Prediction of post-cardiopulmonary bypass cardiac output

The ability to predict cardiac output (CO) before termination of cardiopulmonary bypass (CPB) allows identification of potential complications once the patient is off bypass. We have previously demonstrated that CO early after CPB can be reliably predicted by a plot of venous oxygen saturation at various flow rates on CPB, based on in-line monitoring of venous oxygen saturation. In this study, we evaluated a simplified technique for predicting CO with a series of 50 patients on CPB. When CPB weaning began, patients were normothermic, anesthetized, and paralyzed. Venous oxygen saturation and arterial blood flow were recorded. At low pump flow just before termination of CPB, the final venous oxygen saturation was recorded. Assuming a proportional relationship between venous oxygen saturation and arterial blood flow, CO early after CPB was predicted. The simplified CO prediction was compared with the thermodilution CO immediately after CPB. The simplified technique reliably predicted CO early after CPB compared with the thermodilution technique. The simplicity and reliability increase the clinical value of the CO prediction.