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Comparison of continuous with intermittent bolus thermodilution cardiac output measurements
C E Ditmyer1, M Shively, D B Burns
1Palomar Medical Center, Escondido, Calif., USA.
Background:
Few complete studies have been published to validate the agreement between continuous cardiac output and intermittent thermodilution cardiac output.
Objective:
To analyze the agreement between cardiac output measurements by the continuous thermodilution method and the intermittent bolus thermodilution method, using a continuous cardiac output catheter in postoperative cardiothoracic surgery patients.
Methods:
A convenience sample of 14 adult cardiothoracic surgical patients with thermodilution pulmonary artery catheters placed preoperatively was used. A total of 214 comparison measurements of cardiac output by both the continuous and intermittent thermodilution methods were taken on patient admission to the critical care unit, every 4 hours, and with any change greater than 10% from baseline readings.
Results:
The intraclass correlation between continuous cardiac output and intermittent cardiac output was .89. The limits of agreement were -1.34 to 1.18 L/min, indicating that in 95% of readings the difference between continuous cardiac output and intermittent cardiac output were within this range.
Conclusions:
The continuous cardiac output monitoring method shows clinically acceptable agreement with the intermittent cardiac output method.