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Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique

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Abstract

Objective

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).

Design

Prospective, single-center evaluation.

Setting

University Hospital Intensive Care Unit.

Patients

Patients (n = 23) receiving liver transplantation.

Intervention

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.

Conclusion

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.

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Acknowledgements

We thank Dr. L. Scudeller (MD, Clinic of Infectious Diseases, University of Udine), who performed the statistical analysis.

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Authors and Affiliations

  1. Clinica di Anestesia e Rianimazione, Azienda Ospedaliero Universitaria di Udine, P.le S.M. della Misericordia 15, 33100, Udine, Italy

    Maria Gabriella Costa, Giorgio Della Rocca, Paolo Chiarandini, Silvia Mattelig, Livia Pompei & Maurizio Cecconi

  2. Department of Surgery-Transplant Unit, University of Udine, Udine, Italy

    Mauricio Sainz Barriga

  3. Department of Anesthesia and Intensive Care Medicine, University of Rome “La Sapienza”, Rome, Italy

    Paolo Pietropaoli

  4. St George’s University of London, London, UK

    Toby Reynolds

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  1. Maria Gabriella Costa
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  2. Giorgio Della Rocca
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  4. Silvia Mattelig
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  8. Maurizio Cecconi
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  9. Paolo Pietropaoli
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Correspondence to Maria Gabriella Costa.

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Descriptor: 34 Cardiovascular Monitoring

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Costa, M.G., Della Rocca, G., Chiarandini, P. et al. Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique. Intensive Care Med 34, 257–263 (2008). https://doi.org/10.1007/s00134-007-0878-6

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  • DOI: https://doi.org/10.1007/s00134-007-0878-6

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