Ventilation, Thermal Noise, and Errors in Cardiac Output Measurements after Cardiopulmonary Bypass

Latson, Terry W.; Whitten, Charles W.; O’Flaherty, David

doi:10.1097/00000542-199312000-00014

Cited by 72 publications

(37 citation statements)

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“…Transient increases in the amplitude of respiratory variations in pulmonary artery temperature, occurring in the phases of thermal equilibration between different compartments of the body, are another possible source of error in thermodilution cardiac output [24,25] and may account for the present findings. Timing of intermittent cardiac output determinations may then unpredictably influence the zero reference level of pulmonary artery temperature with a subsequent impact on the area under the thermodilution curve [23,24,26].…”

Section: Discussionmentioning

confidence: 54%

“…Timing of intermittent cardiac output determinations may then unpredictably influence the zero reference level of pulmonary artery temperature with a subsequent impact on the area under the thermodilution curve [23,24,26]. Preliminary data obtained with randomly allocated intermittent cardiac output determinations, however, suggest that this effect does not explain the low levels of accuracy and precision of intermittent vs. continuous cardiac output measurement during these phases (data not shown).…”

Section: Discussionmentioning

confidence: 99%

“…The impact of thermal equilibration phenomena on the congruence between intermittent and continuous cardiac output measurement is underlined by preliminary data that showed a significant difference between intermittent and continuous cardiac output measurement when an upper body warming blanket was applied in patients undergoing aortic reconstruction surgery [13]. In general, rapid changes in pulmonary artery temperature that are not caused by the thermodilution signal are well-known sources of error in intermittent cardiac output determination [23,24]. Almost all available intermittent cardiac output algorithms including the one used in this study are based on the assumption that pulmonary artery temperature remains stable during the measurement phase.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all available intermittent cardiac output algorithms including the one used in this study are based on the assumption that pulmonary artery temperature remains stable during the measurement phase. The pulmonary artery temperature recorded immediately before an intermittent cardiac output measurement is extrapolated and functions as the reference level for calculations [23,24]. A rapid decrease in baseline pulmonary artery temperature therefore leads to a systematic and substantial underestimation in intermittent cardiac output [23].…”

Section: Discussionmentioning

confidence: 99%

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Continuous versus intermittent thermodilution cardiac output measurement during orthotopic liver transplantation

et al. 1997

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SummaryWe evaluated intermittent and continuous thermodilution cardiac output data in 12 patients undergoing orthotopic liver transplantation. Measurements were performed at 16 predefined time points between induction of anaesthesia and 3 h after reperfusion of the liver graft. Cardiac output measurements yielded 192 data pairs (intermittent cardiac output range: 1.8-18.9 l.min ¹1 , continuous cardiac output range: 3.3-20.0 l.min ¹1 ). During most of the procedure the correlation between intermittent and continuous cardiac output measurements was significant (r = 0.87, p < 0.0001), accompanied with a bias of ¹0.240 l.min ¹1 and a degree of precision of 1.789 l.min ¹1 (< 10.0 l.min ¹1 : 1.137 l.min ¹1 , Ն10.0 l.min ¹1 : 2.220 l.min ¹1 ). However, in the early phases after caval clamping and after reperfusion, accuracy was not acceptable. Only during these phases did the difference between the mean values of pulmonary artery blood temperature and rectal temperature increase (after caval clamping) or decrease (after reperfusion). In conclusion, despite acceptable levels of accuracy and precision between intermittent and continuous cardiac output measurement under stable conditions, both methods showed markedly decreased accuracy and precision in the early phases after caval clamping and after reperfusion, possibly owing to increased thermal noise.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Continuous versus intermittent thermodilution cardiac output measurement during orthotopic liver transplantation

et al. 1997

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“…Thermodilution is widely and reliably used as a clinical standard to measure cardiac output in the critical-care setting [15,16]. The thermodilution technique has been shown to be accurate when a stationary flow is present and a series of precautions are taken into account [3,17]. With respect to the recently discussed association between thermodilution determination of cardiac output in the initial care of critically ill patients and increase in mortality, less invasive techniques may be preferable.…”

Section: Discussionmentioning

confidence: 99%

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

Poelaert¹,

Schmidt²,

Aken³

et al. 1999

Anaesthesia

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SummaryThis study was undertaken in order to elucidate the differences between various planes of measurement and Doppler techniques (pulsed-vs. continuous-wave Doppler) across the aortic valve to estimate cardiac output. In 45 coronary artery bypass patients, cardiac output was measured each time using four different Doppler techniques (transverse and longitudinal plane, pulsed-and continuous-wave Doppler) and compared with the thermodilution technique. Measurements were performed after induction of anaesthesia and shortly after arrival in the intensive care unit. Optimal imaging was obtained in 91% of the patients, in whom a total of 82 measurements of cardiac output were performed. The respective mean (SD) areas of the aortic valve were 3.77 (0.71) cm 2 in the transverse plane and 3.86 (0.89) cm 2 in the longitudinal plane. A correlation of 0.87 was found between pulsed-wave Doppler cardiac output and the thermodilution technique in either transverse or longitudinal plane. Correlation coefficients of 0.82 and 0.84 were found between thermodilution cardiac output and transverse and longitudinal continuous-wave Doppler cardiac output, respectively. Although thermodilution cardiac output is a widely accepted clinical standard, transoesophageal Doppler echocardiography across the aortic valve offers adequate estimations of cardiac output. In particular, pulsed-wave Doppler cardiac output in both the transverse and longitudinal plane provides useful data.

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Minimally Invasive Hemodynamic Monitoring Using the Pressure Recording Analytical Method

Scolletta

Romano

Giomarelli

2006

Intensive Care Medicine

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Ventilation, Thermal Noise, and Errors in Cardiac Output Measurements after Cardiopulmonary Bypass

Cited by 72 publications

References 0 publications

Continuous versus intermittent thermodilution cardiac output measurement during orthotopic liver transplantation

Continuous versus intermittent thermodilution cardiac output measurement during orthotopic liver transplantation

A comparison of transoesophageal echocardiographic Doppler across the aortic valve and the thermodilution technique for estimating cardiac output

Minimally Invasive Hemodynamic Monitoring Using the Pressure Recording Analytical Method

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