Skip to main content

Effects of cardiac output levels on the measurement of transpulmonary thermodilution cardiac output in patients with acute lung injury

Introduction

Transpulmonary thermodilution cardiac output (CO) correlates closely with pulmonary artery (PA) thermodilution CO. Levels of CO may contribute varying amounts of thermal indicator loss and recirculation during thermodilution CO measurement. This study aimed to investigate the effects of CO levels on the agreement between transpulmonary and PA thermodilution CO in acute lung injury (ALI) patients.

Methods

Twenty-two ALI patients were prospectively enrolled. Paired bolus transpulmonary thermodilution cardiac index (BCItp) and continuous PA thermodilution cardiac index (CCIpa) data were recorded at baseline and repeated immediately and at 2, 4, and 6 hours after volume expansion with a 500 ml infusion of 10% pentastarch (HES 200/0.5).

Results

One hundred and ten paired CI measurements were recorded and divided into four quartiles from the lowest to the highest CCIpa. The mean BCItp was higher than CCIpa, and the Bland-Altman analysis revealed a bias of 0.57 ± 0.75 l/minute/m2. The limits of agreement (2SD) were +2.07 to -0.93 l/minute/m2. BCItp correlated closely with CCIpa (R = 0.887). CCIpa negatively correlated with the difference between BCItp and CCIpa (R = -0.26). The bias of quartile 1 with the least CCIpa was significantly greater than those of the three other quartiles.

Conclusion

In ALI patients, transpulmonary thermodilution is a clinically acceptable and interchangeable alternative to PA thermodilution for CO measurement. Levels of CO weakly and negatively correlate with the difference between BCItp and CCIpa. There is greater overestimation of BCItp over CCIpa in low than in high CO states.

References

  1. 1.

    Harvey S, et al.: Lancet. 2005, 366: 472-477. 10.1016/S0140-6736(05)67061-4

    Article  PubMed  Google Scholar 

  2. 2.

    Koo KKY, et al.: Crit Care Med. 2011, 39: 1613-1618. 10.1097/CCM.0b013e318218a045

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to K Kao.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Kao, K., Hu, H., Hung, C. et al. Effects of cardiac output levels on the measurement of transpulmonary thermodilution cardiac output in patients with acute lung injury. Crit Care 16, P217 (2012). https://doi.org/10.1186/cc10824

Download citation

Keywords

  • Cardiac Output
  • Pulmonary Artery
  • Emergency Medicine
  • Acute Lung Injury
  • Volume Expansion