PMID- 28125464
OWN - NLM
STAT- MEDLINE
DCOM- 20180216
LR  - 20181202
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Print)
IS  - 1058-2916 (Linking)
VI  - 63
IP  - 4
DP  - 2017 Jul/Aug
TI  - Cardiac Output Assessment in Patients Supported with Left Ventricular Assist 
      Device: Discordance Between Thermodilution and Indirect Fick Cardiac Output 
      Measurements.
PG  - 433-437
LID - 10.1097/MAT.0000000000000528 [doi]
AB  - Cardiac output (CO) assessed by thermodilution (TD) and indirect Fick (iFK) 
      methods is commonly employed in left ventricular assist device (LVAD) patients; 
      however, no study has assessed agreement. This study assesses correlation between 
      these methods and association with hemodynamic/echocardiographic data in LVAD 
      patients. Discordance was defined as a 20% difference between TD and iFK CO 
      measurements. Bias and agreement were determined via the Bland-Altman technique 
      in both the overall sample and iFK-stratified tertiles. Correlation with each 
      assessment of CO and right heart catheterization (RHC) hemodynamics was 
      performed. Among 111 RHCs, the mean CO for TD and iFK were 4.65 +/- 1.33 (range: 
      1.44-9.30) and 5.37 +/- 1.51 (range: 3.07-11.80) L/min (p < 0.001), respectively, 
      with a calculated discordance of 45.9%. A correlation coefficient of 0.66 with a 
      bias of -0.72 L/min was found. The lower and upper limit of precision were -3.12 
      and 1.68 L/min, respectively. By tertile analysis, bias (lower and upper limit of 
      precision) for the low, middle, and high tertile groups were -0.24 (-1.88 and 
      1.40), -0.48 (-2.50 and 1.53), and -1.39 (-4.18 and 1.39) L/min, respectively. No 
      significant correlation was found between either method with right atrial 
      pressure or pulmonary capillary wedge pressure or any valvular condition. 
      Substantial discrepancies exist between TD and iFK CO in LVAD patients. Although 
      fixed bias was small, the limits of agreement extend into the clinically relevant 
      area, with larger bias being present at higher CO. Studies with flow probes are 
      needed to define which method better represents CO in LVAD patients.
FAU - Tehrani, David M
AU  - Tehrani DM
AD  - From the University of Chicago Medical Center, Chicago, Illinois.
FAU - Grinstein, Jonathan
AU  - Grinstein J
FAU - Kalantari, Sara
AU  - Kalantari S
FAU - Kim, Gene
AU  - Kim G
FAU - Sarswat, Nitasha
AU  - Sarswat N
FAU - Adatya, Sirtaz
AU  - Adatya S
FAU - Sayer, Gabriel
AU  - Sayer G
FAU - Uriel, Nir
AU  - Uriel N
LA  - eng
GR  - T32 HL007381/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Catheterization
MH  - *Cardiac Output
MH  - Female
MH  - *Heart-Assist Devices
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Wedge Pressure
MH  - *Thermodilution
PMC - PMC5489370
MID - NIHMS852994
COIS- Conflicts of Interest All other authors have no conflict of interests
EDAT- 2017/01/27 06:00
MHDA- 2018/02/17 06:00
PMCR- 2017/07/01
CRDT- 2017/01/27 06:00
PHST- 2017/01/27 06:00 [pubmed]
PHST- 2018/02/17 06:00 [medline]
PHST- 2017/01/27 06:00 [entrez]
PHST- 2017/07/01 00:00 [pmc-release]
AID - 10.1097/MAT.0000000000000528 [doi]
PST - ppublish
SO  - ASAIO J. 2017 Jul/Aug;63(4):433-437. doi: 10.1097/MAT.0000000000000528.