Cardiac output monitoring: comparison of a new arterial pressure waveform analysis to the bolus thermodilution technique in patients undergoing off-pump coronary artery bypass surgery.
OBJECTIVE
To analyze the clinical agreement between the conventional intermittent bolus thermodilution (TD) technique and a new arterial pressure waveform analysis (APCO) technique (FloTrac; Edward Lifesciences, Irvine, CA) for cardiac output (CO) estimation.


METHODS
Prospective observational clinical study.


METHODS
Cardiac surgery operating room of a tertiary care cardiac center.


METHODS
Twelve patients undergoing elective off-pump coronary artery bypass (OPCAB) surgery.


RESULTS
CO was determined by 2 different methods: TD and APCO at 8 time points (preinduction, postinduction, poststernotomy, left internal mammary artery to left anterior descending artery anastomosis, left [obtuse marginal/diagonal] anastomosis, right [right coronary/posterior descending coronary artery] anastomosis, postprotamine administration, and poststernal closure) in 12 patients undergoing elective OPCAB surgery. The mean bias and limits of agreement (2 standard deviations) expressed in liters per minute at respective points of measurement were -0.54 +/- 1.12, -0.37 +/- 1.0, -0.42 +/- 1.50, -0.25 +/- 1.18, -0.31 + 1.28, +/-0.41 +/- 1.0, 0.06 +/- 1.50, and 0.09 +/- 1.40.


CONCLUSIONS
Good agreement was found between the CO values obtained by the APCO and TD techniques throughout the intraoperative period including the period of coronary artery graft surgery.
Mehta
Yatin
Y
Department of Anaesthesiology and Critical Care, Escorts Heart Institute and Research Centre, New Delhi, India. yatinmehta@hotmail.com
Chand
Rajesh Kumar
RK
Sawhney
Ravindra
R
Bhise
Milind
M
Singh
Ajmer
A
Trehan
Naresh
N
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015924:Blood Pressure Monitors / Q000592:standards; D002302:Cardiac Output / Q000502:physiology*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D013815:Thermodilution / Q000379:methods* / Q000592:standards