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Title: Perioperative pulse contour cardiac output analysis in a patient with severe cardiac dysfunction.
Austin Authors: Jones, Daryl A ;Story, David A ;Peyton, Philip J ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, The Alfred Hospital, Departments of Anaesthesia and Surgery, Austin Hospital, Departments of Intensive Care and Medicine, Austin Hospital, Melboume, Victoria.
Issue Date: 1-Feb-2006
Publication information: Anaesthesia and Intensive Care; 34(1): 97-101
Abstract: We describe a patient with severe left ventricular dysfunction simultaneously monitored with pulse contour cardiac output (PiCCO) analysis, a continuous cardiac output pulmonary artery catheter (continuous COPAC) and intraoperative transoesophageal echocardiography (TOE). There was good agreement between cardiac output (CO) measurements obtained by the three techniques prior to cardiopulmonary bypass (CPB). Agreement of CO measurements following CPB was initially pool; but improved following recalibration of PiCCO. PiCCO-derived global end-diastolic volume index (GEDVI) and cardiac function index (CFI), were assessed as markers of left ventricular preload and myocardial contractility, respectively. GEDVI correlated well with CO in the postoperative period. CFI increased more than two-fold following coronary revascularization and milrinone administration, and there was also a temporal relationship between the CFI and the dose of milrinone in the first 24 hours of treatment. Global end-diastolic volume and cardiac function index may be useful additional measures of left ventricular preload and myocardial contractility in patients with severe left ventricular dysfunction.
Gov't Doc #: 16494159
Journal: Anaesthesia and Intensive Care
Type: Journal Article
Subjects: Cardiac Output.physiology
Cardiopulmonary Bypass.adverse effects.methods
Coronary Angiography
Coronary Artery Bypass.adverse effects.methods
Echocardiography, Transesophageal
Follow-Up Studies
Intraoperative Complications.diagnosis.therapy
Middle Aged
Monitoring, Intraoperative.methods
Monitoring, Physiologic.methods
Perioperative Care.methods
Risk Assessment
Severity of Illness Index
Ventricular Dysfunction, Left.diagnosis.therapy
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