title: Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.
abstract: BACKGROUND
  Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown.
  
  
  METHODS
  We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded.
  
  
  RESULTS
  23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (-0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period.
  
  
  CONCLUSIONS
  The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge.
  
  
  BACKGROUND
  clinicaltrials.gov NCT02063009.
authors.affiliation: Service d'Anesthésie, Gustave Roussy, Villejuif, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Suria
authors.affiliation: Service d'Anesthésie, Gustave Roussy, Villejuif, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Wyniecki
authors.affiliation: Service d'Anesthésie, Gustave Roussy, Villejuif, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Eghiaian
authors.affiliation: Service de réanimation médicale, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France; Unité de recherche EA4533, Université Paris-Sud, Le Kremlin-Bicêtre, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Monnet
authors.affiliation: Service d'Anesthésie, Gustave Roussy, Villejuif, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Weil
mesh_terms: D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology*; D062905:Central Venous Catheters; D005260:Female; D005440:Fluid Therapy; D006321:Heart / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D010052:Ovariectomy; D010053:Ovary / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D013815:Thermodilution / Q000295:instrumentation* / Q000379:methods