Cardiac output measurements using the bioreactance technique in critically ill patients
© BioMed Central Ltd 2012
Published: 9 November 2012
Measurement of cardiac output (CO) using minimally invasive devices has gained popularity. In 11 patients we compared CO values obtained using the bioreactance technique - a new continuous, totally non-invasive CO monitor - with those obtained by semi-continuous thermodilution using a pulmonary artery catheter. We obtained CO measurements at study inclusion and after any relevant change in hemodynamic status (spontaneous or during fluid challenge, inotrope or vasopressor infusions). There was a poor correlation between the two techniques (r = 0.145). These data suggest that caution should be applied when using bioreactance devices in critically ill patients.
Measurement of cardiac output (CO) requires use of invasive or minimally invasive devices; the use of noninvasive and minimally invasive devices has gained popularity in recent years. The bioreactance technique is a relatively new, continuous, totally non-invasive technique for measuring CO that is easily implemented. This new technique involves analyzing phase shifts of a delivered oscillating current that occur when the current traverses the thoracic cavity , and differs from traditional bioimpedance techniques that rely on analysis of changes in signal amplitude. Most validation studies in critically ill patients have shown good correlation and/or agreement of bioreactance values compared with CO values obtained using other devices in patients admitted after cardiac surgery [2–4]. However, validation in critically ill patients is lacking.
Septic shock/distributive shock
Acute respiratory distress syndrome
7 (8, 2 to 20)
4 (5, 5 to 8)
The bioreactance technique is dependent on diffusion of electrical current, so interstitial edema may interfere with measurements; we believe this is the most probable explanation for the poor correlation. Whatever the reason, these data suggest that caution should be applied when using bioreactance devices in critically ill patients.
semi-continuous cardiac output by thermodilution
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