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Related Experiment Videos

Right ventricular function computed by thermodilution and ventriculography. A comparison of methods.

F G Spinale1, A C Smith, B A Carabello

  • 1Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425.

The Journal of Thoracic and Cardiovascular Surgery
|January 1, 1990
PubMed
Summary

Right ventricular ejection fraction (RVEF) can be estimated using thermodilution. Accuracy improves when the thermistor is placed closer to the pulmonic valve, offering a simple method for monitoring RVEF in critical care.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Physiology

Background:

  • Estimating right ventricular ejection fraction (RVEF) clinically is challenging.
  • Thermodilution techniques with fast-response thermistors offer a potential method for RVEF calculation.
  • Previous studies have not fully validated thermodilution against established methods across various hemodynamic conditions.

Purpose of the Study:

  • To compare RVEF measurements obtained via thermodilution and biplane ventriculography.
  • To assess the impact of thermistor placement on thermodilution accuracy for RVEF.
  • To evaluate the utility of thermodilution for monitoring RVEF in critical care settings.

Main Methods:

  • Ten pigs underwent instrumentation with right ventricular angiographic, thermodilution, and systemic arterial catheters.

Related Experiment Videos

  • RVEF was determined by thermodilution and ventriculography under baseline, isoproterenol infusion, hemorrhage-induced hypotension, and hypovolemic reinfusion conditions.
  • Thermodilution RVEF was re-evaluated in 10 additional pigs with jugular versus femoral thermistor insertion.

    • Main Results:

    • A significant correlation (r = 0.74, p = 0.004) was found between thermodilution and ventriculographic RVEF.
    • Thermodilution underestimated RVEF during hypovolemia compared to ventriculography (p < 0.05).
    • Femoral thermistor placement (greater distance from pulmonic valve) yielded significantly lower RVEF than jugular placement (p = 0.008) and ventriculography (p = 0.006).
    • Jugular thermistor placement showed no significant difference from ventriculography (p = 0.35).

    Conclusions:

    • Thermodilution RVEF measurements correlate strongly with ventriculographic methods across a wide hemodynamic range.
    • Optimizing thermistor placement, minimizing pulmonic valve-to-thermistor distance, enhances thermodilution accuracy.
    • Thermodilution presents a simple, repeatable method for monitoring right ventricular function in critical care.