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Cardiac output can be reliably measured noninvasively after coronary artery bypass grafting operation

 

作者: Tiit Kööbi,   Seppo Kaukinen,   Väinö Turjanmaa,  

 

期刊: Critical Care Medicine  (OVID Available online 1999)
卷期: Volume 27, issue 10  

页码: 2206-2211

 

ISSN:0090-3493

 

年代: 1999

 

出版商: OVID

 

关键词: whole-body impedance cardiography;impedance cardiography;bioimpedance;thermodilution;pulmonary artery catheter;cardiac output;repeatability;hemodynamic monitoring;noninvasive diagnostics;intensive care unit

 

数据来源: OVID

 

摘要:

Objective:To evaluate the reliability of whole-body impedance cardiography in the measurement of cardiac output after coronary artery bypass grafting operation in comparison with the thermodilution method.Design:Prospective, consecutive sampling.Patients:A total of 82 patients undergoing coronary artery bypass surgery were investigated. In a group of 41 patients who were intubated, cardiac output measurements were taken simultaneously with whole-body impedance cardiography and the thermodilution method within the first 3 hrs after the operation (early intensive care unit [ICU] period). In another group of 41 patients, the measurements were taken before the operation and in the second 12 hrs after cardiac surgery (late ICU period).Interventions:None.Measurements and Main Results:The agreement between the thermodilution and whole-body impedance cardiography cardiac output measurements was good before the operation, bias 0.04 ± 1.64 L/min (n = 41), and in the late ICU period, bias 0.00 ± 1.84 L/min (±2 SD) (n = 41). The results were within 20% in 81%-85% of the cases. The agreement was satisfactory in the early ICU period, bias 0.38 ± 2.74 L/min (n = 41). It was presumed that thermal instability of the patients was one possible source of measurement errors in the thermodilution method, causing reduced agreement between the methods in this period. The repeatability values (rv = 2.83 × SDs) for whole-body impedance cardiography were 0.44 L/min before the operation, 0.30 L/min in the early ICU period, and 0.65 L/min in the late ICU period, being significantly better than for the thermodilution method (0.79, 0.51, and 1.11 L/min, respectively) in all phases of the investigation (p< .001). The agreement between the thermodilution method and whole-body impedance cardiography is similar to reported comparisons between invasive methods in analogous settings.Conclusions:Whole-body impedance cardiography reliably measures cardiac output in patients after coronary artery bypass grafting operation. The excellent repeatability of whole-body impedance cardiography enhances the value of the method in continuous monitoring of patients after the operation.

 



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