Comparison of pulmonary arterial thermodilution and arterial pulse contour analysis: evaluation of a new algorithm.
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.
Felbinger
Thomas W
TW
Department of Anesthesiology, Grosshadern Medical Center, University of Munich, Munich, Germany.
Reuter
Daniel A
DA
Eltzschig
Holger K
HK
Moerstedt
Karl
K
Goedje
Oliver
O
Goetz
Alwin E
AE
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