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      Comparison of continuous cardiac output measurements in patients after cardiac surgery.

      Journal of cardiothoracic and vascular anesthesia

      Time Factors, Aged, statistics & numerical data, Thermodilution, Respiration, Reproducibility of Results, Pulse, physiology, Pulmonary Circulation, Prospective Studies, Postoperative Period, Monitoring, Physiologic, Middle Aged, Humans, surgery, Coronary Disease, Coronary Artery Bypass, Cardiac Output, metabolism, Carbon Dioxide, Bias (Epidemiology)

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          Abstract

          To investigate in a direct comparison accuracy and precision of continuous cardiac output measurements assessed by continuous pulmonary artery thermodilution technique (TDCCO), continuous pulse contour analysis (PCCO), and noninvasive partial CO(2)-rebreathing technique (NICO) in patients after coronary artery bypass grafting (CABG) during the postoperative period. Prospective, controlled clinical study. University hospital. Twenty-two patients undergoing elective CABG surgery. Hemodynamic measurements were performed after admission to the ICU and in sequence every 2 hours during the subsequent 6-hour period. Simultaneously, cardiac output (CO) was measured using a TDCCO, PCCO, and NICO. After the continuous cardiac output measurements were read, bolus thermodilution-derived cardiac output was obtained from thermodilution curves detected in the pulmonary artery (TDBCO(pa)). Four intermittent consecutive boli consisting of 10 mL of ice-cold saline were randomly injected over the ventilatory cycle. The comparison between the continuous cardiac output measurement methods TDCCO versus PCCO showed a bias of -0.12 L/min, between TDCCO versus NICO -0.17 L/min, and between PCCO versus NICO -0.44 L/min. The comparison to the reference technique between TDBCO(pa) versus TDCCO revealed a bias of -0.28 L/min, between TDBCO(pa) versus PCCO -0.40 L/min, and between TDBCO(pa) versus NICO -0.64 L/min. The results of this clinical investigation show agreement between TDCCO and PCCO to satisfy clinical requirements in a setting of postoperative patients after cardiac surgery. In contrast, the NICO monitor is of very limited use in these patients. Copyright 2003 Elsevier Inc. All rights reserved.

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          Journal
          10.1053/jcan.2003.49
          12698404

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