BJA Advance Access originally published online on May 13, 2005
British Journal of Anaesthesia 2005 95(2):159-165; doi:10.1093/bja/aei154
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Pressure recording analytical method (PRAM) for measurement of cardiac output during various haemodynamic states
Department of Surgery and Bioengineering, Thoracic and Cardiovascular Unit, University of Siena, Siena, Italy
* Corresponding author: Department of Surgery and Bioengineering, Thoracic and Cardiovascular Unit, University of Siena, Viale Bracci 14, 53100 Siena, Italy. E-mail: scolletta{at}unisi.it
Background. Cardiac output (CO) can be measured using the pressure recording analytical method (PRAM), which is a new, less invasive technique allowing beat-by-beat stroke volume monitoring from the pressure signals recorded in femoral or radial arteries.
Methods. We investigated PRAM by comparing its cardiac output (PRAM-CO) with paired measurements obtained by electromagnetic flowmetry (EM-CO) and by standard thermodilution (ThD-CO) during various haemodynamic states in a swine model. Nine pigs were monitored with a pulmonary artery catheter and a femoral artery catheter at baseline, in a hyperdynamic state produced by administration of dobutamine and in a hypodynamic state induced by progressive exsanguination. Bland–Altman analysis was used.
Results. One hundred and eight paired cardiac output values over a range of EM-CO of 1.8–10.4 litre min–1 resulted. We found close agreement between the techniques. Mean bias between EM-CO and PRAM-CO was –0.03 litre min–1 (precision 0.58 litre min–1). The 95% limits of agreement were –0.61 to +0.55 litre min–1. Similar results between ThD-CO and PRAM-CO were found.
Conclusions. In a porcine model we have demonstrated accuracy of PRAM during various haemodynamic states. PRAM is a reliable tool to detect changes in cardiac output in pigs and has ability as a basic research tool.
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