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01-12-2021 | Research

Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis

Authors: Karim Kouz, Frederic Michard, Alina Bergholz, Christina Vokuhl, Luisa Briesenick, Phillip Hoppe, Moritz Flick, Gerhard Schön, Bernd Saugel

Published in: Critical Care | Issue 1/2021

Abstract

Background

Pulmonary artery thermodilution is the clinical reference method for cardiac output monitoring. Because both continuous and intermittent pulmonary artery thermodilution are used in clinical practice it is important to know whether cardiac output measurements by the two methods are clinically interchangeable.

Methods

We performed a systematic review and meta-analysis of clinical studies comparing cardiac output measurements assessed using continuous and intermittent pulmonary artery thermodilution in adult surgical and critically ill patients. 54 studies with 1522 patients were included in the analysis.

Results

The heterogeneity across the studies was high. The overall random effects model-derived pooled estimate of the mean of the differences was 0.08 (95%-confidence interval 0.01 to 0.16) L/min with pooled 95%-limits of agreement of − 1.68 to 1.85 L/min and a pooled percentage error of 29.7 (95%-confidence interval 20.5 to 38.9)%.

Conclusion

The heterogeneity across clinical studies comparing continuous and intermittent pulmonary artery thermodilution in adult surgical and critically ill patients is high. The overall trueness/accuracy of continuous pulmonary artery thermodilution in comparison with intermittent pulmonary artery thermodilution is good (indicated by a pooled mean of the differences < 0.1 L/min). Pooled 95%-limits of agreement of − 1.68 to 1.85 L/min and a pooled percentage error of 29.7% suggest that continuous pulmonary artery thermodilution barely passes interchangeability criteria with intermittent pulmonary artery thermodilution.

PROSPERO registration number CRD42020159730.

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Vincent JL, Pelosi P, Pearse R, Payen D, Perel A, Hoeft A, et al. Perioperative cardiovascular monitoring of high-risk patients: a consensus of 12. Crit Care. 2015;19(1):224.PubMedPubMedCentral

Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40(12):1795–815.PubMedPubMedCentral

Saugel B, Vincent J-L. Cardiac output monitoring: how to choose the optimal method for the individual patient. Curr Opin Crit Care. 2018;24(3):165–72.PubMed

De Backer D, Bakker J, Cecconi M, Hajjar L, Liu DW, Lobo S, et al. Alternatives to the Swan-Ganz catheter. Intensive Care Med. 2018;44(6):730–41.PubMed

Teboul JL, Saugel B, Cecconi M, De Backer D, Hofer CK, Monnet X, et al. Less invasive hemodynamic monitoring in critically ill patients. Intensive Care Med. 2016;42(9):1350–9.PubMed

Kouz K, Scheeren TWL, de Backer D, Saugel B. Pulse wave analysis to estimate cardiac output. Anesthesiology. 2021;134(1):119–26.PubMed

Stewart GN. Researches on the circulation time and on the Influences which affect it. J Physiol. 1897;22(3):159–83.PubMedPubMedCentral

Reuter DA, Huang C, Edrich T, Shernan SK, Eltzschig HK. Cardiac output monitoring using indicator-dilution techniques: basics, limits, and perspectives. Anesth Analg. 2010;110(3):799–811.PubMed

Hamilton WF, Moore JW, Kinsman JM, Spurling RG. Simultaneous determination of the pulmonary and systemic circulation times in man and of a figure related to the cardiac output. Am J Physiol. 1928;84(2):338–44.

10.

Rajaram SS, Desai NK, Kalra A, Gajera M, Cavanaugh SK, Brampton W, et al. Pulmonary artery catheters for adult patients in intensive care. Cochrane Database Syst Rev. 2013;2:CD003408.

11.

Yelderman M. Continuous measurement of cardiac output with the use of stochastic system identification techniques. J Clin Monit. 1990;6(4):322–32.PubMed

12.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W65-94.PubMed

13.

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.PubMed

14.

Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.PubMed

15.

Joosten A, Desebbe O, Suehiro K, Murphy LS, Essiet M, Alexander B, et al. Accuracy and precision of non-invasive cardiac output monitoring devices in perioperative medicine: a systematic review and meta-analysis. Br J Anaesth. 2017;118(3):298–310.PubMed

16.

Saugel B, Hoppe P, Nicklas JY, Kouz K, Korner A, Hempel JC, et al. Continuous noninvasive pulse wave analysis using finger cuff technologies for arterial blood pressure and cardiac output monitoring in perioperative and intensive care medicine: a systematic review and meta-analysis. Br J Anaesth. 2020;125(1):25–37.PubMed

17.

DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.PubMed

18.

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.CrossRefPubMedPubMedCentral

19.

Viechtbauer W. Conducting meta-analyses in R with the metafor Package. J Stat Softw. 2010;36(3):48.

20.

Akiyoshi K, Kandabashi T, Kaji J, Yamaura K, Yoshimura H, Irita K, et al. Accuracy of arterial pressure waveform analysis for cardiac output measurement in comparison with thermodilution methods in patients undergoing living donor liver transplantation. J Anesth. 2011;25(2):178–83.PubMed

21.

Albert NM, Spear BT, Hammel J. Agreement and clinical utility of 2 techniques for measuring cardiac output in patients with low cardiac output. Am J Crit Care. 1999;8(1):464–74.PubMed

22.

Bao FP, Wu J. Continuous versus bolus cardiac output monitoring during orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int. 2008;7(2):138–44.PubMed

23.

Bendjelid K, Schutz N, Suter PM, Romand JA. Continuous cardiac output monitoring after cardiopulmonary bypass: a comparison with bolus thermodilution measurement. Intensive Care Med. 2006;32(6):919–22.PubMed

24.

Boldt J, Menges T, Wollbruck M, Hammermann H, Hempelmann G. Is continuous cardiac output measurement using thermodilution reliable in the critically ill patient? Crit Care Med. 1994;22(12):1913–8.PubMed

25.

Bottiger BW, Rauch H, Bohrer H, Motsch J, Soder M, Fleischer F, et al. Continuous versus intermittent cardiac output measurement in cardiac surgical patients undergoing hypothermic cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1995;9(4):405–11.PubMed

26.

Bottiger BW, Sinner B, Motsch J, Bach A, Bauer H, Martin E. Continuous versus intermittent thermodilution cardiac output measurement during orthotopic liver transplantation. Anaesthesia. 1997;52(3):207–14.PubMed

27.

Bottiger BW, Soder M, Rauch H, Bohrer H, Motsch J, Bauer H, et al. Semi-continuous versus injectate cardiac output measurement in intensive care patients after cardiac surgery. Intensive Care Med. 1996;22(4):312–8.PubMed

28.

Boyle M, Jacobs S, Torda TA, Shehabi Y. Assessment of the agreement between cardiac output measured by bolus thermodilution and continuous methods, with particular reference to the effect of heart rhythm. Aust Crit Care. 1997;10(1):5–8, 10–1.

29.

Burchell SA, Yu M, Takiguchi SA, Ohta RM, Myers SA. Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients. Crit Care Med. 1997;25(3):388–91.PubMed

30.

Button D, Weibel L, Reuthebuch O, Genoni M, Zollinger A, Hofer CK. Clinical evaluation of the FloTrac/Vigileo system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery. Br J Anaesth. 2007;99(3):329–36.PubMed

31.

Cathelyn J, Glenn LL. Effect of ambient temperature and cardiac stability on two methods of cardiac output measurement. J Cardiovasc Nurs. 1999;13(3):93–101.PubMed

32.

Cecchini S, Schena E, Saccomandi P, Polisca F, Di Cecca I, Notaro M, et al. Cardiac output estimation in mechanically ventilated patients: a comparison between prolonged expiration method and thermodilution. Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:2708–11.PubMed

33.

Cecconi M, Dawson D, Casaretti R, Grounds RM, Rhodes A. A prospective study of the accuracy and precision of continuous cardiac output monitoring devices as compared to intermittent thermodilution. Minerva Anestesiol. 2010;76(12):1010–7.PubMed

34.

Cho YJ, Koo CH, Kim TK, Hong DM, Jeon Y. Comparison of cardiac output measures by transpulmonary thermodilution, pulse contour analysis, and pulmonary artery thermodilution during off-pump coronary artery bypass surgery: a subgroup analysis of the cardiovascular anaesthesia registry at a single tertiary centre. J Clin Monit Comput. 2016;30(6):771–82.PubMed

35.

Costa MG, Chiarandini P, Scudeller L, Vetrugno L, Pompei L, Serena G, et al. Uncalibrated continuous cardiac output measurement in liver transplant patients: LiDCOrapid system versus pulmonary artery catheter. J Cardiothorac Vasc Anesth. 2014;28(3):540–6.PubMed

36.

Costa MG, Della Rocca G, Chiarandini P, Mattelig S, Pompei L, Barriga MS, et al. Continuous and intermittent cardiac output measurement in hyperdynamic conditions: pulmonary artery catheter vs lithium dilution technique. Intensive Care Med. 2008;34(2):257–63.PubMed

37.

