Non-invasive Cardiac Output by Transthoracic Electrical Bioimpedence in Post-cardiac Surgery Patients: Comparison with Thermodilution Method

Objective Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument – NICOMON (Larsen & Toubro Ltd. India) with thermodilution (Td) CO...

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Veröffentlicht in:Journal of clinical monitoring and computing 2008-06, Vol.22 (3), p.175-180
Hauptverfasser: Gujjar, Arunodaya R., Muralidhar, K., Banakal, Sanjay, Gupta, Ratan, Sathyaprabha, Talakad N., Jairaj, P. S.
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container_end_page 180
container_issue 3
container_start_page 175
container_title Journal of clinical monitoring and computing
container_volume 22
creator Gujjar, Arunodaya R.
Muralidhar, K.
Banakal, Sanjay
Gupta, Ratan
Sathyaprabha, Talakad N.
Jairaj, P. S.
description Objective Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument – NICOMON (Larsen & Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients. Methods Postoperative cardiac surgical patients requiring a PAC for their management were studied. TEB-CO was measured by passing a 4 mA RMS alternating current across the chest and measuring the analog bioimpedence across the thorax. Kubicek equation was used to estimate TEB-CO. Td-CO was measured using a PAC. Bland-Altman analysis was used to compare paired data. Results One hundred and ninety-seven pairs of CO measurements were made by the two methods among 35 patients. Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 ( P < 0.01), with bias −0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods ( r  = 0.789; P  = 0.01). Conclusions Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indi- cated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.
doi_str_mv 10.1007/s10877-008-9119-y
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Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 ( P &lt; 0.01), with bias −0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods ( r  = 0.789; P  = 0.01). Conclusions Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indi- cated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-008-9119-y</identifier><identifier>PMID: 18418719</identifier><identifier>CODEN: JCMCFG</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Cardiac Output ; Cardiography, Impedance - methods ; Critical Care Medicine ; Diagnosis, Computer-Assisted - methods ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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S.</creatorcontrib><title>Non-invasive Cardiac Output by Transthoracic Electrical Bioimpedence in Post-cardiac Surgery Patients: Comparison with Thermodilution Method</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>Objective Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument – NICOMON (Larsen &amp; Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients. Methods Postoperative cardiac surgical patients requiring a PAC for their management were studied. TEB-CO was measured by passing a 4 mA RMS alternating current across the chest and measuring the analog bioimpedence across the thorax. Kubicek equation was used to estimate TEB-CO. Td-CO was measured using a PAC. Bland-Altman analysis was used to compare paired data. Results One hundred and ninety-seven pairs of CO measurements were made by the two methods among 35 patients. Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 ( P &lt; 0.01), with bias −0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods ( r  = 0.789; P  = 0.01). Conclusions Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indi- cated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia. Intensive care medicine. 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S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non-invasive Cardiac Output by Transthoracic Electrical Bioimpedence in Post-cardiac Surgery Patients: Comparison with Thermodilution Method</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><addtitle>J Clin Monit Comput</addtitle><date>2008-06</date><risdate>2008</risdate><volume>22</volume><issue>3</issue><spage>175</spage><epage>180</epage><pages>175-180</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><coden>JCMCFG</coden><abstract>Objective Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument – NICOMON (Larsen &amp; Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients. Methods Postoperative cardiac surgical patients requiring a PAC for their management were studied. TEB-CO was measured by passing a 4 mA RMS alternating current across the chest and measuring the analog bioimpedence across the thorax. Kubicek equation was used to estimate TEB-CO. Td-CO was measured using a PAC. Bland-Altman analysis was used to compare paired data. Results One hundred and ninety-seven pairs of CO measurements were made by the two methods among 35 patients. Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 ( P &lt; 0.01), with bias −0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods ( r  = 0.789; P  = 0.01). Conclusions Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indi- cated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>18418719</pmid><doi>10.1007/s10877-008-9119-y</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Biological and medical sciences
Cardiac Output
Cardiography, Impedance - methods
Critical Care Medicine
Diagnosis, Computer-Assisted - methods
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Female
Health Sciences
Heart Diseases - diagnosis
Heart Diseases - physiopathology
Heart Diseases - surgery
Humans
Intensive
Intensive care medicine
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Postoperative Care - methods
Reproducibility of Results
Sensitivity and Specificity
Statistics for Life Sciences
Thermodilution - methods
Young Adult
title Non-invasive Cardiac Output by Transthoracic Electrical Bioimpedence in Post-cardiac Surgery Patients: Comparison with Thermodilution Method
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