title: Pulse contour cardiac output derived from non-invasive arterial pressure in cardiovascular disease.
abstract: Pulse contour methods determine cardiac output semi-invasively using standard arterial access. This study assessed whether cardiac output can be determined non-invasively by replacing the intra-arterial pressure input with a non-invasive finger arterial pressure input in two methods, Nexfin CO-trek and Modelflow , in 25 awake patients after coronary artery bypass surgery. Pulmonary artery thermodilution cardiac output served as a reference. In the supine position, the mean (SD) differences between thermodilution cardiac output and Nexfin CO-trek were 0.22 (0.77) and 0.44 (0.81) l.min(-1) , for intra-arterial and non-invasive pressures, respectively. For Modelflow, these differences were 0.70 (1.08) and 1.80 (1.59) l.min(-1) , respectively. Similarly, in the sitting position, differences between thermodilution cardiac output and Nexfin CO-trek were 0.16 (0.78) and 0.34 (0.83), for intra-arterial and non-invasive arterial pressure, respectively. For Modelflow, these differences were 0.58 (1.11) and 1.52 (1.54) l.min(-1) , respectively. Thus, Nexfin CO-trek readings were not different from thermodilution cardiac output, for both invasive and non-invasive inputs. However, Modelflow readings differed greatly from thermodilution when using non-invasive arterial pressure input.
authors.affiliation: Department of Internal Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: L W J
authors.initials: LW
authors.lastname: Bogert
authors.forename: K H
authors.initials: KH
authors.lastname: Wesseling
authors.forename: O
authors.initials: O
authors.lastname: Schraa
authors.forename: E J
authors.initials: EJ
authors.lastname: Van Lieshout
authors.forename: B A J M
authors.initials: BA
authors.lastname: de Mol
authors.forename: J
authors.initials: J
authors.lastname: van Goudoever
authors.forename: B E
authors.initials: BE
authors.lastname: Westerhof
authors.forename: J J
authors.initials: JJ
authors.lastname: van Lieshout
mesh_terms: D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods; D002302:Cardiac Output; D001026:Coronary Artery Bypass; D005260:Female; D005385:Fingers / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011187:Posture / Q000502:physiology; D011651:Pulmonary Artery / Q000502:physiology; D015203:Reproducibility of Results; D013815:Thermodilution