Pressure recording analytical method (PRAM) for measurement of cardiac output during various haemodynamic states.
BACKGROUND
Cardiac output (CO) can be measured using the pressure recording analytical method (PRAM), which is a new, less invasive technique allowing beat-by-beat stroke volume monitoring from the pressure signals recorded in femoral or radial arteries.


METHODS
We investigated PRAM by comparing its cardiac output (PRAM-CO) with paired measurements obtained by electromagnetic flowmetry (EM-CO) and by standard thermodilution (ThD-CO) during various haemodynamic states in a swine model. Nine pigs were monitored with a pulmonary artery catheter and a femoral artery catheter at baseline, in a hyperdynamic state produced by administration of dobutamine and in a hypodynamic state induced by progressive exsanguination. Bland-Altman analysis was used.


RESULTS
One hundred and eight paired cardiac output values over a range of EM-CO of 1.8-10.4 litre min(-1) resulted. We found close agreement between the techniques. Mean bias between EM-CO and PRAM-CO was -0.03 litre min(-1) (precision 0.58 litre min(-1)). The 95% limits of agreement were -0.61 to +0.55 litre min(-1). Similar results between ThD-CO and PRAM-CO were found.


CONCLUSIONS
In a porcine model we have demonstrated accuracy of PRAM during various haemodynamic states. PRAM is a reliable tool to detect changes in cardiac output in pigs and has ability as a basic research tool.
Scolletta
S
S
Department of Surgery and Bioengineering, Thoracic and Cardiovascular Unit, University of Siena, Siena, Italy. scolletta@unisi.it
Romano
S M
SM
Biagioli
B
B
Capannini
G
G
Giomarelli
P
P
D000704:Analysis of Variance; D000818:Animals; D001158:Arteries; D001794:Blood Pressure; D002302:Cardiac Output; D055590:Electromagnetic Phenomena; D023421:Models, Animal; D012212:Rheology; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013552:Swine; D013815:Thermodilution