Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique.
OBJECTIVE
This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (CO(Li)) and continuous cardiac output monitoring (PulseCO(Li)) using the arterial pressure waveform with intermittent thermodilution using a pulmonary artery catheter (CO(PAC)).


METHODS
Prospective, single-center evaluation.


METHODS
University Hospital Intensive Care Unit.


METHODS
Patients (n=23) receiving liver transplantation.


METHODS
Pulmonary artery catheters were placed in all patients and CO(PAC) was determined using thermodilution. CO(Li) and PulseCO(Li) measurements were made using the LiDCO system.


RESULTS
Data were collected after intensive care unit admission and every 8h until the 48th hour. A total of 151 CO(PAC), CO(Li) and PulseCO(Li) measurements were analysed. Bias and 95% limit of agreement were 0.11lmin(-1) and -1.84 to + 2.05 lmin(-1) for CO(PAC) vs. CO(Li) (r=0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for CO(PAC) vs. PulseCO(Li) were 0.29 lmin(-1) and -1.87 to + 2.46 lmin(-1) (r=0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for CO(PAC) vs. CO(Li) and 15.1% for CO(PAC) vs. PulseCO(Li) for data pairs less than 8 lmin(-1), and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin(-1).


CONCLUSIONS
In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent pulmonary artery thermodilution.
Costa
Maria Gabriella
MG
Azienda Ospedaliero Universitaria di Udine, Clinica di Anestesia e Rianimazione, P.le S.M. della Misericordia 15, 33100 Udine, Italy. gabriella.costa@med.uniud.it
Della Rocca
Giorgio
G
Chiarandini
Paolo
P
Mattelig
Silvia
S
Pompei
Livia
L
Barriga
Mauricio Sainz
MS
Reynolds
Toby
T
Cecconi
Maurizio
M
Pietropaoli
Paolo
P
D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology*; D002407:Catheterization, Swan-Ganz / Q000295:instrumentation*; D003422:Critical Care; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D007201:Indicator Dilution Techniques / Q000295:instrumentation*; D008094:Lithium; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery
D008094:Lithium