Comparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients.
OBJECTIVE
We studied the agreement between cardiac output measurements via pulmonary artery thermodilution [CO(PA)], regarded as the current clinical gold standard, and aortic transpulmonary thermodilution [CO(AORTA)].


METHODS
Prospective clinical study.


METHODS
Surgical intensive care unit of a university hospital.


METHODS
37 patients with sepsis or septic shock (n = 34) and subarachnoid haemorrhage (n = 3).


RESULTS
We analysed 449 simultaneous cardiac output measurements. All patients were deeply sedated and mechanically ventilated in a pressure controlled mode. Each patient received a 7.5-F five-lumen pulmonary artery catheter and a 4-F aortic catheter with an integrated thermistor. The thermistors of the two different catheters were connected to one computer system (COLD-Z021, Pulsion Medical Systems, Munich, Germany). Linear regression analysis revealed: CO(AORTA) = 0.96. CO(PA) + 1.02 (l/min) (r = 0.97, p < 0.0001). CO(AORTA) was consistently higher than CO(PA) with a bias of 0.68 (l/min) and a standard deviation of 0.62 (l/min).


CONCLUSIONS
Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.
Sakka
S G
SG
Department of Anaesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Bachstrasse 18, D-07 740 Jena, Germany.
Reinhart
K
K
Meier-Hellmann
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000502:physiology*; D002302:Cardiac Output; D016638:Critical Illness; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000502:physiology*; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012772:Shock, Septic; D013345:Subarachnoid Hemorrhage; D013815:Thermodilution / Q000379:methods / Q000592:standards*