Beat-to-beat measurement of cardiac output by intravascular pulse contour analysis:: A prospective criterion standard study in patients after cardiac surgery

被引:81
作者
Zöllner, C
Haller, M
Weis, M
Mörstedt, K
Lamm, P
Kilger, E
Goetz, AE
机构
[1] Univ Munich, Dept Anesthesiol, Munich, Germany
[2] Univ Munich, Dept Cardiac Surg, Munich, Germany
关键词
pulse contour method; cardiac output; thermodilution; critical care; monitoring; catheterization;
D O I
10.1016/S1053-0770(00)90003-X
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Objective: To evaluate the accuracy of a new pulse contour method of measuring cardiac output in critically ill patients. Design: A prospective criterion standard study. Setting: Cardiac surgery intensive care unit in a university hospital. Participants: Nineteen cardiac surgery patients requiring intensive care treatment with pulmonary artery catheters after surgery. Interventions: None. Measurements and Main Results: The pulse contour cardiac output monitor uses transpulmonary bolus thermodilution measurements to calibrate the system. In each patient, the pulse contour cardiac output values were compared with conventional thermodilution. The method described by Bland and Altman and linear regression analysis were used for comparison. The mean difference (bias) +/- standard deviation of differences (precision) was 0.31 +/- 1.25 L/min for pulmonary bolus thermodilution cardiac output versus pulse contour cardiac output and 0.21 +/- 0.73 L/min for pulmonary bolus thermodilution cardiac output versus transpulmonary bolus thermodilution cardiac output. Linear regression (correlation) analyses were pulse contour cardiac output = 0.97 thermodilution + 0.53 (r = 0.88), and transpulmonary cardiac output = 0.87 thermodilution + 1.09 (r = 0.96). There was a small increase 60 minutes after recalibration but not a statistically significant difference between pulse contour cardiac output and pulmonary bolus thermodilution cardiac output (p = 0.52). Conclusions: Bias and precision are acceptable, and the system provides results that agree with conventional thermodilution. This study demonstrates the clinical applicability of the pulse contour cardiac output monitoring system. Copyright (C) 2000 by W.B. Saunders Company.
引用
收藏
页码:125 / 129
页数:5
相关论文
共 22 条
  • [1] ERRORS IN THERMODILUTION CARDIAC-OUTPUT MEASUREMENTS CAUSED BY RAPID PULMONARY-ARTERY TEMPERATURE DECREASES AFTER CARDIOPULMONARY BYPASS
    BAZARAL, MG
    PETRE, J
    NOVOA, R
    [J]. ANESTHESIOLOGY, 1992, 77 (01) : 31 - 37
  • [2] STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
    BLAND, JM
    ALTMAN, DG
    [J]. LANCET, 1986, 1 (8476) : 307 - 310
  • [3] CONTINUOUS VERSUS INTERMITTENT CARDIAC-OUTPUT MEASUREMENT IN CARDIAC SURGICAL PATIENTS UNDERGOING HYPOTHERMIC CARDIOPULMONARY BYPASS
    BOTTIGER, BW
    RAUCH, H
    BOHRER, H
    MOTSCH, J
    SODER, M
    FLEISCHER, F
    MARTIN, E
    [J]. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 1995, 9 (04) : 405 - 411
  • [4] Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients
    Burchell, SA
    Yu, MH
    Takiguchi, SA
    Ohta, RM
    Myers, SA
    [J]. CRITICAL CARE MEDICINE, 1997, 25 (03) : 388 - 391
  • [5] The effectiveness of right heart catheterization in the initial care of critically ill patients
    Connors, AF
    Speroff, T
    Dawson, NV
    Thomas, C
    Harrell, FE
    Wagner, D
    Desbiens, N
    Goldman, L
    Wu, AW
    Califf, RM
    Fulkerson, WJ
    Vidaillet, H
    Broste, S
    Bellamy, P
    Lynn, J
    Knaus, WA
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1996, 276 (11): : 889 - 897
  • [6] EVALUATION OF A NEW CONTINUOUS THERMODILUTION CARDIAC-OUTPUT MONITOR IN CRITICALLY ILL PATIENTS - A PROSPECTIVE CRITERION STANDARD STUDY
    HALLER, M
    ZOLLNER, C
    BRIEGEL, J
    FORST, H
    [J]. CRITICAL CARE MEDICINE, 1995, 23 (05) : 860 - 866
  • [7] Iberti T J, 1992, J Cardiothorac Vasc Anesth, V6, P267, DOI 10.1016/1053-0770(92)90135-T
  • [8] CONTINUOUS MEASUREMENT OF CARDIAC-OUTPUT USING PULSE CONTOUR ANALYSIS
    IRLBECK, M
    FORST, H
    BRIEGEL, J
    HALLER, M
    PETER, K
    [J]. ANAESTHESIST, 1995, 44 (07): : 493 - 500
  • [9] Analysis of the accuracy of continuous thermodilution cardiac output measurement - Comparison with intermittent thermodilution and Fick cardiac output measurement
    Jacquet, L
    Hanique, G
    Glorieux, D
    Matte, P
    Goenen, M
    [J]. INTENSIVE CARE MEDICINE, 1996, 22 (10) : 1125 - 1129
  • [10] CONTINUOUS CARDIAC-OUTPUT MONITORING BY PULSE CONTOUR DURING CARDIAC-SURGERY
    JANSEN, JRC
    WESSELING, KH
    SETTELS, JJ
    SCHREUDER, JJ
    [J]. EUROPEAN HEART JOURNAL, 1990, 11 : 26 - 32