title: Iced temperature injectate for thermodilution cardiac output determination causes minimal effects on cardiodynamics.
abstract: OBJECTIVE
  Controversy exists regarding the ideal injectate temperature for measuring cardiac output. Iced temperature injectate gives a higher signal/noise ratio and less variability in the measured cardiac output. Thus, less volume and fewer measurements are required. Advocates of room temperature injectate have suggested that iced temperature injectate may perturb cardiodynamics. This concern has remained largely untested. To help resolve this controversy, we examined the effects of 5 mL iced injectate (0 degrees to 4 degrees) infusions on cardiodynamics.
  
  
  METHODS
  Prospective, randomized, controlled study.
  
  
  METHODS
  A critical care research laboratory.
  
  
  METHODS
  Five domestic pigs, weighing between 20 to 25 kg.
  
  
  METHODS
  Under barbiturate anesthesia, pigs underwent placement of a) a thermodilution catheter in the right internal jugular vein; b) a right carotid artery catheter for mean arterial pressure; and c) sonomicrometry crystals for dynamic measurements of left ventricular dimensions. Calculations were made of end-systolic and end-diastolic left ventricular volume and ejection fraction. Six cardiac output measurements were performed in each pig. Data were obtained at baseline (just before iced temperature injectate infusion) and every 3 sec for 9 secs.
  
  
  RESULTS
  The only significant effect seen with iced temperature injectate infusion was a small, transient decrease in heart rate (-5.9 +/- 1.1 beats/min from a baseline heart rate of 144.8 +/- 20.6 beats/min). Indices of preload, contractile function, and dynamic cardiac geometry were unaffected.
  
  
  CONCLUSIONS
  Iced temperature injectate used in clinically relevant volumes causes transient negative chronotropic effects, but reservations regarding other perturbations of cardiodynamics are unfounded. Thus, the use of iced temperature injectate for cardiac output determination is still a viable alternative to room temperature injectate use, especially when a larger signal/noise ratio is required.
authors.affiliation: Department of Surgery, University of Illinois at Chicago, College of Medicine 60612, USA.
authors.forename: H K
authors.initials: HK
authors.lastname: Fang
authors.forename: R L
authors.initials: RL
authors.lastname: Krahmer
authors.forename: E B
authors.initials: EB
authors.lastname: Rypins
authors.forename: W R
authors.initials: WR
authors.lastname: Law
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D002302:Cardiac Output; D005260:Female; D006439:Hemodynamics; D007053:Ice; D008297:Male; D013318:Stroke Volume; D013552:Swine; D013696:Temperature; D013815:Thermodilution / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors
chemical_list: D007053:Ice