Noninvasive versus invasive assessment of cardiac output after cardiac surgery: clinical validation

摘要: Abstract The accuracy of noninvasive cardiac output (CO) measurement techniques, such as electrical bioimpedance (BIO), suprasternal continuous-wave Doppler (CWD), pulsed-wave (PWD), and transesophageal (TED) ultrasound has been variably judged in recent years. In addition, clinical comparisons are hampered by the fact that there is no generally accepted gold standard CO measurement. After coronary artery bypass surgery 25 patients, was simultaneously determined invasive techniques (thermodilution [TD] Fick methods) plus BID, CWD, PWD, TED. There an excellent agreement found between TD method (CO F = 0.13 + 1.01 · ; r 0.96; n 99). Thermodilution thus chosen to be reference method. Bioimpedance underestimated BIO 0.47 0.60 0.78; 111). Allowing physiological ejection times only led improved 0.05 0.69 0.82; 79), but BID still significantly ( P , when CWD computation based on echocardiographic aortic diameter (ECHO) ECHO 0.79 1.40 0.84; 52). With surgical (SURG), SURG 0.75 1.16 0.89; 44), overestimation COTD remained significant PWD values showed a considerable scatter data compared with 1.26 0.62; 64 1.42 0.41 0.47; 61). Correlation absolute TED thermodilution depended used for calibration. All investigated unreliably measured relative changes. Despite its invasiveness, remains choice accurate determination adult patients following surgery.