Key result
Non-invasive cardiac output measurement using carbon dioxide partial rebreathing consistently underestimated cardiac output compared to thermodilution, with a bias of -0.60 +/- 0.87 l/min.
Why the study?
Does a non-invasive carbon dioxide partial rebreathing technique accurately measure cardiac output compared to bolus pulmonary artery thermodilution in postoperative cardiac surgery patients?
Observational (n=24)
No
Does a non-invasive carbon dioxide partial rebreathing technique accurately measure cardiac output compared to bolus pulmonary artery thermodilution in postoperative cardiac surgery patients?
Mean Difference: -0.6
The non-invasive carbon dioxide partial rebreathing technique provides reliable but consistently underestimated cardiac output measurements compared to standard thermodilution in postoperative cardiac patients.
Caution advised against sole reliance on non-invasive CO2 rebreathing for CO monitoring post-cardiac surgery; leaves open its clinical role pending larger validation.
This study investigated the accuracy of a new technique for measuring cardiac output using the derivative Fick principle based on the ratio of change in the partial pressures of end-tidal and mixed expired carbon dioxide produced by short periods of partial rebreathing. A prospective clinical study involving 24 patients following cardiopulmonary bypass for coronary artery bypass grafting or valvular surgery was undertaken in the intensive care unit of a university-affiliated hospital. Haemodynamic measurements were performed after admission to the intensive care unit. Cardiac output was measured simultaneously by bolus pulmonary artery thermodilution and by a non-invasive carbon dioxide partial rebreathing technique. Cardiac output measurement using the new technique demonstrated a significant but consistent underestimate, with a bias of -0.60 +/- 0.87 l/min. This new adaptation of the partial rebreathing technique is reliable in measuring cardiac output in postoperative patients. Reasons for the consistent discrepancy between thermodilution and partial rebreathing techniques are discussed.
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Killick et al. (2008) conducted an observational in Postoperative cardiac surgery (n=24). Non-invasive carbon dioxide partial rebreathing technique vs. Bolus pulmonary artery thermodilution was evaluated on Cardiac output measurement bias (bias of -0.60 +/- 0.87 l/min). Non-invasive cardiac output measurement using carbon dioxide partial rebreathing consistently underestimated cardiac output compared to thermodilution, with a bias of -0.60 +/- 0.87 l/min.
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