NDLI: Novel continuous capnodynamic method for cardiac output assessment during mechanical ventilation.

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Novel continuous capnodynamic method for cardiac output assessment during mechanical ventilation.

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Novel continuous capnodynamic method for cardiac output assessment during mechanical ventilation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hällsjö Sander, C. Hallbäck, M. Wallin, M. Emtell, P. Oldner, A. Björne, H.
Description	Country affiliation: Sweden Author Affiliation: Hällsjö Sander C ( Department of Anaesthesiology, Surgical Services and Intensive Care Medicine, Karolinska University Hospital, Solna SE-171 76, Sweden.)
Abstract	BACKGROUND: It is important to be able to accurately monitor cardiac output (CO) during high-risk surgery and in critically ill patients. The invasiveness of the pulmonary artery catheter (PAC) limits its use, and therefore, new minimally invasive methods for CO monitoring are needed. A potential method is estimation of CO from endogenous carbon dioxide measurements, using a differentiated Fick's principle to determine effective pulmonary blood flow (EPBF). In this study, we aimed to validate a novel capnodynamic method (COEPBF) in a wide range of clinically relevant haemodynamic conditions. METHODS: COEPBF was studied in 10 pigs during changes in preload, afterload, CO increase, and bleeding. An ultrasonic flow probe around the pulmonary artery was used as reference method of CO determination. CO was also measured using a PAC thermodilution technique (COPAC). CO and other haemodynamic data were recorded before and during each intervention. Accuracy and precision and also the ability to track changes in CO were determined using Bland-Altman, four-quadrant plot and polar plot analysis. RESULTS: COEPBF and COPAC showed equally good agreement, with a tendency to overestimate CO (bias 0.2 and 0.3 litre min(-1), respectively). The overall percentage error was 47% for COEPBF and 49% for COPAC. The concordance for tracking CO changes was 97 and 95% for COEPBF and COPAC, respectively, with an exclusion zone of 15% and radial limits of ±30°. CONCLUSIONS: COEPBF showed reliable trending abilities, equivalent to COPAC. COEPBF and COPAC also showed low bias but high percentage errors. Further studies in animal models of lung injury and in high-risk surgery patients are warranted.
File Format	HTM / HTML
ISSN	00070912
e-ISSN	14716771
Journal	British Journal of Anaesthesia
Issue Number	5
Volume Number	112
Language	English
Publisher	Oxford University Press
Publisher Date	2014-05-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Anesthesiology Capnography Carbon Dioxide Cardiac Output Physiology Hemodynamics Monitoring, Physiologic Respiration, Artificial Animals Blood Flow Velocity Metabolism Models, Animal Monitoring, Intraoperative Statistics & Numerical Data Pulmonary Artery Reproducibility Of Results Swine Thermodilution Ultrasonography Research Support, Non-u.s. Gov't Validation Studies
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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