Della Rocca G, Costa MG, Coccia C, Pompei L, Di Marco P, Vilardi V, et al. Cardiac output monitoring: aortic transpulmonary thermodilution and pulse contour analysis agree with standard thermodilution methods in patients undergoing lung transplantation. Can J Anaesth. 2003;50(7):707–11.PubMed

38.

Della Rocca G, Costa MG, Pompei L, Coccia C, Pietropaoli P. Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth. 2002;88(3):350–6.PubMed

39.

Ditmyer CE, Shively M, Burns DB, Reichman RT. Comparison of continuous with intermittent bolus thermodilution cardiac output measurements. Am J Crit Care. 1995;4(6):460–5.PubMed

40.

Ganter MT, Alhashemi JA, Al-Shabasy AM, Schmid UM, Schott P, Shalabi SA, et al. Continuous cardiac output measurement by un-calibrated pulse wave analysis and pulmonary artery catheter in patients with septic shock. J Clin Monit Comput. 2016;30(1):13–22.PubMed

41.

Greim CA, Roewer N, Thiel H, Laux G, SchulteamEsch J. Continuous cardiac output monitoring during adult liver transplantation: thermal filament technique versus bolus thermodilution. Anesth Analg. 1997;85(3):483–8.PubMed

42.

Haller M, Zollner C, Briegel J, Forst H. Evaluation of a new continuous thermodilution cardiac output monitor in critically ill patients: a prospective criterion standard study. Crit Care Med. 1995;23(5):860–6.PubMed

43.

Hamm JB, Nguyen BV, Kiss G, Wargnier JP, Jauffroy A, Helaine L, et al. Assessment of a cardiac output device using arterial pulse waveform analysis, Vigileo, in cardiac surgery compared to pulmonary arterial thermodilution. Anaesth Intensive Care. 2010;38(2):295–301.PubMed

44.

Hogue CW Jr, Rosenbloom M, McCawley C, Lappas DG. Comparison of cardiac output measurement by continuous thermodilution with electromagnetometry in adult cardiac surgical patients. J Cardiothorac Vasc Anesth. 1994;8(6):631–5.PubMed

45.

Ishihara H, Okawa H, Tanabe K, Tsubo T, Sugo Y, Akiyama T, et al. A new non-invasive continuous cardiac output trend solely utilizing routine cardiovascular monitors. J Clin Monit Comput. 2004;18(5–6):313–20.PubMed

46.

Jacquet L, Hanique G, Glorieux D, Matte P, Goenen M. Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med. 1996;22(10):1125–9.PubMed

47.

Jakobsen CJ, Melsen NC, Andresen EB. Continuous cardiac output measurements in the perioperative period. Acta Anaesthesiol Scand. 1995;39(4):485–8.PubMed

48.

Kotake Y, Moriyama K, Innami Y, Shimizu H, Ueda T, Morisaki H, et al. Performance of noninvasive partial CO₂ rebreathing cardiac output and continuous thermodilution cardiac output in patients undergoing aortic reconstruction surgery. Anesthesiology. 2003;99(2):283–8.PubMed

49.

Kotake Y, Yamada T, Nagata H, Suzuki T, Serita R, Katori N, et al. Improved accuracy of cardiac output estimation by the partial CO₂ rebreathing method. J Clin Monit Comput. 2009;23(3):149–55.PubMed

50.

Lazor MA, Pierce ET, Stanley GD, Cass JL, Halpern EF, Bode RH Jr. Evaluation of the accuracy and response time of STAT-mode continuous cardiac output. J Cardiothorac Vasc Anesth. 1997;11(4):432–6.PubMed

51.

Le Tulzo Y, Belghith M, Seguin P, Dall’Ava J, Monchi M, Thomas R, et al. Reproducibility of thermodilution cardiac output determination in critically ill patients: comparison between bolus and continuous method. J Clin Monit. 1996;12(5):379–85.PubMed

52.

Leather HA, Vuylsteke A, Bert C, M’Fam W, Segers P, Sergeant P, et al. Evaluation of a new continuous cardiac output monitor in off-pump coronary artery surgery. Anaesthesia. 2004;59(4):385–9.PubMed

53.

Lefrant JY, Bruelle P, Ripart J, Ibanez F, Aya G, Peray P, et al. Cardiac output measurement in critically ill patients: comparison of continuous and conventional thermodilution techniques. Can J Anaesth. 1995;42(11):972–6.PubMed

54.

