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Estimation of cardiac output in a pharmacological trial using a simple method based on arterial blood pressure signal waveform: a comparison with pulmonary thermodilution and echocardiographic methods

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Abstract

Objective

Cardiac output (CO) has traditionally been measured using invasive techniques, which involve an element of risk. Thus, a reliable less-invasive method for determining CO would be very valuable for research use. We tested whether simple analysis of the arterial pulse waveform, not requiring large-vessel catheterisation or expensive equipment, could provide an estimate of CO that is accurate enough for pharmacological studies.

Methods

We measured CO in 11 healthy male subjects who received low and high doses of dexmedetomidine (α2-adrenoceptor agonist), using pulse contour analysis, echocardiography and pulmonary thermodilution techniques.

Results

At baseline, these methods gave the following mean (SD) values of CO: 6.18 (1.59), 5.22 (1.35) and 7.03 (1.54) l/min, respectively. High-dose dexmedetomidine reduced CO to 4.50 (0.68), 3.65 (0.65) and 4.80 (0.89) l/min, corresponding to −25 (14) %, −28 (12) % and −30 (14) % reductions from baseline, respectively. The pulse contour method described these dexmedetomidine-induced changes in CO very similarly to the thermodilution and echocardiographic methods. The limits of agreement [bias (2SD)] were 0.55 (2.55) and −0.10 (2.04) l/min, respectively.

Conclusion

The minimally invasive pulse contour analysis technique might be suitable for pharmacological studies for the detection of major drug-induced reductions in CO.

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Acknowledgements

This study was financially supported by grants of EVO from the Turku University Hospital, Finland, the Juselius Foundation, and the Finnish Heart Foundation.

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Authors and Affiliations

  1. Turku PET Centre, Turku University Central Hospital, Turku, Finland

    Jani Penttilä & Harry Scheinin

  2. Department of Pharmacology and Clinical Pharmacology, University of Turku, Turku, Finland

    Amir Snapir, Jussi Posti, Mika Scheinin & Harry Scheinin

  3. Department of Anesthesiology and Intensive Care Unit, Turku University Central Hospital, Turku, Finland

    Erkki Kentala

  4. Department of Clinical Physiology, Turku University Central Hospital, Turku, Finland

    Juha Koskenvuo

  5. Department of Physics, University of Turku, Vesilinnantie 5, 20014, Turku, Finland

    Tom Kuusela

Authors
  1. Jani Penttilä
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  2. Amir Snapir
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  4. Juha Koskenvuo
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  5. Jussi Posti
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  6. Mika Scheinin
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  7. Harry Scheinin
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  8. Tom Kuusela
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Correspondence to Tom Kuusela.

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Penttilä, J., Snapir, A., Kentala, E. et al. Estimation of cardiac output in a pharmacological trial using a simple method based on arterial blood pressure signal waveform: a comparison with pulmonary thermodilution and echocardiographic methods. Eur J Clin Pharmacol 62, 401–407 (2006). https://doi.org/10.1007/s00228-006-0115-1

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  • DOI: https://doi.org/10.1007/s00228-006-0115-1

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