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Re: Realtime Haemodynamic Monitoring During Beating Heart Coronaory Bypass Grafting
- Per S Halvorsen (26 October 2007)
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Realtime Haemodynamic Monitoring During Beating Heart Coronaory Bypass Grafting
- John George George Cherian (11 October 2007)
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Per S Halvorsen
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Sirs, We would like to thank Dr Cherian for his interest and comments on our article -Continuous cardiac output during off-pump coronary artery bypass surgery: pulse-contour analyses vs pulmonary artery thermodilution. We agree that heamodynamic monitoring is of great importance during OPCAB surgery. CCO monitoring with the pulmonary artery catheter is frequently applied during surgery. As pointed out in our article understanding the delayed response time of CCO catheters is important for appropriate clinical use. We do not recommend CCO monitoring with the pulmonary artery catheter during haemodynamic instability due to the considerable time delay of the CCO measurements. In our article we consider this a main message and we believe this is clearly stated. Conflict of Interest:None declared |
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John George George Cherian Fellow - Malaysian Institute of Medical Laboratory Sciences
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Sirs, Realtime haemodynamic information is invaluable when operating on the beating heart.Thermodilution catheters for cardiac output monitoring, however, has important limitations. They provide intermittent measurements only. The in vitro response time of a change in cardiac output is approximately between 5 and 15 min . Hence displayed values are accurate only in situations of haemodynamic stability, which cannot generally be assumed during cardiac manipulation and coronary grafting on the beating heart. Hence the large discrepancies in CO during off pump coronary artery bypass grafting is not unusual. John George Fellow - Malaysian Institute of Medical Laboratory Sciences Correspondence : 4 Lrg 4/48 F, 46050, PJ, Selangor, Malaysia Conflict of Interest:None declared |
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