A comparison between the transthoracic electrical impedance method and the direct Fick and the dye dilution methods for cardiac output measurements in man

Enghoff, Ebba; Lovheim, Olof

doi:10.3109/00365517909108837

Cited by 25 publications

(11 citation statements)

References 9 publications

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“…CO was calculated from the formula: CO=Vi(T,T,)/A, where Vi=volume of indicator, Tb=body temperature and T,=indicator temperature. Corrections for differences in specific heat and density between blood and saline were omitted, in accordance with Enghoff et al (1970). CO (microsphere method) and regional blood flows were calculated by means of a computer program (Schosser et at.…”

Section: Calculations and Statisticsmentioning

confidence: 99%

Anaphylactic shock in monkeys passively sensitized with human reaginic serum

Smedegård

Revenäs²,

Lundberg

et al. 1981

Acta Physiologica Scandinavica

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Mechanisms inducing a low cardiac output (CO) state in IgE-mediated (cytotropic) anaphylactic shock in anesthetized Macaca irus monkeys were studied. 7 monkeys were sensitized by 2 i.v. injections of a human reaginic serum containing a high concentration of IgE antibodies against dog albumin. Anaphylactic shock was elicited 48 h after the last sensitization dose, by an i.v. injection of dog albumin. The severe anaphylactic shock which developed was characterized by an initial phase consisting of increased CO (+16%, mean value, 1 min after challenge), pulmonary hypertension and systemic vasodilatation followed by a phase consisting of decreased CO (-67%), a fall in mean arterial pressure from 113 to 45 mmHg, decreases in left and right arterial pressures (-5.3 and -3.2 mmHg, respectively) and increases in pulmonary vascular (+364%) and total peripheral (+30%) resistances. These changes were recorded 5 min after challenge and the values then remained essentially unaltered during the rest of the 30-min observation period. Pulmonary vascular resistance was only increased by 140% at the end of that period. Myocardial blood flow was maintained during shock at the expense of flow to other organs. However, initially there was a redistribution of blood flow within the left ventricular myocardium, resulting in a relative decrease in subendocardial flow. This finding was not related either to occasional S-T changes in the electrocardiograms or to the level of decreased CO. The oxygen supply to the myocardium was reduced in shock but the reduction was always smaller than the corresponding decrease in heart work. Two additional monkeys sensitized with an IgE fraction from the human serum showed a smaller amount of specific IgG in their serum prior to challenge than the other monkeys. The response to challenge was milder, but resembled the initial vasodilatory reaction in monkeys sensitized with serum. These data on cytotropic anaphylaxis in the monkey show that the main cause of decreased CO and thus of the shock state is a decreased venous return, primarily due to peripheral blood pooling and, to a smaller extent, extravasation of plasma. No appreciable involvement of the heart in the induction of shock was detected.

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Section: Calculations and Statisticsmentioning

confidence: 99%

Anaphylactic shock in monkeys passively sensitized with human reaginic serum

Smedegård

Revenäs²,

Lundberg

et al. 1981

Acta Physiologica Scandinavica

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“…cardiac output determined by thermo‐dilution or by Doppler examination ) is time consuming and may not provide sufficient data for meaningful statistical comparisons of the different pacing sites and AV delays in a single patient. This is due to the fact that these techniques can have measurement errors that are in the same order of magnitude than the changes that we are trying to detect . Therefore, they force the use of group statistics to try to get around this technical limitation.…”

Section: Technique For Acute Testingmentioning

confidence: 99%

Pacing for heart failure: selection of patients, techniques and benefits

Auricchio

Klein

Spinelli³

1999

European J of Heart Fail

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“…Comparisons of thermodilution cardiac output and metabolic cardiac output have demonstrated statistically significant correlations [7,9,10,11,12,13,14,15], but this does not mean 'agreement' or 'clinical interchangeability'. More recently, a satisfactory agreement has been found between the two methods in stable children [16] and in stable patients with pulmonary hypertension [17].…”

Section: Introductionmentioning

confidence: 99%

Comparison of bedside measurement of cardiac output with the thermodilution method and the Fick method in mechanically ventilated patients

González

Christian²,

Fartoukh

et al. 2002

Crit Care

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Introduction Bedside cardiac output determination is a common preoccupation in the critically ill. All available methods have drawbacks. We wished to re-examine the agreement between cardiac output determined using the thermodilution method (QTTHERM) and cardiac output determined using the metabolic (Fick) method (QTFICK) in patients with extremely severe states, all the more so in the context of changing practices in the management of patients. Indeed, the interchangeability of the methods is a clinically relevant question; for instance, in view of the debate about the risk-benefit balance of right heart catheterization. Patients and methods Eighteen mechanically ventilated passive patients with a right heart catheter in place were studied (six women, 12 men; age, 39-84 years; simplified acute physiology score II, 39-111). QTTHERM was obtained using a standard procedure. QTFICK was measured from oxygen consumption, carbon dioxide production, and arterial and mixed venous oxygen contents. Forty-nine steady-state pairs of measurements were performed. The data were normalized for repeated measurements, and were tested for correlation and agreement. Results The QTFICK value was 5.2 ± 2.0 l/min whereas that of QTTHERM was 5.8 ± 1.9 l/min (R = 0.840, P < 0.0001; mean difference, -0.7 l/min; lower limit of agreement, -2.8 l/min; upper limit of agreement, 1.5 l/min). The agreement was excellent between the two techniques at QTTHERM values < 5 l/min but became too loose for clinical interchangeability above this value. Tricuspid regurgitation did not influence the results.

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A comparison between the transthoracic electrical impedance method and the direct Fick and the dye dilution methods for cardiac output measurements in man

Cited by 25 publications

References 9 publications

Anaphylactic shock in monkeys passively sensitized with human reaginic serum

Anaphylactic shock in monkeys passively sensitized with human reaginic serum

Pacing for heart failure: selection of patients, techniques and benefits

Comparison of bedside measurement of cardiac output with the thermodilution method and the Fick method in mechanically ventilated patients

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