0
Clinical Investigations in Critical Care |

Comparison of Cardiac Output and Circulatory Blood Volumes by Transpulmonary Thermo-Dye Dilution and Transcutaneous Indocyanine Green Measurement in Critically Ill Patients*

Samir G. Sakka, MD; Konrad Reinhart, MD; Karl Wegscheider, PhD; Andreas Meier-Hellmann, MD
Author and Funding Information

*From the Department of Anesthesiology and Intensive Care Medicine (Drs. Sakka, Reinhart, and Meier-Hellman), Friedrich-Schiller-University of Jena, Jena, Germany; and the Department of Statistics and Econometry (Dr. Wegscheider), University of Hamburg, Hamburg, Germany.

Correspondence to: Samir G. Sakka, MD, DEAA, Department of Anesthesiology and Intensive Care Medicine, Friedrich-Schiller-University of Jena, Bachstrasse 18, D-07740 Jena, Germany; e-mail: Samir. Sakka@med.uni-jena.de



Chest. 2002;121(2):559-565. doi:10.1378/chest.121.2.559
Text Size: A A A
Published online

Objective: We prospectively studied the agreement between transpulmonary aortic fiberoptic-based and pulse dye densitometry (PDD) measurements of cardiac output and circulatory blood volumes.

Design: Prospective clinical study.

Setting: Operative ICU of a university hospital.

Patients: Sixteen critically ill, deeply sedated patients receiving mechanical ventilation with ARDS (n = 8), sepsis/septic shock (n = 6), subarachnoid hemorrhage (n = 1), and severe head injury (n = 1).

Measurements and results: Each patient received a 4F aortic catheter with an integrated fiberoptic and thermistor that was connected to a computer system for automatic calculation of the transpulmonary indicator dilution (TPID) technique for the measurement of cardiac output (COtpid), intrathoracic blood volume (ITBV), and total blood volume measured by TPID technique (TBVtpid). In each patient, an indocyanine green sensor was attached to one nasal wing and connected to an analyzer for the PDD measurement of cardiac output (COpdd), central blood volume (CBV), and TBV measured by PDD (TBVpdd). For all first measurements, linear regression analysis between COtpid and COpdd revealed that COpdd = 0.63 × COtpid + 3.69 (L/min)[ r = 0.64, p = 0.008]. Mean bias between both techniques was − 0.8 L/min (SD, 1.7 L/min). Correlations between ITBV/CBV (r = 0.52) and TBVtpid/TBVpdd were only moderate: TBVpdd = 0.74 × TBVtpid + 2,362 (mL)[ r = 0.60, p = 0.015; mean bias, − 999 mL; SD, 1,353 mL]. Over all 55 measurements, TPID measurements were on average 11.5% (cardiac output) and 17.6% (TBV) higher than PDD measurements. The differences between both measurements ranged from − 58 to 81% (cardiac output) and from − 47 to 82% (TBV; 95% reference ranges). The main source of variation were the intraindividual differences, resulting in different peaks and trends in the patients’ time courses depending on which measurement method was used.

Conclusion: PDD measurement of cardiac output and circulatory blood volumes agrees moderately with transpulmonary thermo-dye dilution technique in critically ill patients.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543