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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

Copyright © 1998 EDIZIONI MINERVA MEDICA

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


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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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