open access

Vol 15, No 1 (2008)
Original articles
Published online: 2007-12-17
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The reliability of noninvasive cardiac output measurement using the inert gas rebreathing method in patients with advanced heart failure

Piotr Sobański, Władysław Sinkiewicz, Jacek Kubica, Jan Błażejewski, Robert Bujak
Cardiol J 2008;15(1):63-70.

open access

Vol 15, No 1 (2008)
Original articles
Published online: 2007-12-17

Abstract

Background: Impaired cardiac output (CO) is a key element of heart failure (HF). So far, there has been no simple, reliable, inexpensive and non-invasive CO measurement method feasible for clinical practice. Not a single diagnostic test has been elaborated to diagnose and monitor HF. The aim of the study was the evaluation of the reliability of a new, non-invasive CO measurement device utilizing an inert gas rebreathing technique and an infrared photoacoustic gas analyzer, in comparison with standard invasive methods.
Methods: In 21 patients with advanced HF (NYHA classes III and IV) undergoing cardiac catheterization as a routine hemodynamic evaluation before heart transplantation, CO measurements with the tested non-invasive method were carried out during invasive examination.
Results: CO measured by the inert gas rebreathing technique (CORB), according to the statistical Bland-Altman method, was, on average, 0.1 L/min higher than that determined by thermodilution (COTD) and 0.006 L/min higher than the CO determined by the Fick formula (COFick). This magnitude of difference equals 2.8% of COTD and 0.15% of COFick values. The limits of agreement between CORB and COTD were ± 1.4 L/min, and between CORB and COFick ± 1.3 L/min. In the subgroup with atrial fibrillation, the mean difference between tested and reference methods (0.3 ± 1.0 L/min for both COTD and COFick) was higher than in the sinus rhythm subgroup (0.06 ± 1.5 L/min for COTD and 0.08 ± 1.5 for COFick).
Conclusions: CO measurement with the inert gas rebreathing method utilizing an infrared photoacoustic gas analyzer seems reliable enough to be employed in clinical practice. Being non-invasive, it may well be used for repeated determinations in patients with HF. (Cardiol J 2008; 15: 63-70)

Abstract

Background: Impaired cardiac output (CO) is a key element of heart failure (HF). So far, there has been no simple, reliable, inexpensive and non-invasive CO measurement method feasible for clinical practice. Not a single diagnostic test has been elaborated to diagnose and monitor HF. The aim of the study was the evaluation of the reliability of a new, non-invasive CO measurement device utilizing an inert gas rebreathing technique and an infrared photoacoustic gas analyzer, in comparison with standard invasive methods.
Methods: In 21 patients with advanced HF (NYHA classes III and IV) undergoing cardiac catheterization as a routine hemodynamic evaluation before heart transplantation, CO measurements with the tested non-invasive method were carried out during invasive examination.
Results: CO measured by the inert gas rebreathing technique (CORB), according to the statistical Bland-Altman method, was, on average, 0.1 L/min higher than that determined by thermodilution (COTD) and 0.006 L/min higher than the CO determined by the Fick formula (COFick). This magnitude of difference equals 2.8% of COTD and 0.15% of COFick values. The limits of agreement between CORB and COTD were ± 1.4 L/min, and between CORB and COFick ± 1.3 L/min. In the subgroup with atrial fibrillation, the mean difference between tested and reference methods (0.3 ± 1.0 L/min for both COTD and COFick) was higher than in the sinus rhythm subgroup (0.06 ± 1.5 L/min for COTD and 0.08 ± 1.5 for COFick).
Conclusions: CO measurement with the inert gas rebreathing method utilizing an infrared photoacoustic gas analyzer seems reliable enough to be employed in clinical practice. Being non-invasive, it may well be used for repeated determinations in patients with HF. (Cardiol J 2008; 15: 63-70)
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Keywords

chronic heart failure; cardiac output; gas rebreathing

About this article
Title

The reliability of noninvasive cardiac output measurement using the inert gas rebreathing method in patients with advanced heart failure

Journal

Cardiology Journal

Issue

Vol 15, No 1 (2008)

Pages

63-70

Published online

2007-12-17

Bibliographic record

Cardiol J 2008;15(1):63-70.

Keywords

chronic heart failure
cardiac output
gas rebreathing

Authors

Piotr Sobański
Władysław Sinkiewicz
Jacek Kubica
Jan Błażejewski
Robert Bujak

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