Manecke GR Jr, Auger WR. Cardiac output determination from the arterial pressure wave: clinical testing of a novel algorithm that does not require calibration. J Cardiothorac Vasc Anesth. 2007;21(1):3–7.PubMed

55.

McGee WT, Horswell JL, Calderon J, Janvier G, Van Severen T, Van den Berghe G, et al. Validation of a continuous, arterial pressure-based cardiac output measurement: a multicenter, prospective clinical trial. Crit Care. 2007;11(5):R105.PubMedPubMedCentral

56.

Mielck F, Buhre W, Hanekop G, Tirilomis T, Hilgers R, Sonntag H. Comparison of continuous cardiac output measurements in patients after cardiac surgery. J Cardiothorac Vasc Anesth. 2003;17(2):211–6.PubMed

57.

Mihm FG, Gettinger A, Hanson CW 3rd, Gilbert HC, Stover EP, Vender JS, et al. A multicenter evaluation of a new continuous cardiac output pulmonary artery catheter system. Crit Care Med. 1998;26(8):1346–50.PubMed

58.

Monchi M, Thebert D, Cariou A, Bellenfant F, Joly LM, Brunet F, et al. Clinical evaluation of the Abbott Qvue-OptiQ continuous cardiac output system in critically ill medical patients. J Crit Care. 1998;13(2):91–5.PubMed

59.

Nelson LD, Safcsak K, Cheatham ML, Block EF. Mathematical coupling does not explain the relationship between right ventricular end-diastolic volume and cardiac output. Crit Care Med. 2001;29(5):940–3.PubMed

60.

Neto EP, Piriou V, Durand PG, Du Gres B, Lehot JJ. Comparison of two semicontinuous cardiac output pulmonary artery catheters after valvular surgery. Crit Care Med. 1999;27(12):2694–7.PubMed

61.

Padua G, Canestrelli G, Pala G, Sechi D, Spanu MC. Original insight into continuous cardiac output monitoring: "TruCCOMS". Correlation with other methods. Miner Anestesiol. 2003;69(7–8):617–22, 22–4.

62.

Peyton P. Hybrid measurement to achieve satisfactory precision in perioperative cardiac output monitoring. Anaesth Intensive Care. 2014;42(3):340–9.PubMed

63.

Rauch H, Muller M, Fleischer F, Bauer H, Martin E, Bottiger BW. Pulse contour analysis versus thermodilution in cardiac surgery patients. Acta Anaesthesiol Scand. 2002;46(4):424–9.PubMed

64.

Rodig G, Keyl C, Liebold A, Hobbhahn J. Intra-operative evaluation of a continuous versus intermittent bolus thermodilution technique of cardiac output measurement in cardiac surgical patients. Eur J Anaesthesiol. 1998;15(2):196–201.PubMed

65.

Rodig G, Prasser C, Keyl C, Liebold A, Hobbhahn J. Continuous cardiac output measurement: pulse contour analysis vs thermodilution technique in cardiac surgical patients. Br J Anaesth. 1999;82(4):525–30.PubMed

66.

Sakka SG, Reinhart K, Wegscheider K, Meier-Hellmann A. Is the placement of a pulmonary artery catheter still justified solely for the measurement of cardiac output? J Cardiothorac Vasc Anesth. 2000;14(2):119–24.PubMed

67.

Schmid ER, Schmidlin D, Tornic M, Seifert B. Continuous thermodilution cardiac output: clinical validation against a reference technique of known accuracy. Intensive Care Med. 1999;25(2):166–72.PubMed

68.

Seguin P, Colcanap O, Le Rouzo A, Tanguy M, Guillou YM, Malledant Y. Evaluation of a new semi-continuous cardiac output system in the intensive care unit. Can J Anaesth. 1998;45(6):578–83.PubMed

69.

Singh A, Juneja R, Mehta Y, Trehan N. Comparison of continuous, stat, and intermittent cardiac output measurements in patients undergoing minimally invasive direct coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2002;16(2):186–90.PubMed

70.

Thierry S, Thebert D, Brocas E, Razzaghi F, Van De Louw A, Loisance D, et al. Evaluation of a new invasive continuous cardiac output monitoring system: the truCCOMS system. Intensive Care Med. 2003;29(11):2096–9.PubMed

71.

Yelderman ML, Ramsay MA, Quinn MD, Paulsen AW, McKown RC, Gillman PH. Continuous thermodilution cardiac output measurement in intensive care unit patients. J Cardiothorac Vasc Anesth. 1992;6(3):270–4.PubMed

72.

