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A novel continuous capnodynamic method for cardiac output assessment in a porcine model of lung lavage.

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A novel continuous capnodynamic method for cardiac output assessment in a porcine model of lung lavage.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hällsjö Sander, C. Hallbäck, M. Suarez Sipmann, F. Wallin, M. 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, Sweden.); Hallbäck M ( Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.); Suarez Sipmann F ( Maquet Critical Care AB, Solna, Sweden.); Wallin M ( Department of Surgical Sciences, Section of Anaesthesiology and Critical Care, Hedenstierna's Laboratory, Uppsala University, Uppsala, Sweden.); Oldner A ( CIBERES, CIBER de enfermedades respiratorias, Instituto Carlos III, Madrid, Spain.); Björne H ( Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.)
Abstract	BACKGROUND: We have evaluated a new method for continuous monitoring of effective pulmonary blood flow (COEPBF ), i.e. cardiac output (CO) minus intra-pulmonary shunt, during mechanical ventilation. The method has shown good trending ability during severe hemodynamic challenges in a porcine model with intact lungs. In this study, we further evaluate the COEPBF method in a model of lung lavage. METHODS: COEPBF was compared to a reference method for CO during hemodynamic and PEEP alterations, 5 and 12 cmH2 O, before and after repeated lung lavages in 10 anaesthetised pigs. Bland-Altman, four-quadrant and polar plot methodologies were used to determine agreement and trending ability. RESULTS: After lung lavage at PEEP 5 cmH2 O, the ratio of arterial oxygen partial pressure related to inspired fraction of oxygen significantly decreased. The mean difference (limits of agreement) between methods changed from 0.2 (-1.1 to 1.5) to -0.9 (-3.6 to 1.9) l/min and percentage error increased from 34% to 70%. Trending ability remained good according to the four-quadrant plot (concordance rate 94%), whereas mean angular bias increased from 4° to -16° when using the polar plot methodology. CONCLUSION: Both agreement and precision of COEPBF were impaired in relation to CO when the shunt fraction was increased after lavage at PEEP 5 cmH2 O. However, trending ability remained good as assessed by the four-quadrant plot, whereas the mean polar angle, calculated by the polar plot, was wide.
File Format	HTM / HTML
ISSN	00015172
Issue Number	8
Volume Number	59
e-ISSN	00015172
Journal	Acta Anaesthesiologica Scandinavica
Language	English
Publisher	Wiley
Publisher Date	2015-09-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Bronchoalveolar Lavage Capnography Methods Cardiac Output Physiology Pulmonary Artery Animals Positive-pressure Respiration Reproducibility Of Results Swine Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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