Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11446
Title: Continuous minimally invasive peri-operative monitoring of cardiac output by pulmonary capnotracking: comparison with thermodilution and transesophageal echocardiography.
Authors: Peyton, Philip J
Affiliation: Department of Anaesthesia, Austin Hospital, Heidelberg, Melbourne, VIC 3084, Australia. phil.peyton@austin.org.au
Issue Date: 18-Feb-2012
Citation: Journal of Clinical Monitoring and Computing 2012; 26(2): 121-32
Abstract: A number of technologies are available for minimally-invasive cardiac output measurement in patients during surgery but remain little used. A system has been developed based on CO(2) elimination (VCO(2)) by the lungs for use in ventilated patients, which can be fully integrated into a modern anesthesia/monitoring platform, and provides semi-automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO(2) and end-tidal CO(2) concentration with each breath. A baseline measurement of non-shunt cardiac output was made during a brief change in ventilator rate, according to the differential CO(2) Fick approach. Continuous breath-by-breath monitoring of cardiac output was then performed from measurement of VCO(2), using a derivation of the Fick equation applied to pulmonary CO(2) elimination. Automated recalibration was done periodically and data was processed and cardiac output displayed in real time. Measurements were compared with simultaneous measurements by bolus thermodilution in 77 patients undergoing cardiac surgery or liver transplantation. Overall mean bias [sd] for agreement in cardiac output measurement was -0.1 [1.2] L/min, percentage error +44.2%, r = 0.92. Concordance in measurement of changes of at least 15% in cardiac output was 80%. The method followed sudden changes in cardiac output due to arrythmias and run onto cardiopulmonary bypass in real time. The accuracy and precision were comparable to other clinical techniques. The method is relatively seamless and largely automated and has potential for continuous, cardiac output monitoring in ventilated patients during anesthesia and critical care.
Internal ID Number: 22350312
URI: http://ahro.austin.org.au/austinjspui/handle/1/11446
DOI: 10.1007/s10877-012-9342-4
URL: http://www.ncbi.nlm.nih.gov/pubmed/22350312
Type: Journal Article
Subjects: Adult
Aged
Aged, 80 and over
Algorithms
Anesthesiology.methods
Capnography.methods
Carbon Dioxide.metabolism
Cardiac Output.physiology
Cardiopulmonary Bypass.methods
Echocardiography, Transesophageal.methods
Female
Humans
Lung.metabolism.ultrasonography
Male
Middle Aged
Minimally Invasive Surgical Procedures.methods
Monitoring, Physiologic.methods
Software
Thermodilution.methods
Appears in Collections:Journal articles

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