Cardiac output monitoring using a brachial arterial catheter during off-pump coronary artery bypass grafting.
OBJECTIVE
To investigate the accuracy of cardiac output measurements by transpulmonary thermodilution and pulse contour analysis using a brachial arterial catheter.


METHODS
Criterion standard study.


METHODS
University hospital, single institution.


METHODS
Twenty-three adult patients undergoing off-pump coronary artery bypass grafting.


RESULTS
Cardiac output was measured with a thermistor-tipped brachial arterial catheter using pulse contour analysis (COpc) and transpulmonary thermodilution (COba), which serves to calibrate COpc in the system tested. Both methods were compared separately with standard pulmonary artery thermodilution (COpa). COba was closely correlated with COpa (r = 0.93, p < 0.001). Bland-Altman analysis showed a bias of 0.91 L/min with limits of agreement of +/-0.98 L/min. COpc was also closely correlated (r = 0.80, p < 0.001) with COpa and was found to have a bias of 1.08 L/min with limits of agreement of +/-1.50 L/min. During the surgical procedure, changes in COpa from baseline were closely correlated with changes in COba (r = 0.90, p < 0.01) and COpc (r = 0.81, p < 0.01).


CONCLUSIONS
The brachial arterial access allows a reliable assessment of cardiac output by transpulmonary thermodilution and pulse contour analysis in patients undergoing off-pump coronary artery bypass grafting.
Wouters
Patrick F
PF
Department of Anesthesiology, University Hospitals Katholieke Universiteit Leuven, B-3000 Leuven, Belgium. patrick.wouters@uz.kuleuven.ac.be
Quaghebeur
Bert
B
Sergeant
Paul
P
Van Hemelrijck
Jan
J
Vandermeersch
Eugène
E
D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000502:physiology*; D002302:Cardiac Output / Q000502:physiology*; D002406:Catheterization, Peripheral; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D015203:Reproducibility of Results; D013815:Thermodilution