Comparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients

Abstract

Cardiac output derived from aortic transpulmonary thermodilution is suitable for measurement in the intensive care unit. Measurements of CO(AORTA) are consistent with, but slightly higher than, those obtained from pulmonary artery thermodilution.

Transpulmonary thermodilution curves for detection of shunt

“…In our case, CO and EVLW measurements were obtained after central venous injections of 20 ml of cooled (4°C) 0.9% saline. Cooled saline was injected into the central venous catheter while the thermistor tip on the femoral artery catheter measured the downstream temperature change within the abdominal aorta [3]. Cardiac output was then calculated by analysis of the temperature change of the TPTD curve using the Stewart-Hamilton method.…”

Advances in Critical Care for the Nephrologist

“…In fact, if one were to take a large population of patients and gather an aggregate of filling pressures, the low CVP and PaOP would likely predict volume responsiveness among this large group; however, when caring for the individual patient, these filling pressures do not predict with enough accuracy or reliability that a low value translates to volume responsiveness. Not only are the absolute values of CVP and PaOP poor surrogates for volume responsiveness, but also several studies have shown that changes in CVP and PaOP after a fluid challenge do not correlate with changes in CO (9,13,15,16). Kumar et al (13) demonstrated this concept definitively in a study of healthy volunteers.…”

Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos

“…Antes de realizar el análisis corroboramos la presencia de una buena correlación tanto para el valor absoluto de GC como el ∆ IC, hecho que ha sido confirmado previamente [15][16][17] . Fue relevante aclarar este aspecto debido a que el GC obtenido por TDP es muy sensible al incremento de la presión intratorácica, ya que ésta puede inducir una reducción del flujo sanguíneo en la arteria pulmonar e interferir por ende con la estimación del flujo sanguíneo sistémico (GC) 18 .…”