Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T03:06:11.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of cardiac output measurements between NICO and the pulmonary artery catheter during repeat surgery for total hip replacement

Published online by Cambridge University Press:  01 December 2007

G. Gueret ,
G. Kiss ,
S. Khaldi ,
R. Le Jouan ,
A. Le Grand ,
Y. Perrament ,
C. Lefèvre  and
C. C. Arvieux
G. Gueret*
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
G. Kiss
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
S. Khaldi
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
R. Le Jouan
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
A. Le Grand
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
Y. Perrament
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
C. Lefèvre
Affiliation:
University Hospital, Orthopedic Surgery Department, La Cavale Blanche, Brest, France
C. C. Arvieux
Affiliation:
University Hospital, Anesthesiology and Critical Care Department, La Cavale Blanche, Brest, France
*
Correspondence to: Gildas Gueret, Anesthesiology and Critical Care Department, University Hospital, Boulevard T Prigent, Brest 29609, France. E-mail: [email protected]; Tel: +33 2 9834 7288; Fax: +33 2 9834 7441
Get access

Summary

Objective

The aim of this study was to compare cardiac output measurements of the non-invasive cardiac output and the pulmonary artery catheter during repeat surgery for hip replacement.

Methods

In this prospective observational study, patients undergoing repeat hip surgery who needed a pulmonary artery catheter were included. A standard protocol was followed for induction, endotracheal intubation and maintenance of anaesthesia (sufentanil, etomidate, sevoflurane, cisatracurium). After endotracheal intubation, the non-invasive cardiac output was connected and a pulmonary artery catheter was inserted. Data were collected every 3 min until patients were extubated.

Results

Ten patients were included and 2455 points of comparison recorded. Cardiac output from the pulmonary artery catheter varied from 1.7 to 8.9 L min−1 (mean 4.1 L min−1) and the non-invasive cardiac output (using averaging mode) from 1.7 to 8.0 L min−1 (mean 3.7 L min−1). There was a significant correlation between them (P < 0.01; bias 0.3 L min−1; limits of agreement +1.9 and –2.5 L min−1), although these differed between patients.

Conclusion

The perioperative bias was small and the non-invasive cardiac output slightly underestimated cardiac output intraoperatively compared to the pulmonary artery catheter. The bias was smaller when mean cardiac output was below 3 L min−1. Core temperature between 34.4°C and 37.6°C had no influence on the differences.

Keywords

CARDIAC OUTPUTMEASUREMENTTHERMODILUTIONSURGERY ORTHOPAEDIC, hip replacement
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 12 , December 2007 , pp. 1028 - 1033
Copyright
Copyright © European Society of Anaesthesiology 2007

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

1.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
2.JrPerrino, AC, O’Connor, T, Luther, M. Transtracheal Doppler cardiac output monitoring: comparison to thermodilution during noncardiac surgery. Anesth Analg 1994; 78: 1060–1066.CrossRefGoogle ScholarPubMed
3.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
4.Harris, SN, Ballantyne, GH, Luther, MA, JrPerrino, AC. Alterations of cardiovascular performance during laparoscopic colectomy: a combined hemodynamic and echocardiographic analysis. Anesth Analg 1996; 83: 482–487.CrossRefGoogle ScholarPubMed
5.Shoemaker, WC, Wo, CC, Chan, L et al. . Outcome prediction of emergency patients by noninvasive hemodynamic monitoring. Chest 2001; 120: 528–537.CrossRefGoogle ScholarPubMed
6.Rauch, H, Muller, M, Fleischer, F, Bauer, H, Martin, E, Bottiger, BW. Pulse contour analysis vs. thermodilution in cardiac surgery patients. Acta Anaesthesiol Scand 2002; 46: 424–429.CrossRefGoogle Scholar
7.Sandham, JD, Hull, RD, Brant, RF et 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
8.Spodick, DH. The pulmonary artery catheter. Chest 1999; 115: 857–858.CrossRefGoogle Scholar
9.Berthelsen, PG. Clinical evaluation of a partial CO2 rebreathing technique. Acta Anaesthesiol Scand 2002; 46: 1175–1180; discussion 1175–1176.Google Scholar
10.Jaffe, MB. Partial CO2 rebreathing cardiac output--operating principles of the NICO system. J Clin Monit Comput 1999; 15: 387–401.Google Scholar
11.Botero, M, Hess, P, Kirby, D, Briesacher, K, Gravenstein, N, Lobato, EB. Measurement of cardiac output in the intensive care unit (ICU) after coronary artery bypass grafting (CABG): comparison of pulmonary artery catheter and non invasive partial CO2 rebreathing (NICO2). Anesthesiology 2000; 92: A590.Google Scholar
12.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
13.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.CrossRefGoogle ScholarPubMed
14.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.CrossRefGoogle Scholar
15.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
16.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
17.Zollner, C, Polasek, J, Kilger, E et 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.CrossRefGoogle ScholarPubMed
18.Gueret, G, Rossignol, B, Kiss, G et al. . Cardiac output measurements in off-pump coronary surgery: comparison between NICO and the Swan-Ganz catheter. Eur J Anaesthesiol 2006; 23: 848–854.CrossRefGoogle ScholarPubMed
19.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
20.Triantafillou, AN, Benumof, JL, Lecamwasam, HS. Physiology of the lateral decumitus position, the open chest, and one-lung ventilation. In: Kaplan, JA, Slinger, PD, eds. Thoracic Anesthesia, 3rd edn. Philadelphia: Churchill Livingstone, 2003: 71–94.Google Scholar
21.Murias, GE, Villagra, A, Vatua, S et al. . Evaluation of a noninvasive method for cardiac output measurement in critical care patients. Intensive Care Med 2002; 28: 1470–1474.CrossRefGoogle ScholarPubMed
22.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.CrossRefGoogle ScholarPubMed
23.Schulz, K, Abel, HH, Werning, P. Comparison between continuous and intermittent thermodilution measurement of cardiac output during coronary artery bypass operation (German). Anasthesiol Intensivmed Notfallmed Schmerzther 1997; 32: 226–233.Google Scholar
24.Zink, W, Noll, J, Rauch, H et al. . Continuous assessment of right ventricular ejection fraction: new pulmonary artery catheter vs. transoesophageal echocardiography. Anaesthesia 2004; 59: 1126–1132.CrossRefGoogle Scholar