Non-invasive measurement of cardiac output: whole-body impedance cardiography in simultaneous comparison with thermodilution and direct oxygen Fick methods

• Published in: Intensive care medicine Vol. 23; no. 11; pp. 1132 - 1137
• Main Authors: Kööbi, T., Kaukinen, S., Ahola, T., Turjanmaa, V. M. H.
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.11.1997; Berlin Springer Nature B.V
• Subjects: Adult; Aged; Bias; Biological and medical sciences; Breath Tests; Cardiac Output; Cardiography; Cardiography, Impedance - methods; Cardiovascular system; Coronary artery; Coronary Artery Bypass; Female; Heart; Heart surgery; Humans; Impedance; Intensive care; Investigative techniques of hemodynamics; Investigative techniques, diagnostic techniques (general aspects); Male; Medical instruments; Medical sciences; Middle Aged; Oxygen; Oxygen - analysis; Oxygen - blood; Patients; Preoperative Care; Prospective Studies; Pulmonary arteries; Pulmonary artery; Reproducibility; Reproducibility of Results; Thermodilution - methods; Heart; Human; Rheology; Mechanical impedance; Flow measurement; Blood flow; Electrodiagnosis; Thermodilution; Electrocardiography; Whole body; Recording; Hemodynamics; Measurement method; Cardiac output; Comparative study
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s001340050469

To determine the reliability of whole-body impedance cardiography (ICGWB), with electrodes attached to wrists and ankles, in the measurement of cardiac output (CO) on the basis of simultaneous comparison with thermodilution (TD) and direct oxygen Fick (Fick) methods. Prospective clinical study. A surgical intensive care unit at a university hospital. Thirty consecutive subjects undergoing a coronary artery bypass surgery were investigated preoperatively. ICGWB derived CO was measured simultaneously with the TD and Fick methods to establish the biases and limits of agreement (LA) between the methods. The results obtained by ICGWB and the invasive methods showed good agreement. The bias and LA between COTD and COICG were 0.00 l/min: 1.37 and 1.37 l/min, respectively, and were close to those obtained between COTD and COFICK, 0.32 l/min; 1.74 and -1.10 l/min. The bias and LA between the COFICK and COICG were -0.32 l/min; -2.24 and 1.60 l/min respectively. The repeatability value of consecutive single measurements for ICGWB (RVICG = 0.57 l/min) was much better than for the TD method (RVTD = 1.10 l/min). There was close agreement between the results of the three methods in the measurement of CO. In sedated preoperative patients the accuracy of ICGWB is within clinically acceptable limits and its repeatability is excellent. ICGWB provides a useful alternative to the TD and Fick methods in cases where the pressures supplied by the pulmonary artery catheter are not essential.