Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T15:14:59.176Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiac output measurements in off-pump coronary surgery: comparison between NICO and the Swan-Ganz catheter

Published online by Cambridge University Press:  04 April 2006

G. Gueret ,
G. Kiss ,
B. Rossignol ,
E. Bezon ,
J. P. Wargnier ,
A. Miossec ,
O. Corre  and
C. C. Arvieux
G. Gueret
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
G. Kiss
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
B. Rossignol
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
E. Bezon
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
J. P. Wargnier
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
A. Miossec
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
O. Corre
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
C. C. Arvieux
Affiliation:
University Hospital, Department of Anesthesiology and Surgical Intensive Care Unit, Brest, France
Get access

Abstract

Summary

Background: The aim of this prospective study was to compare continuous cardiac output measurements of the non-invasive cardiac output system (NICO) with the pulmonary artery catheter during off-pump coronary bypass surgery. Methods: Twenty-two patients enrolled for off-pump coronary surgery received both a pulmonary artery catheter and a non-invasive cardiac output system for measurement of cardiac output. Data were compared by the Bland–Altman method to calculate the degree of agreement and to analyse if a significant difference existed between the two methods of cardiac output measurements. Results: Perioperatively, the non-invasive cardiac output underestimated cardiac output, but postoperatively overestimated it. The limits of agreement were larger during surgery compared to the postoperative period (−3.1; +2.5 vs. −1.4; +2.2 L min−1). Perioperatively, cardiac output measured with the pulmonary artery catheter varied from 0.5 to 7.5 L min−1 (mean 3.6 L min−1) and with the non-invasive cardiac output from 0.5 to 8.4 L min−1 (mean 3.9 L min−1). Postoperatively, these were 2.5–7.7 L min−1 (mean 4.5 L min−1) and 2.3–8.4 L min−1 (mean 4.9 L min−1), respectively. Conclusion: During off-pump cardiac surgery, the non-invasive cardiac output reliably measures cardiac output and does it more rapidly than a pulmonary artery catheter and may be more useful in order to detect rapid haemodynamic changes.

