This observational study was designed to evaluate the clinical value of cardiac output (CO) obtained via bioreactance (NICOM™) as compared with values of CO obtained via thermodilution (using pulmonary artery catheter, Vigilance™) and the thoracic bioimpedance (BioZ.com™), in patients undergoing off-pump coronary artery bypass surgery.
Fifty American Society of Anesthesiologists physical status I–III patients, aged 38–81 years, scheduled for off-pump coronary artery bypass surgery were enrolled in this study. CO data (NCO, BCO, PCO) were recorded during the operative period at ten time points after stable hemodynamic conditions were achieved.
The equation of the relationship between the PCO and NCO is PCO = 0.945 × NCO + 0.328 (r = 0.77), and that of PCO and BCO is PCO = 0.965 × BCO + 0.729 (r = 0.63). Furthermore, no statistical difference was found between PCO versus NCO (mean (SD): 4.4 (1.1) versus 4.4 (0.9), p = 0.431). A significant correlation was found between PCO and NCO (r = 0.77, p < 0.001). Correlation was also found between PCO and BCO (r = 0.63, p < 0.001).
The NICOM device is a safe, convenient, and reliable device for measuring continuous non-invasive cardiac output and cardiac index, and the trends of change in CO during the surgery are similar between NICOM and PAC.
Connors AF Jr, Speroff T, Dawson NV, Thomas C, Harrell FE Jr, Wagner D, Desbiens N, Goldman L, Wu AW, Califf RM, Fulkerson WJ Jr, Vidaillet H, Broste S, Bellamy P, Lynn J, Knaus WA. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA. 1996;276:889–97. PubMedCrossRef
Guyatt G. A randomized control trial of right-heart catheterization in critically ill patients. Ontario Intensive Care Study Group. Intensive Care Med. 1991;6:91–5.
Sphör F, Hettrich P, Hass H, Martin E, Böttiger BW. Comparison of two methods for enhanced continuous circulatory monitoring in patients with septic shock. Intensive Care Med. 2007;33:1805–10. CrossRef
Leslien S, McKee S, Newby D, Webb D, Denvir M. Non-invasive measurement of cardiac output in patients with chronic heart failure. Blood Press Monit. 2004;9:277–80. CrossRef
Engoren M, Barbee D. Comparison of cardiac output determined by bioimpedance, thermodilution, and the Fick method. Am J Crit Care. 2005;14:40–5. PubMed
Hirschl MM, Kittler H, Woisetchläger C, Siostrzonek P, Staudinger T, Kofler J, Oschatz E, Bur A, Gwechenberger M, Laggner AN. Simultaneous comparison of thoracic bioimpedance and arterial pulse waveform-derived cardiac output with thermodilution measurement. Crit Care Med. 2000;28:1798–802. PubMedCrossRef
Keren H, Burkhoff D, Squara P. Evaluation of a non-invasive continuous cardiac output monitoring system based on thoracic bioreactance. Am J Physiol. 2007;293:583–9.
Schwann NM, Hillel Z, Hoeft A, Barash P, Möhnle P, Miao Y, Mangano DT. Lack of effectiveness of the pulmonary artery catheter in cardiac surgery. Anesth Analg. 2011;133:994–1002. CrossRef
Brahim B, Ouattara A, Estagnasie P, Brusset A, Squara P. Fluid responsiveness predicted by noninvasive bioreactance-based passive leg raise test. Intensive Care Med. 2010;36:1875–81. CrossRef
- Correlation of cardiac output measured by non-invasive continuous cardiac output monitoring (NICOM) and thermodilution in patients undergoing off-pump coronary artery bypass surgery
- Springer Japan
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
e.Med Kampagnen-Visual, Mail Icon II