PMID- 21354828
OWN - NLM
STAT- MEDLINE
DCOM- 20120203
LR  - 20111003
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 25
IP  - 5
DP  - 2011 Oct
TI  - Cardiac output determination from endotracheally measured impedance cardiography: 
      clinical evaluation of endotracheal cardiac output monitor.
PG  - 770-5
LID - 10.1053/j.jvca.2010.12.017 [doi]
AB  - OBJECTIVES: To evaluate the accuracy, precision, and trending of a new 
      endotracheally sourced impedance cardiography-based cardiac output (CO) monitor 
      (ECOM; ConMed Corp, Irvine, CA). SETTING: Two university hospitals. PARTICIPANTS: 
      Thirty patients scheduled for elective coronary artery bypass graft (CABG) 
      surgery. INTERVENTIONS: All patients received a pulmonary artery catheter (PAC), 
      arterial catheter, endotracheal CO monitor (ECOM), endotracheal intubation, and 
      transesophageal echocardiographic monitoring. ECOM CO was compared with CO 
      measured with pulmonary artery thermodilution, and left ventricular CO measured 
      with transesophageal echocardiography. MEASUREMENTS: One hundred forty-five pairs 
      of triplicate CO measurements using intermittent bolus pulmonary artery 
      thermodilution (TD) and ECOM were compared at 5 distinct time points: 
      postinduction, postinduction passive leg raise, poststernotomy, post-CABG 
      completion, and post-chest closure. Eighty-seven pairs of triplicate CO 
      measurements using transesophageal echocardiography were obtained at 3 time 
      points: postinduction, post-CABG completion, and post-chest closure and compared 
      with ECOM- and PA-derived CO measurements. The measurements at each time point 
      were compared by using Bland-Altman and polar plot analyses. RESULTS: The mean CO 
      ranged from 2.16 to 9.41 L/min. ECOM CO, compared with TD CO, revealed a bias of 
      0.02 L/min, 95% limits of agreement of -2.26 to 2.30 L/min, and a percent error 
      of 50%. ECOM CO showed trending with TD CO with 91% and 99% of values within 
      0.5L/min and 1 L/min limits of agreement, respectively. ECOM CO, compared with 
      TEE CO, revealed a bias of -0.25 L/min, 95% limits of agreement of -2.41 to 1.92 
      L/min, and a percent error of 48%. ECOM CO showed trending with TEE CO with 83% 
      and 95% of values within 0.5L/min and 1 L/min limits of agreement, respectively. 
      CONCLUSION: ECOM CO shows an acceptable bias with wide limits of agreement and a 
      large percent error when compared with TD CO or TEE CO; however, it shows 
      acceptable trending of CO to both modalities in patients undergoing cardiac 
      surgery. Further studies are required to evaluate ECOM in other patient 
      populations and clinical situations.
CI  - Copyright (c) 2011 Elsevier Inc. All rights reserved.
FAU - Maus, Timothy M
AU  - Maus TM
AD  - Thornton Hospital, University of California San Diego, La Jolla, CA 92093-7770, 
      USA. tmaus@ucsd.edu
FAU - Reber, Bradley
AU  - Reber B
FAU - Banks, Dalia A
AU  - Banks DA
FAU - Berry, Ashley
AU  - Berry A
FAU - Guerrero, Emmanuel
AU  - Guerrero E
FAU - Manecke, Gerard R
AU  - Manecke GR
LA  - eng
PT  - Journal Article
DEP - 20110226
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
MH  - Aged
MH  - Anesthesia, General
MH  - Cardiac Output/*physiology
MH  - Cardiography, Impedance/*methods
MH  - Catheterization, Swan-Ganz
MH  - Coronary Artery Bypass
MH  - Diabetes Complications/epidemiology
MH  - Echocardiography, Transesophageal
MH  - Female
MH  - Humans
MH  - Intubation, Intratracheal/*methods
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/methods
MH  - Thermodilution
EDAT- 2011/03/01 06:00
MHDA- 2012/02/04 06:00
CRDT- 2011/03/01 06:00
PHST- 2010/10/22 00:00 [received]
PHST- 2011/03/01 06:00 [entrez]
PHST- 2011/03/01 06:00 [pubmed]
PHST- 2012/02/04 06:00 [medline]
AID - S1053-0770(10)00575-6 [pii]
AID - 10.1053/j.jvca.2010.12.017 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2011 Oct;25(5):770-5. doi: 
      10.1053/j.jvca.2010.12.017. Epub 2011 Feb 26.