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Related Experiment Videos

Stroke volume equation for impedance cardiography.

D P Bernstein1, H J M Lemmens

  • 1Department of Anesthesiology, Palomar Medical Center, Escondido, CA, USA. strokevolumedon@aol.com

Medical & Biological Engineering & Computing
|November 1, 2005
PubMed
Summary

A new equation (N) significantly improved cardiac output (CO) measurements using impedance cardiography (ICG) compared to older methods. This advancement offers more accurate CO assessment in cardiac surgery patients.

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Area of Science:

  • Cardiovascular Physiology
  • Biomedical Engineering
  • Medical Instrumentation

Background:

  • Cardiac output (CO) is a critical hemodynamic parameter.
  • Accurate CO monitoring is essential, especially in cardiac surgery.
  • Existing impedance cardiography (ICG) methods have limitations in precision.

Purpose of the Study:

  • To evaluate a novel equation (N) for calculating CO using ICG.
  • To compare the accuracy of equation N against thermodilution cardiac output (TDCO).
  • To assess improvements in stroke volume (SV) and CO determination.

Main Methods:

  • 106 cardiac surgery patients underwent pre-operative pulmonary artery catheterization.
  • Post-operative CO was measured simultaneously using ICG and TDCO.

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  • Four stroke volume equations (Kubicek, Sramek, Sramek-Bernstein, and N) were applied to ICG data.

    • Main Results:

    • Equation N yielded CO values (6.06 +/- 1.48 l/min) not significantly different from TDCO (5.97 +/- 1.41 l/min).
    • Older equations (K, S, SB) significantly underestimated CO compared to TDCO.
    • Bland-Altman analysis demonstrated good agreement between equation N and TDCO, unlike other methods.

    Conclusions:

    • The new equation N, incorporating a square-root transformation and mass-based volume conductor, significantly enhances ICG accuracy for CO measurement.
    • Equation N provides a superior, non-invasive alternative to existing transthoracic impedance techniques.
    • This improved ICG method offers more reliable CO assessment in post-operative cardiac patients.