title: The impact of intra-aortic balloon pumping on cardiac output determination by pulmonary arterial and transpulmonary thermodilution in pigs.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of intra-aortic balloon pumping (IABP) on the comparison of simultaneous measurements of cardiac output via pulmonary arterial and transpulmonary thermodilution (PiCCO; Pulsion Medical Systems, Munich, Germany).
  
  
  METHODS
  Prospective.
  
  
  METHODS
  University research laboratory.
  
  
  METHODS
  The data were derived from 9 anesthetized (fentanyl, propofol, flunitrazepam, rocuronium) and ventilated pigs.
  
  
  METHODS
  A thermodilution catheter was inserted into the pulmonary artery, a PiCCO catheter into the abdominal aorta through the right femoral artery, epicardial atrial pacing wires through a thoracotomy, and a balloon catheter for counterpulsation into the descending thoracic aorta through the left femoral artery. Cardiac output was varied over a wide range by cardiac pacing between 80 and 150/min in steps of 10/min and was measured without and during IABP at an assist frequency of 1:1.
  
  
  RESULTS
  A total of 236 paired cardiac output measurements were carried out in a range of cardiac output between 1.4 to 4.9 L/min. A close correlation was found between transpulmonary and pulmonary arterial thermodilution both without and during IABP (r = 0.94 and 0.93, respectively) and a good agreement of both methods (bias of 0.30 and 0.26 L/min, respectively; precision 0.47 and 0.52 L/min, respectively).
  
  
  CONCLUSIONS
  Transpulmonary thermodilution is suitable for cardiac output measurement during IABP. Hence, in critically ill patients with cardiac pump failure, blood flow may be determined as accurately with the less-invasive transpulmonary method as with the traditional pulmonary arterial thermodilution one.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Rostock, Rostock, Germany. matthias.janda@medizin.uni-rostock.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Janda
authors.forename: Thomas W L
authors.initials: TW
authors.lastname: Scheeren
authors.forename: Jörn
authors.initials: J
authors.lastname: Bajorat
authors.forename: Bernd
authors.initials: B
authors.lastname: Westphal
authors.forename: Dierk A
authors.initials: DA
authors.lastname: Vagts
authors.forename: Birgit
authors.initials: B
authors.lastname: Pohl
authors.forename: Corneliu
authors.initials: C
authors.lastname: Popescu
authors.forename: Rainer
authors.initials: R
authors.lastname: Hofmockel
mesh_terms: D000818:Animals; D002302:Cardiac Output; D005260:Female; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000502:physiology*; D013552:Swine; D013815:Thermodilution