Original articleComparison of the Endotracheal Cardiac Output Monitor to Thermodilution in Cardiac Surgery Patients
Section snippets
Methods
After obtaining institutional review board approval, 40 unselected patients undergoing nonemergent cardiac surgery were prospectively enrolled. General anesthesia in all patients was induced using propofol, fentanyl, and/or midazolam per the attending cardiac anesthesiologist's preference. Maintenance of inhaled anesthesia was either with isoflurane or desflurane; fentanyl and midazolam were titrated as indicated. Each patient enrolled had a preinduction radial arterial catheter as well as
Results
A total of 50 patients were screened; 40 patients were enrolled and completed the study. Reasons subjects did not complete the study included failure to float a PAC, predicted or unexpected difficult intubation, or the attending cardiac anesthesiologist's decision not to place a PAC. In 2 enrolled subjects, immediate post-induction data pairs were not obtained because of hemodynamic instability. Patients underwent coronary artery bypass graft (CABG) surgery (n = 28, 70.0%), aortic valve
Discussion
Thermodilution via the PAC is an imperfect method of measuring CO with its own intrinsic errors. Variations in flow rates, hemodynamic changes, respiratory variations, and user variability all contribute to these intrinsic errors with TD, leading to an overall accuracy of 15% to 20%.2, 3, 10, 14, 15, 16 These imperfections with TD technology coupled with the inherent risk of pulmonary arterial catheterization have driven the development of minimally invasive CO monitoring techniques including
Acknowledgments
The authors wish to thank Juhee Song, PhD, of the Department of Research Operations and Biostatistics for her assistance with the statistical planning and analysis.
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Comparing the Mutual Interchangeability of ECOM, FloTrac/Vigileo, 3D-TEE, and ITD-PAC Cardiac Output Measuring Systems in Coronary Artery Bypass Grafting
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