The impact of intra-aortic balloon pumping on cardiac output determination by pulmonary arterial and transpulmonary thermodilution in pigs.
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.
Janda
Matthias
M
Department of Anesthesiology and Intensive Care Medicine, University of Rostock, Rostock, Germany. matthias.janda@medizin.uni-rostock.de
Scheeren
Thomas W L
TW
Bajorat
Jörn
J
Westphal
Bernd
B
Vagts
Dierk A
DA
Pohl
Birgit
B
Popescu
Corneliu
C
Hofmockel
Rainer
R
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