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Cardiac output measurements with electrical velocimetry in patients undergoing CABG surgery: a comparison with intermittent thermodilution

Published online by Cambridge University Press:  01 March 2008

D. Mekiš ,
M. Kamenik ,
V. Starc  and
S. Jeretin
D. Mekiš
Affiliation:
Maribor Teaching Hospital, Department of Anaesthesiology, Intensive Care and Pain Management, Maribor, Slovenia
M. Kamenik*
Affiliation:
Maribor Teaching Hospital, Department of Anaesthesiology, Intensive Care and Pain Management, Maribor, Slovenia
V. Starc
Affiliation:
Ljubljana University School of Medicine, Institute of Physiology, Ljubljana, Slovenia
S. Jeretin
Affiliation:
Maribor Teaching Hospital, Department of Anaesthesiology, Intensive Care and Pain Management, Maribor, Slovenia
*
Correspondence to: Mirt Kamenik, Department of Anaesthesiology, Intensive Care and Pain Management, Maribor Teaching Hospital, Ljubljanska 5, 2000 Maribor, Slovenia. E-mail: mirt.kamenik@mf.uni-lj.si; Tel: +386 2 3211568; Fax: +386 2 312 393
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Summary

Background and objective

The purpose was to study the agreement between cardiac output measurements with electrical velocimetry vs. intermittent thermodilution before and after coronary artery bypass graft surgery.

Methods

Cardiac output was measured simultaneously with electrical velocimetry and intermittent thermodilution before and immediately after coronary artery bypass graft surgery, and in the intensive care unit. Measurements were performed in three different body positions. The results were analysed according to Bland and Altman.

Results

The mean bias of all 150 paired measurements in 16 patients was 0.21 ± 0.78 L min−1, and the mean error was 40%. Before skin incision the mean bias was 0.04 ± 0.41 L min−1, and the mean error was 25%. After skin closure the mean bias was 0.57 ± 0.92 L min−1, and the mean error was 42%. In the intensive care unit the mean bias was 0.26 ± 0.68 L min−1, and the mean error was 32%.

Conclusions

The agreement between cardiac output measurements with electrical velocimetry and intermittent thermodilution was clinically acceptable only before skin incision in coronary artery bypass graft surgery. The mean error was unacceptably high immediately after skin closure and was at a borderline level in the intensive care unit. Thus, the overall accuracy of cardiac output measurements with the electrical velocimetry technique during coronary artery bypass graft surgery is not clinically unacceptable.

Keywords

CARDIAC SURGERYCORONARY ARTERY GRAFTINGCARDIAC OUTPUT
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 3 , March 2008 , pp. 237 - 242
Copyright
Copyright © European Society of Anaesthesiology 2008

