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Cardiac output assessed by arterial thermodilution during exsanguination and fluid resuscitation: experimental validation against a reference technique

Published online by Cambridge University Press:  16 August 2006

Z. Friedman
Affiliation:
Tel Aviv University, Department of Anaesthesiology and Intensive Care, Israel
H. Berkenstadt
Affiliation:
Tel Aviv University, Department of Anaesthesiology and Intensive Care, Israel
N. Margalit
Affiliation:
Tel Aviv University, Department of Neurosurgery, The Chaim Sheba Medical Center, Affiliated to the Sackler School of Medicine, Tel Hashomer, Israel
E. Segal
Affiliation:
Tel Aviv University, Department of Anaesthesiology and Intensive Care, Israel
A. Perel
Affiliation:
Tel Aviv University, Department of Anaesthesiology and Intensive Care, Israel
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Abstract

Background and objective: The arterial thermodilution technique offers the ability to measure cardiac output using only central venous and arterial catheters. However, the technique has been reported to overestimate cardiac output because of a higher loss of cold indicator due to the increased distance between the sites of injection and measurement. In this study, the two techniques were compared with respect to conditions of low cardiac output in which a longer passage time may further increase loss of indicator.

Methods: Seventeen anaesthetized dogs were studied during hypovolaemic shock and fluid resuscitation. Cardiac output measurements were carried out simultaneously by arterial and pulmonary artery thermodilution techniques.

Results: One-hundred-and-two measurements were performed. The mean cardiac output was 2.28 ± 1.4 L min−1 by the pulmonary arterial technique and 2.29 ± 1.56 L min−1 by the arterial thermodilution technique. The correlation coefficient between the two measurements was 0.95, the precision −0.04 ± 0.41 L min−1 and the limits of agreement from −0.86 to 0.78 L min−1. The agreement was also consistent at low cardiac outputs.

Conclusions: The arterial thermodilution technique may serve as a less invasive cardiac output monitor in conditions of severe bleeding and shock.

Type
Original Article
Copyright
2002 European Society of Anaesthesiology

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