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Published on: August 16, 2016
Mean cardiac output by thermodilution with a single controlled injection
J R Jansen1, J J Schreuder, K D Punt
1Department of Intensive Care, Leiden University Medical Center, The Netherlands. JRCJansen@LUMC.nl
Objective:
A new method to estimate mean cardiac output by thermodilution with a single duration-controlled injection was evaluated in patients.
Design:
Prospective criterion standard study.
Setting:
University hospital cardiac surgical intensive care unit and cardiac operation room.
Patients:
Of 33 patients, 24 underwent coronary bypass graft surgery, four had a valve replacement, and five were treated in the intensive care unit.
Interventions:
Interventions consisted of thermodilution cardiac output measurements. One single duration-controlled injection of cold fluid was used to calculate cardiac output. This controlled injection was performed with a duration equal to one whole ventilation cycle of the ventilator. An algorithm adapted to this duration-controlled injection calculated cardiac output. Moreover, this algorithm has properties to reduce errors caused by artificial ventilation and thermal noise.
Measurements And Main Results:
In 33 patients, the averaged values of four measurements equally spread over the ventilatory cycle (phase-controlled) were compared with the values of two single duration-controlled measurements. The measurements were performed during periods of stable respiration and circulation. No significant difference was observed between the mean of four phase-controlled measurements and the mean of the two duration-controlled measurements. The cardiac output values in the intensive care patients were significantly higher compared with the two other patient groups (p <.05). The difference between the two methods could not be subdivided for the three patient groups (p >.05). The coefficient of variation of the single duration-controlled thermodilution measurements was significantly lower than the single phase-controlled measurements, 3% vs. 6% (p <.01).
Conclusions:
One single duration-controlled injection thermodilution measurement is as accurate and repeatable as the mean of four phase-controlled measurements and is clinically feasible.
