Monitoring in resuscitation: comparison of cardiac output measurement between pulmonary artery catheter and NICO.
OBJECTIVE
The cardiac output and coronary perfusion pressure generated from chest compressions during resuscitation manoeuvres can predict effectiveness and successful outcome. Until now, there is no good method for haemodynamic monitoring during resuscitation. Noninvasive partial carbon dioxide rebreathing system (NICO, Novametrix Medical Systems, Inc., Wallingford, CT, USA) is a relatively new non-invasive alternative to thermodilution for measuring cardiac output. The accuracy of the NICO system has not been evaluated during resuscitation. The aim of this study is to compare thermodilution cardiac output method with NICO system and to assess the utility of NICO during resuscitation.


METHODS
Experimental study in 24 Yorkshire pigs. Paired measurements of cardiac output were determined during resuscitation (before ventricular fibrillation and after 5, 15, 30 and 45 min of resuscitation) in the supine position. The average of 3 consecutive thermodilution cardiac output measurements (10 ml 20 degrees C saline) was compared with the corresponding NICO measurement.


RESULTS
Bland and Altman plot and Lin's concordance coefficient showed a high correlation between NICO and thermodilution cardiac output measurements although NICO has a tendency to underestimate cardiac output when compared to thermodilution at normal values of cardiac output.


CONCLUSIONS
There is a high degree of agreement between cardiac output measurements obtained with NICO and thermodilution cardiac output during resuscitation. The present study suggests that the NICO system may be useful to measure cardiac output generated during cardiopulmonary resuscitation.
Carretero
M José
MJ
Department of Anaesthesiology, Critical Care and Pain Management, Hospital Clínic, Universitat de Barcelona, Villarroel 170, C/Mina 47, ático 1, 08906 L'Hospitalet del Llobregat, Barcelona, Spain.
Fontanals
Jaume
J
Agustí
Mercé
M
Arguis
M José
MJ
Martínez-Ocón
Julia
J
Ruiz
Ana
A
Rios
José
J
D000818:Animals; D002245:Carbon Dioxide / Q000378:metabolism*; D002302:Cardiac Output / Q000502:physiology*; D008991:Monitoring, Physiologic / Q000379:methods*; D012151:Resuscitation; D013552:Swine; D013815:Thermodilution
D002245:Carbon Dioxide