Measurement of cardiac output by transpulmonary arterial thermodilution using a long radial artery catheter. A comparison with intermittent pulmonary artery thermodilution.
Cardiac output can be measured accurately by transpulmonary arterial thermodilution using the PiCCO (Pulsion Medical Systems, Munich, Germany) system with a femoral artery catheter. We have investigated the accuracy of a new 50 cm 4 French gauge radial artery catheter and the ability to use the system with a shorter radial catheter. We studied 18 patients who had undergone coronary artery surgery and made three simultaneous measurements of cardiac output by arterial thermodilution and with a pulmonary artery catheter. The radial catheter was withdrawn in 5 cm increments and the measurements were repeated. We found close agreement between arterial thermodilution and pulmonary artery thermodilution with a mean (SD) bias of 0.38 (0.77) l x min(-1). Arterial thermodilution became unreliable once the catheter had been withdrawn by more than 5 cm. We conclude that cardiac output measurement with arterial thermodilution with a radial catheter is interchangeable with that derived from a pulmonary artery catheter, and that a centrally sited arterial catheter is required for accurate determination of cardiac output by transpulmonary arterial thermodilution.
Orme
R M L'e
RM
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK. robert@orme1969.freeserve.co.uk
Pigott
D W
DW
Mihm
F G
FG
D000368:Aged; D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation / Q000379:methods*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D017534:Radial Artery; D015203:Reproducibility of Results; D013815:Thermodilution / Q000379:methods*