Evaluation of a noninvasive method for cardiac output measurement in critical care patients

Objective: Thermodilution (TD) is the gold standard to monitor cardiac output (CO) in critical care. However, there is concern about the safety of right-ventricular catheterization. The CO2 rebreathing technique allows noninvasive CO determination by means of the indirect Fick principle. Our objecti...

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Detalles Bibliográficos
Autores: Murias, GE, Villagrá, A, Vatua, S, Fernandez, MDM, Solar, H, Ochagavía, A, Fernández, R, Aguilar, JL, Romero, PV, Blanch, L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2002
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p5182
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/5182
Access Level:acceso abierto
Palabra clave:cardiac output
carbon dioxide rebreathing
thermodilution
monitoring
hemodynamics
critical care
Descripción
Sumario:Objective: Thermodilution (TD) is the gold standard to monitor cardiac output (CO) in critical care. However, there is concern about the safety of right-ventricular catheterization. The CO2 rebreathing technique allows noninvasive CO determination by means of the indirect Fick principle. Our objectives were: (a) to assess the accuracy of a new system of CO measurement using the CO2 partial rebreathing method (PRCO); (b) to evaluate whether the PRCO itself may induce changes in CO. Design and setting: Prospective study in the intensive care department in a university-affiliated hospital. Patients: Twenty-two mechanically ventilated critically ill patients. Interventions: CO measured simultaneously by PRCO and TDCO. Measurements and results: PRCO and TDCO values were compared by concordance analysis. Stability of cardiac output during PRCO was evaluated by comparing the TDCO measurements before, during, and after the partial rebreathing period using analysis of variance. From a total of 79 valid sets of measurements, bias and precision was calculated at -0.18 +/- 1.39 l/min. The concordance analysis of lower and intermediate CO values (<7 1/min) yielded a bias and precision calculation of -0.07 +/- 0.91 1/min. No changes in hemodynamics were observed during the partial rebreathing period. Conclusions: The noninvasive partial CO2 rebreathing technique may be an alternative method for CO determination in mechanically ventilated critically ill patients. The rebreathing maneuver alone does not induce changes in CO.