Pulse contour cardiac output derived from non‐invasive arterial pressure in cardiovascular disease

Pulse contour methods determine cardiac output semi-invasively using standard arterial access. This study assessed whether cardiac output can be determined non-invasively by replacing the intra-arterial pressure input with a non-invasive finger arterial pressure input in two methods, Nexfin CO-trek and Modelflow , in 25 awake patients after coronary artery bypass surgery. Pulmonary artery thermodilution cardiac output served as a reference. In the supine position, the mean (SD) differences between thermodilution cardiac output and Nexfin CO-trek were 0.22 (0.77) and 0.44 (0.81) l.min(-1) , for intra-arterial and non-invasive pressures, respectively. For Modelflow, these differences were 0.70 (1.08) and 1.80 (1.59) l.min(-1) , respectively. Similarly, in the sitting position, differences between thermodilution cardiac output and Nexfin CO-trek were 0.16 (0.78) and 0.34 (0.83), for intra-arterial and non-invasive arterial pressure, respectively. For Modelflow, these differences were 0.58 (1.11) and 1.52 (1.54) l.min(-1) , respectively. Thus, Nexfin CO-trek readings were not different from thermodilution cardiac output, for both invasive and non-invasive inputs. However, Modelflow readings differed greatly from thermodilution when using non-invasive arterial pressure input.