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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1998 March;64(3):67-73

language: Italian

Non-inva­sive eval­u­a­tion of car­diac out­put by ­means of arte­ri­al ­pulse con­tour anal­y­sis in Inten­sive ­Care ­patients

Girardis M. 1, Antonutto G. 2, Vecellio A. 1, Dal Pos L. 1, Pasetto A. 1

1 Università degli Studi - Udine, Cattedra di Anestesiologia e Rianimazione;
2 Università degli Studi - Udine, Dipartimento di Scienze e Tecnologie Biomediche


Background. The anal­y­sis of the arte­ri­al ­pulse con­tour ­obtained by ­means of a non-inva­sive ­device (Finapres) ­seems to be an ­ideal meth­od to meas­ure car­diac out­put (CO). An indi­vid­u­al cal­i­bra­tion fac­tor (Z) dimen­sion­al­ly ­equal to aor­tic impe­dence is the nec­es­sary pre-req­ui­site to cal­cu­late CO by ­pulse con­tour anal­y­sis. To ver­i­fy the reli­abil­ity of non-inva­sive ­pulse con­tour meth­od, we com­pared the COs meas­ured ­from Finapres trac­ings ­with ­those meas­ured ­from ther­mo­di­lu­tion meth­od in Inten­sive ­Care ­patients.
Methods. In 9 ­patients under­go­ing car­diac and gen­er­al sur­gery, CO was meas­ured ­from ther­mo­di­lu­tion (­COTD) with­in 24 ­hours of post­op­er­a­tive peri­od (­total of 67 meas­ure­ments). During ­COTD meas­ure­ments, Finapres trac­ings ­were record­ed and ­then ana­lysed to cal­cu­late CO by two dif­fer­ent pro­ce­dures. In the for­mer (COA), Z was cal­cu­lat­ed ­from an algo­rithm ­which ­takes ­into ­account ­heart ­rate, ­mean arte­ri­al pres­sure and age of the ­patient. In the lat­ter pro­ce­dure (COB), Z was experi­men­tal­ly deter­mined ­from the ­initial ­COTD meas­ure and ­then updat­ed for the hemo­dy­nam­ic con­di­tions of the ­patient.
Results. ­COTD ­ranged ­between 3.5 and 9.5 L.min-1 (­mean val­ue 5.53±1.29 L.min-1). The ­mean dif­fer­ence ­between ­COTD e COA was 0.485±1.537 L.min-1 and the ­mean per­cent­age ­error was 25.1±14.5%. The experi­men­tal deter­mi­na­tion of Z ­reduced the ­mean dif­fer­ence and the ­mean per­cent­age ­error ­between ther­mo­di­lu­tion and Finapres meth­od to -0.002±1.056 L.min-1 and 15.5±11.0%, respec­tive­ly. The regres­sion ­line ­between ­COTD and COB ­turned out to be: COB=0.68+0.88.­COTD (r=0.73).
Conclusions. The ­pulse con­tour anal­y­sis ­applied to Finapres trac­ing ­allows to cal­cu­late CO ­with rea­son­able accu­ra­cy in the inten­sive ­care ­patients. An ­initial experi­men­tal deter­mi­na­tion of Z is rec­om­mend­ed to ­improve the accu­ra­cy of Finapres meth­od.

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