Keywords

SURGERY CARDIAC, off-pumpCARDIAC OUTPUT, thermodilution, non-invasiveMETHODS, cardiac output monitoring, comparisonCATHETERIZATION, SWAN-GANZ
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 10 , October 2006 , pp. 848 - 854
Copyright
2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sun Q, Rogiers P, Pauwels D, Vincent JL. Comparison of continuous thermodilution and bolus cardiac output measurements in septic shock. Intensive Care Med 2002; 28: 1276–1280.Google Scholar
Valtier B, Cholley BP, Belot JP, de la Coussaye JE, Mateo J, Payen DM. Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med 1998; 158: 77–83.Google Scholar
Berthelsen PG. Clinical evaluation of a partial CO2 rebreathing technique. Acta Anaesthesiol Scand 2002; 46: 1175–1180; discussion 1175–1176.Google Scholar
Botero M, Kirby D, Lobato EB, Staples ED, Gravenstein N. Measurement of cardiac output before and after cardiopulmonary bypass: comparison among aortic transit-time ultrasound, thermodilution, and noninvasive partial CO2 rebreathing. J Cardiothorac Vasc Anesth 2004; 18: 563–572.Google Scholar
Shoemaker WC, Wo CC, Chan Let al. Outcome prediction of emergency patients by noninvasive hemodynamic monitoring. Chest 2001; 120: 528–537.Google Scholar
Bettex DA, Hinselmann V, Hellermann JP, Jenni R, Schmid ER. Transoesophageal echocardiography is unreliable for cardiac output assessment after cardiac surgery compared with thermodilution. Anaesthesia 2004; 59: 1184–1192.Google Scholar
Rauch H, Muller M, Fleischer F, Bauer H, Martin E, Bottiger BW. Pulse contour analysis versus thermodilution in cardiac surgery patients. Acta Anaesthesiol Scand 2002; 46: 424–429.Google Scholar
Sandham JD, Hull RD, Brant RFet al. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 2003; 348: 5–14.Google Scholar
Spodick DH. The pulmonary artery catheter. Chest 1999; 115: 857–858.Google Scholar
Grow MP, Singh A, Fleming NW, Young N, Watnik M. Cardiac output monitoring during off-pump coronary artery bypass grafting. J Cardiothorac Vasc Anesth 2004; 18: 43–46.Google Scholar
Schulz K, Abel HH, Werning P. Comparison between continuous and intermittent thermodilution measurement of cardiac output during coronary artery bypass operation. Anasthesiol Intensivmed Notfallmed Schmerzther 1997; 32: 226–233.Google Scholar
Jaffe MB. Partial CO2 rebreathing cardiac output – operating principles of the NICO system. J Clin Monit Comput 1999; 15: 387–401.Google Scholar
Yelderman ML, Ramsay MA, Quinn MD, Paulsen AW, McKown RC, Gillman PH. Continuous thermodilution cardiac output measurement in intensive care unit patients. J Cardiothorac Vasc Anesth 1992; 6: 270–274.Google Scholar
Yelderman M. Continuous measurement of cardiac output with the use of stochastic system identification techniques. J Clin Monit 1990; 6: 322–332.Google Scholar
Thrush D, Downs JB, Smith RA. Continuous thermodilution cardiac output: agreement with Fick and bolus thermodilution methods. J Cardiothorac Vasc Anesth 1995; 9: 399–404.Google Scholar
Gueret G, Rossignol B, Kiss Get al. Is muscle relaxant necessary for cardiac surgery? Anesth Analg 2004; 99: 1330–1333.Google Scholar
Bland JM, Altman DG. Statistical methods for assessing agreement between 2 methods of clinical measurement. Lancet 1986; 1: 307–310.Google Scholar
Tachibana K, Imanaka H, Miyano H, Takeuchi M, Kumon K, Nishimura M. Effect of ventilatory settings on accuracy of cardiac output measurement using partial CO2 rebreathing. Anesthesiology 2002; 96: 96–102.Google Scholar
Burchell SA, Yu M, Takiguchi SA, Ohta RM, Myers SA. Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients. Crit Care Med 1997; 25: 388–391.Google Scholar
Zollner C, Polasek J, Kilger Eet al. Evaluation of a new continuous thermodilution cardiac output monitor in cardiac surgical patients: a prospective criterion standard study. Crit Care Med 1999; 27: 293–298.Google Scholar
Jacquet L, Hanique G, Glorieux D, Matte P, Goenen M. Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med 1996; 22: 1125–1129.Google Scholar
Mielck F, Buhre W, Hanekop G, Tirilomis T, Hilgers R, Sonntag H. Comparison of continuous cardiac output measurements in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2003; 17: 211–216.Google Scholar
Rocco M, Spadetta G, Morelli Aet al. A comparative evaluation of thermodilution and partial CO2 rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation. Intensive Care Med 2004; 30 (1): 82–89.Google Scholar
Murias GE, Villagra A, Vatua Set al. Evaluation of a noninvasive method for cardiac output measurement in critical care patients. Intensive Care Med 2002; 28: 1470–1474.Google Scholar
de Abreu MG, Geiger S, Winkler Tet al. Evaluation of a new device for noninvasive measurement of nonshunted pulmonary capillary blood flow in patients with acute lung injury. Intensive Care Med 2002; 28: 318–323.Google Scholar
van Heerden PV, Baker S, Lim SI, Weidman C, Bulsara M. Clinical evaluation of the non-invasive cardiac output (NICO) monitor in the intensive care unit. Anaesth Intensive Care 2000; 28: 427–430.Google Scholar
Odenstedt H, Stenqvist O, Lundin S. Clinical evaluation of a partial CO2 rebreathing technique for cardiac output monitoring in critically ill patients. Acta Anaesthesiol Scand 2002; 46: 152–159.Google Scholar
Nilsson LB, Eldrup N, Berthelsen PG. Lack of agreement between thermodilution and carbon dioxide-rebreathing cardiac output. Acta Anaesthesiol Scand 2001; 45: 680–685.Google Scholar
Binder JC, Parkin WG. Non-invasive cardiac output determination: comparison of a new partial-rebreathing technique with thermodilution. Anaesth Intensive Care 2001; 29: 19–23.Google Scholar
Rocco M, Spadetta G, Morelli Aet al. A comparative evaluation of thermodilution and partial CO2 rebreathing techniques for cardiac output assessment in critically ill patients during assisted ventilation. Intensive Care Med 2004; 30: 82–87.Google Scholar
Dhingra VK, Fenwick JC, Walley KR, Chittock DR, Ronco JJ. Lack of agreement between thermodilution and fick cardiac output in critically ill patients. Chest 2002; 122: 990–997.Google Scholar
Schrijen F, Henriquez A, Renondo J, Poincelot F, Pichene M. Inter- and intrasubject variability of the thermodilution measurement of right ventricular ejection fraction and volume in patients with chronic obstructive pulmonary disease. Cardiovasc Res 1990; 24: 33–36.Google Scholar
Haller M, Zollner C, Briegel J, Forst H. Evaluation of a new continuous thermodilution cardiac output monitor in critically ill patients: a prospective criterion standard study. Crit Care Med 1995; 23: 860–866.Google Scholar
Padua G, Canestrelli G, Pala G, Sechi D, Spanu MC. Original insight into continuous cardiac output monitoring: “TruCCOMS” correlation with other methods. Minerva Anestesiol 2003; 69: 617–622.Google Scholar
Fujii S, Kikura M, Takada T, Katoh S, Aoyama N, Sato S. A noninvasive partial carbon dioxide rebreathing technique for measurement of pulmonary capillary blood flow is also a useful oxygenation monitor during one-lung ventilation. J Clin Anesth 2004; 16: 347–352.Google Scholar
Bein B, Hanne P, Hanss Ret al. Effect of xenon anaesthesia on accuracy of cardiac output measurement using partial CO2 rebreathing. Anaesthesia 2004; 59: 1104–1110.Google Scholar
Haryadi DG, Orr JA, Kuck K, McJames S, Westenskow DR. Partial CO2 rebreathing indirect Fick technique for non-invasive measurement of cardiac output. J Clin Monit Comput 2000; 16: 361–374.Google Scholar
Zink W, Noll J, Rauch Het al. Continuous assessment of right ventricular ejection fraction: new pulmonary artery catheter vs. transoesophageal echocardiography. Anaesthesia 2004; 59: 1126–1132.Google Scholar