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Cardiovascular monitoring by pulse dye densitometry or arterial indocyanine green dilution

Marije Reekers1, Mischa J G Simon, Fred Boer

  • 1Department of Anesthesiology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands. m.reekers@lumc.n

Anesthesia and Analgesia
|July 18, 2009
PubMed

Insights

Pulse dye densitometry (PDD) for noninvasive cardiac output (CO) monitoring showed wide limits of agreement for CO and central blood volume (CBV) compared to invasive methods. This suggests PDD has limited clinical reliability for individual patient cardiovascular assessment.

Area of Science:

  • Cardiovascular Physiology
  • Medical Instrumentation
  • Diagnostic Technologies

Background:

  • Noninvasive cardiac output (CO) monitoring is crucial for patient management.
  • Indocyanine green (ICG) dilution measured by pulse dye densitometry (PDD) offers a noninvasive approach.
  • Validation of PDD's precision against invasive methods is necessary.

Purpose of the Study:

  • To validate the precision of PDD for measuring hemodynamic variables.
  • To compare CO, central blood volume (CBV), and total blood volume (TBV) derived from PDD with invasive ICG measurements.
  • To assess the clinical utility of PDD in individual patients.

Main Methods:

  • 36 sessions in 20 patients using PDD (finger and nose probes) after IV ICG administration.
  • Simultaneous arterial blood sampling for ICG concentration measurement.
  • Comparison of PDD-derived and invasive ICG-derived hemodynamic variables using Bland-Altman analysis.

Main Results:

  • PDD with finger probe: CO (LOA -56% to 47%), CBV (LOA -54% to 96%), TBV (LOA -38% to 8%).
  • PDD with nose probe: CO (LOA -67% to 127%), CBV (LOA -98% to 193%), TBV (LOA -47% to 27%).
  • Both probes showed wide limits of agreement for CO and CBV.

Conclusions:

  • Despite acceptable bias, wide LOA indicate PDD is unsuitable for individual CO and CBV evaluation.
  • The reliability and clinical use of PDD for cardiovascular variables appear limited.
  • Further research may be needed to improve PDD accuracy and precision.
Abstract

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