01-02-2008 | Original
Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs. lithium dilution technique
Published in: Intensive Care Medicine | Issue 2/2008
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Objective
This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous cardiac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a pulmonary artery catheter (COPAC).
Design
Prospective, single-center evaluation.
Setting
University Hospital Intensive Care Unit.
Patients
Patients (n = 23) receiving liver transplantation.
Intervention
Pulmonary artery catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system.
Measurements and main results
Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11 lmin–1 and –1.84 to + 2.05 lmin–1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29 lmin–1 and –1.87 to + 2.46 lmin–1 (r = 0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for COPAC vs. COLi and 15.1% for COPAC vs. PulseCOLi for data pairs less than 8 lmin–1, and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin–1.
Conclusion
In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent pulmonary artery thermodilution.