Evaluation of the CO2 rebreathing cardiac output method in seriously ill patients

The CO2 rebreathing cardiac output method is a totally noninvasive Fick procedure needing validation in various disease states to become clinically applicable. Simultaneous measurements of cardiac output by CO2 rebreathing and dye-dilution or direct Fick techniques were performed in 53 patients. In nine patients with pulmonary disease rebreathing cardiac output averaged 4.85 L/min compared to 5.18 L/min by dye-dilution or Fick (r = 0.16). In 14 instances of acute myocardial infarction cardiac output was 5.53 L/min by rebreathing and 5.87 L/min by dye-dilution (r = 0.95), while in nine shock cases it averaged 3.98 L/min by dye-dilution or Fick and 3.75 L/min by CO2 rebreathing (r = 0.94). In five heart failure cases with mitral insufficiency, which may distort dye durves, correlation between standard and rebreathing methods was r = 0.09, but in 16 cases without mitral regurgitation, r = 0.89. Acute interventions in ten patients increased dye-dilution cardiac output by 0.92 L/min and rebreathing outputs by 0.60 L/min (r = 0.87). The data suggest that the CO2 rebreathing cardiac output method may be useful in the CCU-MICU setting.