title: Automated cardiac output measurements by ultrasound are inaccurate at high cardiac outputs.
abstract: OBJECTIVE
  The sonographic technique of automated cardiac output measurement (ACM) is a promising new method to measure cardiac output and could be of use in a high-risk obstetric unit in the treatment of pre-eclamptic patients. The aim was to determine the accuracy of the ACM method.
  
  
  METHODS
  Comparative study of the sonographic technique of ACM versus cardiac output measured by thermodilution (TD).
  
  
  METHODS
  The study included 39 intensive care patients, 21 men, 13 non-pregnant women and five severely pre-eclamptic pregnant patients, with a wide range of cardiac outputs, in whom TD catheters had been inserted for clinical reasons. Two separate experienced observers, blinded to the results obtained with the other method, performed four successive measurements in each patient with either the ACM or TD technique. The averaged cardiac output value per patient and method was used for comparison.
  
  
  RESULTS
  Cardiac output was successfully measured with ACM and TD in 85 and 100% of patients, respectively. Mean cardiac output measured by ACM (6.77 +/- 1.90 L/min) was significantly lower than that measured by TD (9.12 +/- 3.06 L/min). Although cardiac output values obtained with ACM were significantly correlated with those measured by TD, the ACM values were consistently lower than TD values in the higher cardiac output range; the relationship was represented by ACM = 0.35 TD + 3.55 L/min (r = 0.57, P < 0.001). The (ACM - TD) difference increased significantly with cardiac output, through a difference in stroke volume, not in heart rate.
  
  
  CONCLUSIONS
  The ACM is not an accurate tool to measure cardiac output in patients with a high cardiac output, including treated pre-eclamptic women.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Hospital, Rotterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Basdogan
authors.forename: W
authors.initials: W
authors.lastname: Visser
authors.forename: P C
authors.initials: PC
authors.lastname: Struijk
authors.forename: J R
authors.initials: JR
authors.lastname: Jansen
authors.forename: W B
authors.initials: WB
authors.lastname: Vletter
authors.forename: J W
authors.initials: JW
authors.lastname: Wladimiroff
authors.forename: F K
authors.initials: FK
authors.lastname: Lotgering
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002302:Cardiac Output; D016534:Cardiac Output, High / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D015203:Reproducibility of Results; D013815:Thermodilution / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data