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References

1.Osypka, MJ, Bernstein, DP. Electrophysiologic principles and theory of stroke volume determination by thoracic electrical bioimpedance. AACN Clin Issues 1999; 10: 385–399.CrossRefGoogle ScholarPubMed
2.Kubicek, WG, Karnegis, JN, Patterson, RP, Witsoe, DA, Mattson, RH. Development and evaluation of an impedance cardiac output system. Aerospace Med 1966; 37: 1208–1212.Google ScholarPubMed
3.Bernstein, DP. A new stroke volume equation for thoracic electrical bioimpedance: theory and rationale. Crit Care Med 1986; 14: 904–909.CrossRefGoogle ScholarPubMed
4.Albert, N, Hail, M, Li, J, Young, J. Equivalence of bioimpedance and thermodilution in measuring cardiac output and index in patients with advanced, decompensated chronic heart failure hospitalized in critical care. J Am Coll Cardiol 2003; 41: 211A.CrossRefGoogle Scholar
5.Brown, CV, Martin, MJ, Shoemaker, WC et al. . The effect of obesity on bioimpedance cardiac index. Am J Surg 2005; 189: 547–550.CrossRefGoogle ScholarPubMed
6.Sageman, WS, Riffenburgh, RH, Spiess, BD. Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery. J Cardiothorac Vasc Anesth 2002; 16: 8–14.CrossRefGoogle ScholarPubMed
7.Spiess, BD, Patel, MA, Soltow, LO, Wright, IH. Comparison of bioimpedance vs. thermodilution cardiac output during cardiac surgery: evaluation of a second-generation bioimpedance device. J Cardiothorac Vasc Anesth 2001; 15: 567–573.CrossRefGoogle Scholar
8.Marik, PE, Pendelton JE Smith, R. A comparison of hemodynamic parameters derived from transthoracic electrical bioimpedance with those parameters obtained by thermodilution and ventricular angiography. Crit Care Med 1997; 25: 1545–1550.CrossRefGoogle ScholarPubMed
9.Genoni, M, Pelosi, P, Romand, JA, Pedoto, A, Moccetti, T, Malacrida, R. Determination of cardiac output during mechanical ventilation by electrical bioimpedance or thermodilution in the patients with acute lung injury: effects of positive end-expiratory pressure. Crit Care Med 1998; 26: 1441–1445.CrossRefGoogle ScholarPubMed
10.Funk, M, Nystrom, KV, Hutchinson, C et al. . Bioimpedance monitoring in patients with chronic heart failure. J Card Fail 2003; 9: S6.CrossRefGoogle Scholar
11.Raaijmakers, E, Faes, TJ, Scholten, RJ, Goovaerts, HG, Hetthaar, RM. A meta-analysis of three decades of validating thoracic impedance cardiography. Crit Care Med 1999; 27: 1203–1213.CrossRefGoogle ScholarPubMed
12 Bernstein DP, Osypka MJ. Apparatus and method for determining an approximation of the stroke volume and the cardiac output of the heart. US Patent No. 6,511,438 B2, 2003.Google Scholar
13.Schmidt, C, Theilmeier, G, Van Aken, H et al. . Comparison of electrical velocimetry and transoesophageal Doppler echocardiography for measuring stroke volume and cardiac output. Br J Anaesth 2005; 95: 603–610.CrossRefGoogle ScholarPubMed
14.Bland, JM, Altman, DG. Statistical methods for assesing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.CrossRefGoogle Scholar
15.Critchley, LA, Critchley, JA. A meta analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput 1999; 15: 85–91.CrossRefGoogle ScholarPubMed
16.Kiefer, H, Bellinghausen, W, Osypka, M et al. . Comparison of cardiac output measurements by electrical velocimetry with thermodilution in patients undergoing CABG surgery. Eur J Anaesthiol 2003; 20 (Suppl. 30):A-80: 21.Google Scholar
17.Suttner, S, Schollhorn, T, Boldt, J et al. . Noninvasive assessment of cardiac output using thoracic electrical bioimpedance in hemodynamically stable and unstable patients after cardiac surgery: a comparison with pulmonary artery thermodilution. Intensive Care Med 2006; 32: 2053–2058.CrossRefGoogle ScholarPubMed
18.Faltlhauser, A, Weber, T, Thomas, A. Electrical velocimetry – clinical validation of a new noninvasive co-monitor in postoperative non cardic surgical patients. Crit Care Med 2005; 33 (Suppl): A64.CrossRefGoogle Scholar
19.Doering, L, Lum, E, Dracup, K, Friedman, A. Predictors of between method differences in cardiac output measurement using thoracic electrical bioimpedance and thermodilution. Crit Care Med 1995; 23: 1667–1673.CrossRefGoogle ScholarPubMed
20.Nishikawa, T, Dohi, S. Errors in the measurement of cardiac output by thermodilution. Can J Anaesth 1993; 40: 142–153.CrossRefGoogle ScholarPubMed
21.Latson, TW, Whitten, CW, O Flaherty, D. Ventilation, thermal noise, and errors in cardiac output measurement after cardiopulmonary bypass. Anesthesiology 1993; 79: 1233–1243.CrossRefGoogle ScholarPubMed