title: Thermodilution vs pressure recording analytical method in hemodynamic stabilized patients.
abstract: OBJECTIVE
  Many mini-invasive devices to monitor cardiac output (CO) have been introduced and, among them, the pressure recording analytical method (PRAM). The aim of this study was to assess the agreement of PRAM with the intermittent transpulmonary thermodilution and continuous pulmonary thermodilution in measuring CO in hemodynamically stabilized patients.
  
  
  METHODS
  This is a prospective clinical study in a mixed medical-surgical intensive care unit (ICU) and in a postcardiac surgical ICU. Forty-eight patients were enrolled: 32 patients to the medical-surgical ICU monitored with PiCCO (Pulsion Medical System AG, Munich, Germany) and 16 were cardiac patients monitored with Vigilance (Edwards Lifesciences, Irvine, CA).
  
  
  RESULTS
  A total of 112 measurements were made. Ninety-six comparisons of paired CO measurements were made in patients hospitalized in medical-surgical ICU; 16, in cardiac surgical patients. The mean Vigilance-CO was 4.49 ± 0.99 L/min (range, 2.80-5.90 L/min), and the mean PRAM-CO was 4.27 ± 0.88 L/min (range, 2.85-6.19 L/min). The correlation coefficient between Vigilance-CO and PRAM-CO was 0.83 (95% confidence interval, 0.57-0.94; P < .001). The bias was 0.22 ± 0.55 L/min with limits of agreement between 0.87 and 1.30 L/min. The percentage error was 25%. Mean TP-CO was 6.78 ± 2.04 L/min (range, 4.12-11.27 L/min), and the mean PRAM-CO was 6.11 ± 2.18 L/min (range, 2.82-10.90 L/min). The correlation coefficient between PiCCO-CO and PRAM-CO was 0.91 (95% confidence interval, 0.83-0.96; P < .0001). The bias was 0.67 ± 0.89 L/min with limits of agreement -1.07 and 2.41 L/min. The coefficient of variation for PiCCO was 4% ± 2%, and the coefficient of variation for PRAM was 10% ± 8%. The percentage error was 28%.
  
  
  CONCLUSIONS
  The PRAM system showed good agreement with pulmonary artery catheter and PiCCO in hemodynamically stabilized patients.
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy. Electronic address: a.donati@univpm.it.
authors: Abele
authors: A
authors: Donati
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Andrea
authors: A
authors: Carsetti
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Stefania
authors: S
authors: Tondi
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Claudia
authors: C
authors: Scorcella
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Roberta
authors: R
authors: Domizi
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Elisa
authors: E
authors: Damiani
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Vincenzo
authors: V
authors: Gabbanelli
authors: Anesthesia and Intensive Care Unit, Department of Medical and Surgical Cardiological Sciences, AOU Ospedali Riuniti, via Conca, 60126, Ancona, Italy.
authors: Christopher
authors: C
authors: Münch
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Erica
authors: E
authors: Adrario
authors: Anesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/A, 60126, Ancona, Italy.
authors: Paolo
authors: P
authors: Pelaia
authors: Department of General Intensive Care, St George's Healthcare NHS Trust, SW17 0QT London, UK; St George's Medical School, SW17 0QT London, UK.
authors: Maurizio
authors: M
authors: Cecconi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output / Q000502:physiology*; D002407:Catheterization, Swan-Ganz; D016638:Critical Illness; D005260:Female; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D013815:Thermodilution / Q000379:methods*
keywords: Cardiac output; Hemodynamic monitoring; Pressure recording analytical method; Thermodilution