin de l’opération. Le PulseCO™ a été calibré au départ avec le débit cardiaque mesuré par la thermodilution après l’induction de l’anesthésie.
Résultats
Les coefficients de corrélation entre les deux techniques et à trois périodes de mesures différentes ont été : 1) R2 = 0,49 2) R2 = 0,52 3) R2 = 0,55. Les limites de concordance (biais ± 2 écarts types de biais) ont été : 1) 0,71 ± 2,66, 2) 0,30 ± 1,97, 3) 0,76 ± 3,85 L·min-1.
Conclusion
La mesure du débit cardiaque avec le PulseCO™ n’est pas interchangeable avec la mesure réalisée par thermodilution chez des patients devant subir un PACCB.
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Yamashita, K., Nishiyama, T., Yokoyama, T. et al. Cardiothoracic Anesthesia, Respiration and Airway Cardiac output by PulseCO™ is not interchangeable with thermodilution in patients undergoing OPCAB. Can J Anesth 52, 530–534 (2005). https://doi.org/10.1007/BF03016534
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DOI: https://doi.org/10.1007/BF03016534