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Room-temperature thermodilution cardiac output: central venous vs right ventricular port
G R Pesola1, H P Rostata, G C Carlon
1Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, New York, N.Y.
Objective:
To assess the accuracy of room-temperature thermodilution cardiac output measurements from the right ventricular port. In addition, waveform patterns were evaluated to determine the actual location of the right ventricular port.
Design:
Central venous port cardiac output measurements were compared with right ventricular port cardiac output measurements using the same right-heart catheter.
Setting:
The general intensive care unit of Memorial Sloan-Kettering Cancer Center.
Patients:
Thirty-seven critically ill cancer patients with 38 different right-heart catheters were evaluated.
Intervention:
Four injections of 10 mL normal saline at room temperature were made through each port; the results of the last three injections were averaged. Cardiac output determinations from both ports were completed in less than 10 minutes. The order of port injection was random.
Results:
No difference was noted between cardiac output determinations from the two ports in a paired t test. Of 38 right-heart catheters, 17 were in the right ventricle and the other 21 in the right atrium. A comparison of ports in the 17 right ventricle catheters showed no difference with a significant (P < .01; R2 = 0.96) correlation.
Conclusion:
Thermodilution cardiac output measurements using 10 mL normal saline at room temperature can be determined accurately using the right ventricular port if the central venous port becomes nonfunctional.