Intraoperative validation of a new system for invasive continuous cardiac output measurement

Giuseppe D'Ancona, Matteo Parrinello, Gianluca Santise, Domenico Biondo, Francesco Pirone, Sergio Sciacca, Marco Turrisi, Antonio Arcadipane, Michele Pilato

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Although bolus thermodilution technique for cardiac output (CO) measurement has widespread acceptance, new systems are currently available. We evaluated a continuous CO system (TruCCOMS, Aortech International Inc.) that operates on the thermal conservation principle and we compared it with the reference standard transit time flow measurement (TTFM). Materials and methods: Nine consecutive cardiac surgery patients were evaluated. After general anesthesia and intubation, a TruCCOMS catheter was percutaneously placed in the pulmonary artery (PA). After median sternotomy and pericardiotomy, a TTFM probe was placed around the main PA. Right ventricular (RV) CO measurements were recorded with both TruCCOMS and TTFM at different times: before cardiopulmonary bypass (CPB) (T0), during weaning from CPB (T1), and prior to sternal closure (T2). Data analysis included paired student t test, Pearson correlation test, and Bland-Altman plotting. Results: TruCCOMS CO values were significantly lower at T0 (TruCCOMS 4.0 ± 1.0 vs. TTFM 4.5 ± 1.0 L/min; P <0.0001) and T1 (TruCCOMS 3.6 ± 0.5 vs. TTFM 4.2 ± 0.7 L/min; P <0.0001), and comparable at T2 (TruCCOMS 4.5 ± 0.7 vs. TTFM 4.6 ± 0.8 L/min; P = 0.4). Pearson test showed a significant correlation between TruCCOMS and TTFM CO measurements (RT0 = 0.9, RT1 = 0.8, RT2 = 0.6; P <0.0001). Bland-Altmann plotting showed a bias of -0.53 ± 0.43 L (-12%) at T0, -0.64 ± 0.43 L (-14.5%) at T1, and -0.1 ± 0.66 L (-0.8%) at T2. Conclusion: Although TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.

Original languageEnglish
Pages (from-to)943-947
Number of pages5
JournalIntensive Care Medicine
Volume35
Issue number5
DOIs
Publication statusPublished - May 2009

Keywords

  • Continuous cardiac output monitoring catheter

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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