PMID- 2131856
OWN - NLM
STAT- MEDLINE
DCOM- 19911231
LR  - 20191029
IS  - 0888-6296 (Print)
IS  - 0888-6296 (Linking)
VI  - 4
IP  - 1
DP  - 1990 Feb
TI  - Noninvasive versus invasive assessment of cardiac output after cardiac surgery: 
      clinical validation.
PG  - 46-59
AB  - The accuracy of noninvasive cardiac output (CO) measurement techniques, such as 
      electrical bioimpedance (BIO), suprasternal continuous-wave Doppler (CWD), 
      pulsed-wave Doppler (PWD), and transesophageal continuous-wave Doppler (TED) 
      ultrasound has been variably judged in recent years. In addition, clinical 
      comparisons are hampered by the fact that there is no generally accepted gold 
      standard in CO measurement. After coronary artery bypass surgery in 25 patients, 
      CO was simultaneously determined by invasive standard techniques (thermodilution 
      [TD] and Fick methods) plus BIO, CWD, PWD, and TED. There was an excellent 
      agreement found between TD and the Fick method (COF = 0.13 + 1.01.COTD; r = 0.96; 
      n = 99). Thermodilution was thus chosen to be the reference method. Bioimpedance 
      underestimated COTD (COBIO = 0.47 + 0.60.COTD; r = 0.78; n = 111). Allowing 
      physiological ejection times only led to an improved agreement between BIO and TD 
      (COBIO = 0.05 + 0.69.COTD; r = 0.82; n = 79), but BIO still significantly 
      underestimated COTD (P less than 0.0005). Using physiologic ejection times during 
      COCWD determination reduced the scatter of data as compared with TD; however, CWD 
      still considerably overestimated COTD, when COCWD computation was based on the 
      echocardiographic aortic diameter (ECHO) (COCWD ECHO = 0.79 + 1.40.COTD; r = 
      0.84; n = 52). With the surgical aortic diameter (SURG), the agreement improved 
      (COCWD SURG = 0.75 + 1.16.COTD; r = 0.89; n = 44), but overestimation of COTD 
      remained significant (P less than 0.05). Irrespective of the aortic diameter, 
      COPWD values showed a considerable scatter of data compared with COTD (COPWD ECHO 
      = 1.26 + 0.60.COTD; r = 0.62; n = 64 and COPWD SURG = 1.42 + 0.41.COTD; r = 0.47; 
      n = 61). Correlation of absolute COTED values to thermodilution depended on the 
      method used for calibration. All investigated noninvasive CO measurement 
      techniques unreliably measured relative CO changes. Despite its invasiveness, TD 
      remains the method of choice for accurate CO determination in adult patients 
      following cardiac surgery.
FAU - Spahn, D R
AU  - Spahn DR
AD  - Division of Cardiovascular Anesthesia, University Hospital, Zurich, Switzerland.
FAU - Schmid, E R
AU  - Schmid ER
FAU - Tornic, M
AU  - Tornic M
FAU - Jenni, R
AU  - Jenni R
FAU - von Segesser, L
AU  - von Segesser L
FAU - Turina, M
AU  - Turina M
FAU - Baetscher, A
AU  - Baetscher A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiothorac Anesth
JT  - Journal of cardiothoracic anesthesia
JID - 8709732
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Aorta/diagnostic imaging/physiology
MH  - Blood Flow Velocity/physiology
MH  - Cardiac Output/*physiology
MH  - *Cardiography, Impedance/statistics & numerical data
MH  - *Coronary Artery Bypass
MH  - *Echocardiography, Doppler/methods/statistics & numerical data
MH  - Evaluation Studies as Topic
MH  - Female
MH  - Heart Rate/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oxygen/*blood
MH  - Oxygen Consumption/*physiology
MH  - Regression Analysis
MH  - Reproducibility of Results
MH  - Stroke Volume/physiology
MH  - *Thermodilution/statistics & numerical data
EDAT- 1990/02/01 00:00
MHDA- 1990/02/01 00:01
CRDT- 1990/02/01 00:00
PHST- 1990/02/01 00:00 [pubmed]
PHST- 1990/02/01 00:01 [medline]
PHST- 1990/02/01 00:00 [entrez]
AID - 10.1016/0888-6296(90)90447-n [doi]
PST - ppublish
SO  - J Cardiothorac Anesth. 1990 Feb;4(1):46-59. doi: 10.1016/0888-6296(90)90447-n.