title: Comparison of pulmonary arterial thermodilution and arterial pulse contour analysis: evaluation of a new algorithm.
abstract: OBJECTIVE
  To compare cardiac index (CI) measurement by arterial pulse contour analysis using two different algorithms (CI(PC), CI(PCnew)) with pulmonary arterial thermodilution values (CI(PA)) so as to evaluate the difference between the conventional algorithm, CI(PC), and a new algorithm, CI(PCnew), that accounts for patients' individual aortic compliance.
  
  
  METHODS
  Prospective, clinical study.
  
  
  METHODS
  Intensive care unit of a university hospital.
  
  
  METHODS
  20 ASA physical status II and III patients following elective cardiac surgery.
  
  
  RESULTS
  360 parallel triplicate determinations of CI (CI(PA), CI(PC), CI(PCnew)) were performed within a 90-minute period during the immediate postoperative period. Prior to the start of the study period, CI(PC) as well as CI(PCnew) were calibrated by triplicate femoral arterial thermodilution measurements. Regression analysis of CI(PA) and CI(PC), as well as CI(PA) and CI(PCnew), revealed r = 0.89, p < 0.001, and r = 0.93, p < 0.001, respectively. Bland-Altman analysis was used for determining the accuracy and precision of CI(PC) and CI(PCnew) compared with CI(PA). The mean differences (m) and standard deviation (SD) between CI(PA) and CI(PC,) as well as CI(PA) and CI(PCnew), resulted in m = -0.312 L/min/m(2), SD = 0.456 L/min/m(2), and m = - 0.140 L/min/m(2), SD = 0.328 L/min/m(2), respectively.
  
  
  CONCLUSIONS
  Arterial pulse contour analysis measurement of CI using either algorithm correlates well with CI values derived by pulmonary arterial thermodilution. However, the algorithm introduced in this study proved to be a more accurate predictor of values as derived by pulmonary artery catheter.
authors.affiliation: Department of Anesthesiology, Grosshadern Medical Center, University of Munich, Munich, Germany.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Felbinger
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Reuter
authors.forename: Holger K
authors.initials: HK
authors.lastname: Eltzschig
authors.forename: Karl
authors.initials: K
authors.lastname: Moerstedt
authors.forename: Oliver
authors.initials: O
authors.lastname: Goedje
authors.forename: Alwin E
authors.initials: AE
authors.lastname: Goetz
mesh_terms: D000465:Algorithms; D001011:Aorta / Q000502:physiology; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D011651:Pulmonary Artery; D011674:Pulse; D013815:Thermodilution