Skip Navigation


BJA Advance Access originally published online on July 24, 2007
British Journal of Anaesthesia 2007 99(4):484-492; doi:10.1093/bja/aem199
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
99/4/484    most recent
aem199v1
Right arrow E-Letters: Submit a response to the article
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Halvorsen, P. S.
Right arrow Articles by Tønnessen, T. I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Halvorsen, P. S.
Right arrow Articles by Tønnessen, T. I.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Continuous cardiac output during off-pump coronary artery bypass surgery: pulse-contour analyses vs pulmonary artery thermodilution

P. S. Halvorsen1,*, A. Sokolov1,3, M. Cvancarova2, P. K. Hol1, R. Lundblad4 and T. I. Tønnessen1,3,5

1 The Interventional Centre
2 Department of Biostatistics
3 Department of Anaesthesiology
4 Department of Cardio-Thoracic Surgery, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
5 Medical Faculty, University of Oslo, Oslo, Norway

* Corresponding author: The Interventional Centre, Rikshospitalet-Radiumhospitalet Medical Centre, NO-0027 Oslo, Norway. E-mail: per.steinar.halvorsen{at}rikshospitalet.no

Background: No gold standard method exists for monitoring continuous cardiac output (CO). In this study, the agreement between the two most frequently used methods, PiCCO pulse-contour analysis (PCCO) and STAT pulmonary artery thermodilution (STAT-CO), was assessed during multiple-vessel off-pump coronary artery bypass (OPCAB) surgery.

Methods: Thirty patients were enrolled in the study. Two time periods were defined during surgery; Period 1 included positioning of the heart and stabilizer device and Period 2 included the coronary occlusion. Measurements were obtained every minute during both periods. The agreement for the continuous CO and the change in CO ({Delta}CO) was estimated using the Bland–Altman method.

Results: Significant changes in mean arterial pressure ({Delta}MAP), central venous saturation, PCCO and STAT-CO were seen only during Period 1. {Delta}MAP correlated only with changes in PCCO, (P < 0.001, r = 0.60). The mean difference (2SD) between PCCO and STAT-CO ranged from – 0.29 (1.82) to – 0.71 (2.57) litre min–1, and the percentage error varied from 32 to 50%. For the CO measurements, the limits of agreements did not differ between Period 1 and Period 2. In contrast, for the {Delta}CO measurements, the limits of agreements were wider in Period 1 than in the more haemodynamically stable Period 2.

Conclusions: PCCO and STAT-CO show large discrepancies in CO during OPCAB surgery. Clinically acceptable agreement was seen only for trends in CO during haemodynamically stable periods.

Keywords: anaesthesia, cardiovascular; heart, cardiac output; measurement techniques, pulse-contour analysis; measurement techniques, thermodilution; surgery, coronary artery bypass


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
J. Bergsland, P. S. Lingaas, H. Skulstad, P. K. Hol, P. S. Halvorsen, R. Andersen, M. Smastuen, R. Lundblad, J. Svennevig, K. Andersen, et al.
Intracoronary Shunt Prevents Ischemia in Off-Pump Coronary Artery Bypass Surgery
Ann. Thorac. Surg., January 1, 2009; 87(1): 54 - 60.
[Abstract] [Full Text] [PDF]

E-letters:

Read all E-letters

Realtime Haemodynamic Monitoring During Beating Heart Coronaory Bypass Grafting
John George George Cherian
British Journal of Anaesthesia, 11 Oct 2007 [Full text]
Re: Realtime Haemodynamic Monitoring During Beating Heart Coronaory Bypass Grafting
Per S Halvorsen
British Journal of Anaesthesia, 26 Oct 2007 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.