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Cardiac output measurements using the bioreactance technique in critically ill patients.

Fagnoul D, Vincent JL, Backer de D - Crit Care (2012)

Bottom Line: In 11 patients we compared CO values obtained using the bioreactance technique--a new continuous, totally non-invasive CO monitor--with those obtained by semi-continuous thermodilution using a pulmonary artery catheter.We obtained CO measurements at study inclusion and after any relevant change in hemodynamic status (spontaneous or during fluid challenge, inotrope or vasopressor infusions).There was a poor correlation between the two techniques (r = 0.145).

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ABSTRACT
Measurement of cardiac output (CO) using minimally invasive devices has gained popularity. In 11 patients we compared CO values obtained using the bioreactance technique--a new continuous, totally non-invasive CO monitor--with those obtained by semi-continuous thermodilution using a pulmonary artery catheter. We obtained CO measurements at study inclusion and after any relevant change in hemodynamic status (spontaneous or during fluid challenge, inotrope or vasopressor infusions). There was a poor correlation between the two techniques (r = 0.145). These data suggest that caution should be applied when using bioreactance devices in critically ill patients.

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Correlation between pulmonary artery catheter semi-continuous cardiac output by thermodilution and bioreactance cardiac output. A total of 141 measurements in 11 patients, r = 0.1455. PAC-CCO, pulmonary artery catheter semi-continuous cardiac output by thermodilution.
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Figure 1: Correlation between pulmonary artery catheter semi-continuous cardiac output by thermodilution and bioreactance cardiac output. A total of 141 measurements in 11 patients, r = 0.1455. PAC-CCO, pulmonary artery catheter semi-continuous cardiac output by thermodilution.

Mentions: We recorded bioreactance CO (average of five values over a 5-minute period) just after obtaining the pulmonary artery catheter CCO (average of five CCO values over a 5-minute period). We collected 141 pairs of measurements (3 to 23 per patient); the duration of monitoring was at least 3 hours but never exceeded 24 hours. The pulmonary artery catheter CCO values ranged from 3.9 to 11 l/minute. There was poor correlation between the two techniques (correlation coefficient r = 0.145) (Figure 1). To limit the time effect, we randomly selected one pair of measurements for each patient - but this did not improve the results (r = 0.13). Bland and Altman analysis with correction for multiple measurements showed wide limits of agreement (Figure 2). The time course of CO was not well tracked either, sometimes with opposite trends between the two devices. We therefore decided to stop the evaluation.


Cardiac output measurements using the bioreactance technique in critically ill patients.

Fagnoul D, Vincent JL, Backer de D - Crit Care (2012)

Correlation between pulmonary artery catheter semi-continuous cardiac output by thermodilution and bioreactance cardiac output. A total of 141 measurements in 11 patients, r = 0.1455. PAC-CCO, pulmonary artery catheter semi-continuous cardiac output by thermodilution.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672548&req=5

Figure 1: Correlation between pulmonary artery catheter semi-continuous cardiac output by thermodilution and bioreactance cardiac output. A total of 141 measurements in 11 patients, r = 0.1455. PAC-CCO, pulmonary artery catheter semi-continuous cardiac output by thermodilution.
Mentions: We recorded bioreactance CO (average of five values over a 5-minute period) just after obtaining the pulmonary artery catheter CCO (average of five CCO values over a 5-minute period). We collected 141 pairs of measurements (3 to 23 per patient); the duration of monitoring was at least 3 hours but never exceeded 24 hours. The pulmonary artery catheter CCO values ranged from 3.9 to 11 l/minute. There was poor correlation between the two techniques (correlation coefficient r = 0.145) (Figure 1). To limit the time effect, we randomly selected one pair of measurements for each patient - but this did not improve the results (r = 0.13). Bland and Altman analysis with correction for multiple measurements showed wide limits of agreement (Figure 2). The time course of CO was not well tracked either, sometimes with opposite trends between the two devices. We therefore decided to stop the evaluation.

Bottom Line: In 11 patients we compared CO values obtained using the bioreactance technique--a new continuous, totally non-invasive CO monitor--with those obtained by semi-continuous thermodilution using a pulmonary artery catheter.We obtained CO measurements at study inclusion and after any relevant change in hemodynamic status (spontaneous or during fluid challenge, inotrope or vasopressor infusions).There was a poor correlation between the two techniques (r = 0.145).

View Article: PubMed Central - HTML - PubMed

ABSTRACT
Measurement of cardiac output (CO) using minimally invasive devices has gained popularity. In 11 patients we compared CO values obtained using the bioreactance technique--a new continuous, totally non-invasive CO monitor--with those obtained by semi-continuous thermodilution using a pulmonary artery catheter. We obtained CO measurements at study inclusion and after any relevant change in hemodynamic status (spontaneous or during fluid challenge, inotrope or vasopressor infusions). There was a poor correlation between the two techniques (r = 0.145). These data suggest that caution should be applied when using bioreactance devices in critically ill patients.

Show MeSH
Related in: MedlinePlus