Comparison of cardiac output assessed by pulse-contour analysis and thermodilution in patients undergoing minimally invasive direct coronary artery bypass grafting.
OBJECTIVE
To investigate the precision and accuracy of continuous pulse contour cardiac output (PCCO) compared with intermittent transcardiopulmonary (TCPCO) and pulmonary artery thermodilution (TDCO) measurements in patients undergoing minimally invasive coronary bypass surgery (MIDCAB).


METHODS
Prospective, controlled, clinical study.


METHODS
University hospital.


METHODS
Twelve patients undergoing MIDCAB.


METHODS
Thirty-six measurements of PCCO and thermodilution cardiac output (CO) were simultaneously performed after the start of surgery, during bypass grafting, and at the end of surgery. TCPCO and TDCO were simultaneously assessed by three injections of ice-cold saline randomly spread over the respiratory cycle. The pulse contour device was initially calibrated with an additional set of aortic thermodilution measurements.


RESULTS
Absolute values of CO ranged between 1.6 and 9.2 L/min. A close agreement among the three techniques was observed at all measurements. Mean bias between PCCO and TDCO and TCPCO was 0.003 L/min (2 SD of differences between methods = 1.26 L/min) and 0.27 L/min (2 SD of differences between methods = 1.16 L/min), respectively. The correlation coefficients were r2 = 0.90 for TCPCO versus PCCO and r2 = 0.88 for TDCO versus PCCO.


CONCLUSIONS
The results of the present study show that compared with thermodilution CO, pulse contour analysis enables accurate measurement of continuous CO in patients undergoing MIDCAB.
Buhre
W
W
Zentrum Anaesthesiologie, Rettungs-und Intensivmedizin der Universität Göttingen, and the Klinik und Poliklinik für HerzThroax- und Gefässchirurgie der Universität Göttingen, Germany.
Weyland
A
A
Kazmaier
S
S
Hanekop
G G
GG
Baryalei
M M
MM
Sydow
M
M
Sonntag
H
H
D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz; D001026:Coronary Artery Bypass; D006334:Heart Function Tests / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D011674:Pulse; D013815:Thermodilution / Q000379:methods*