Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives.
The ability to monitor cardiac output is one of the important cornerstones of hemodynamic assessment for managing critically ill patients at increased risk for developing cardiac complications, and in particular in patients with preexisting cardiovascular comorbidities. For >30 years, single-bolus thermodilution measurement through a pulmonary artery catheter for assessment of cardiac output has been widely accepted as the "clinical standard" for advanced hemodynamic monitoring. In this article, we review this clinical standard, along with current alternatives also based on the indicator-dilution technique, such as the transcardiopulmonary thermodilution and lithium dilution techniques. In this review, not only the underlying technical principles and the unique features but also the limitations of each application of indicator dilution are outlined.
Reuter
Daniel A
DA
Department of Anesthesiology, Hamburg-Eppendorf University Hospital, Martinistr. 52, 20246 Hamburg, Germany. dreuter@uke.de
Huang
Cecil
C
Edrich
Thomas
T
Shernan
Stanton K
SK
Eltzschig
Holger K
HK
D000818:Animals; D002302:Cardiac Output; D002407:Catheterization, Swan-Ganz; D003326:Coronary Circulation; D003422:Critical Care / Q000379:methods*; D006801:Humans; D007201:Indicator Dilution Techniques; D007202:Indicators and Reagents / Q000008:administration & dosage; D007269:Injections, Intra-Arterial; D018021:Lithium Chloride / Q000008:administration & dosage; D008955:Models, Cardiovascular; D008991:Monitoring, Physiologic / Q000379:methods*; D011237:Predictive Value of Tests; D011652:Pulmonary Circulation; D015203:Reproducibility of Results; D013696:Temperature; D013997:Time Factors
D007202:Indicators and Reagents; D018021:Lithium Chloride