open access

Vol 44, No 4 (2012 Oct-Dec)
Original and clinical articles
Published online: 2013-01-04
Submitted: 2013-01-07
Accepted: 2013-01-07
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Assessment of three minimally invasive continuous cardiac output measurement methods in critically ill patients and a review of the literature

Pieter-Jan Palmers, Wesley Vidts, Koen Ameloot, Colin Cordemans, Niels Van Regenmortel, Inneke De Laet, Karen Schoonheydt, Hilde Dits, Volker Eichhorn, Daniel Reuter, Manu LNG Malbrain
Anaesthesiol Intensive Ther 2012;44(4):213-224.

open access

Vol 44, No 4 (2012 Oct-Dec)
Original and clinical articles
Published online: 2013-01-04
Submitted: 2013-01-07
Accepted: 2013-01-07

Abstract

BACKGROUND: In this study we compared the accuracy of three continuous cardiac output (CCO) measurement methods, with intermittent transcardiopulmonary thermodilution (TPTD-CO) as the gold standard. The three studied CCO measurement methods were: uncalibrated peripheral pulse contour measurement (FCCO), calibrated central pulse contour measurement (PCCO), and CCO obtained by indirect Fick principle (NCCO).

METHODS: We performed an observational study in 23 critically ill patients. Statistical analysis was done using Pearson’s correlation and Bland-Altman analysis. A review of the relevant medical literature was performed.

RESULTS: Only PCCO showed good correlation (R = 0.9) and agreement with a bias of 0.0 ± 0.8 L min-1 and percentage error of 24.5% when compared to TPTD-CO. In patients with normal systemic vascular resistance index (SVRI > 1,700 dyne sec cm-5 m-2), NCCO (R = 0.8 and bias 0.4 ± 1.3 L min-1) and FCCO (R = 0.8 and bias 0.1 ± 1 L min-1) also produced reliable results.

CONCLUSIONS: These results indicate that in our patient population, CCO can be most reliably monitored by calibrated central pulse contour measurements. All other methods appeared less accurate, especially in situations of low SVRI.

Abstract

BACKGROUND: In this study we compared the accuracy of three continuous cardiac output (CCO) measurement methods, with intermittent transcardiopulmonary thermodilution (TPTD-CO) as the gold standard. The three studied CCO measurement methods were: uncalibrated peripheral pulse contour measurement (FCCO), calibrated central pulse contour measurement (PCCO), and CCO obtained by indirect Fick principle (NCCO).

METHODS: We performed an observational study in 23 critically ill patients. Statistical analysis was done using Pearson’s correlation and Bland-Altman analysis. A review of the relevant medical literature was performed.

RESULTS: Only PCCO showed good correlation (R = 0.9) and agreement with a bias of 0.0 ± 0.8 L min-1 and percentage error of 24.5% when compared to TPTD-CO. In patients with normal systemic vascular resistance index (SVRI > 1,700 dyne sec cm-5 m-2), NCCO (R = 0.8 and bias 0.4 ± 1.3 L min-1) and FCCO (R = 0.8 and bias 0.1 ± 1 L min-1) also produced reliable results.

CONCLUSIONS: These results indicate that in our patient population, CCO can be most reliably monitored by calibrated central pulse contour measurements. All other methods appeared less accurate, especially in situations of low SVRI.

Get Citation

Keywords

haemodynamic monitoring; cardiac output; pulse contour; thermodilution

About this article
Title

Assessment of three minimally invasive continuous cardiac output measurement methods in critically ill patients and a review of the literature

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 44, No 4 (2012 Oct-Dec)

Pages

213-224

Published online

2013-01-04

Bibliographic record

Anaesthesiol Intensive Ther 2012;44(4):213-224.

Keywords

haemodynamic monitoring
cardiac output
pulse contour
thermodilution

Authors

Pieter-Jan Palmers
Wesley Vidts
Koen Ameloot
Colin Cordemans
Niels Van Regenmortel
Inneke De Laet
Karen Schoonheydt
Hilde Dits
Volker Eichhorn
Daniel Reuter
Manu LNG Malbrain

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