Zollner C, Goetz AE, Weis M, Morstedt K, Pichler B, Lamm P, et al. Continuous cardiac output measurements do not agree with conventional bolus thermodilution cardiac output determination. Can J Anaesth. 2001;48(11):1143–7.PubMed

73.

Zollner C, Polasek J, Kilger E, Pichler B, Jaenicke U, Briegel J, et al. Evaluation of a new continuous thermodilution cardiac output monitor in cardiac surgical patients: a prospective criterion standard study. Crit Care Med. 1999;27(2):293–8.PubMed

74.

Squara P, Scheeren TWL, Aya HD, Bakker J, Cecconi M, Einav S, et al. Metrology part 1: definition of quality criteria. J Clin Monit Comput. 2020;35(1):17–25.PubMedPubMedCentral

75.

Squara P, Scheeren TWL, Aya HD, Bakker J, Cecconi M, Einav S, et al. Metrology part 2: procedures for the validation of major measurement quality criteria and measuring instrument properties. J Clin Monit Comput. 2020;35(1):27–37.PubMedPubMedCentral

76.

Hapfelmeier A, Cecconi M, Saugel B. Cardiac output method comparison studies: the relation of the precision of agreement and the precision of method. J Clin Monit Comput. 2016;30(2):149–55.PubMed

77.

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.PubMed

78.

Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135–60.PubMed

79.

Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571–82.PubMed

80.

Michard F. Thinking outside the (cardiac output) box. Crit Care Med. 2012;40(4):1361–2.PubMed

81.

Medin DL, Brown DT, Wesley R, Cunnion RE, Ognibene FP. Validation of continuous thermodilution cardiac output in critically ill patients with analysis of systematic errors. J Crit Care. 1998;13(4):184–9.PubMed

82.

Siegel LC, Hennessy MM, Pearl RG. Delayed time response of the continuous cardiac output pulmonary artery catheter. Anesth Analg. 1996;83(6):1173–7.PubMed

83.

Aranda M, Mihm FG, Garrett S, Mihm MN, Pearl RG. Continuous cardiac output catheters: delay in in vitro response time after controlled flow changes. Anesthesiology. 1998;89(6):1592–5.PubMed

84.

De Backer D, Vincent JL. The pulmonary artery catheter: is it still alive? Curr Opin Crit Care. 2018;24(3):204–8.PubMed

85.

Vincent JL. The pulmonary artery catheter. J Clin Monit Comput. 2012;26(5):341–5.PubMed

86.

De Backer D, Hajjar LA, Pinsky MR. Is there still a place for the SwanGanz catheter? We are not sure. Intensive Care Med. 2018;44(6):960–2.PubMed

87.

Demiselle J, Mercat A, Asfar P. Is there still a place for the Swan-Ganz catheter? Yes. Intensive Care Med. 2018;44(6):954–6.PubMed

88.

Teboul JL, Cecconi M, Scheeren TWL. Is there still a place for the Swan-Ganz catheter? No. Intensive Care Med. 2018;44(6):957–9.PubMed

89.

Richard C, Warszawski J, Anguel N, Deye N, Combes A, Barnoud D, et al. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2003;290(20):2713–20.PubMed

90.

Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D, et al. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet. 2005;366(9484):472–7.PubMed

91.

Chiang Y, Hosseinian L, Rhee A, Itagaki S, Cavallaro P, Chikwe J. Questionable benefit of the pulmonary artery catheter after cardiac surgery in high-risk patients. J Cardiothorac Vasc Anesth. 2015;29(1):76–81.PubMed

92.

Seifi A, Elliott RJ, Elsehety MA. Usage of Swan-Ganz catheterization during the past 2 decades in United States. J Crit Care. 2016;35:213–4.PubMed

93.

Wiener RS, Welch HG. Trends in the use of the pulmonary artery catheter in the United States, 1993–2004. JAMA. 2007;298(4):423–9.PubMed

94.

Peyton PJ, Chong SW. Minimally invasive measurement of cardiac output during surgery and critical care: a meta-analysis of accuracy and precision. Anesthesiology. 2010;113(5):1220–35.PubMed

95.

Chong SW, Peyton PJ. A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM). Anaesthesia. 2012;67(11):1266–71.PubMed

Title: Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis
Authors: Karim Kouz
Frederic Michard
Alina Bergholz
Christina Vokuhl
Luisa Briesenick
Phillip Hoppe
Moritz Flick
Gerhard Schön
Bernd Saugel
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2021
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-021-03523-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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