TY - JOUR
T1 - Non-invasive cardiac output by transthoracic electrical bioimpedence in post-cardiac surgery patients
T2 - Comparison with thermodilution method
AU - Gujjar, Arunodaya R.
AU - Muralidhar, K.
AU - Banakal, Sanjay
AU - Gupta, Ratan
AU - Sathyaprabha, Talakad N.
AU - Jairaj, P. S.
N1 - Funding Information:
This research was supported by Larsen & Toubro (India) Ltd., Electrical & Electronics Division, Mysore, India. The sponsors however did not influence the study design, execution, analysis or conclusions. The authors acknowledge Prof. Jindal GD, Bhabha Atomic Research Institute, Mumbai, India for expert advice and guidance; Dr. Janaki for assistance in data collection and the ICU nursing and technical staff at Narayana Institute of Cardiac Sciences for their support.
PY - 2008/6
Y1 - 2008/6
N2 - Objective: Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument - NICOMON (Larsen & Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients. Methods: Postoperative cardiac surgical patients requiring a PAC for their management were studied. TEB-CO was measured by passing a 4 mA RMS alternating current across the chest and measuring the analog bioimpedence across the thorax. Kubicek equation was used to estimate TEB-CO. Td-CO was measured using a PAC. Bland-Altman analysis was used to compare paired data. Results: One hundred and ninety-seven pairs of CO measurements were made by the two methods among 35 patients. Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 (P < 0.01), with bias -0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods (r = 0.789; P = 0.01). Conclusions: Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indicated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.
AB - Objective: Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument - NICOMON (Larsen & Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients. Methods: Postoperative cardiac surgical patients requiring a PAC for their management were studied. TEB-CO was measured by passing a 4 mA RMS alternating current across the chest and measuring the analog bioimpedence across the thorax. Kubicek equation was used to estimate TEB-CO. Td-CO was measured using a PAC. Bland-Altman analysis was used to compare paired data. Results: One hundred and ninety-seven pairs of CO measurements were made by the two methods among 35 patients. Mean TEB-CO was 5.15 ± 1.27 l/min and mean Td-CO was 5.22 ± 1.28 l/min. Pearson correlation coefficient (r) for these measurements was 0.856 (P < 0.01), with bias -0.0651 l and precision: ±1.37 l/min. The percentage error of measurement of this precision was 26.44%. Cardiac index also correlated among the two methods (r = 0.789; P = 0.01). Conclusions: Thoracic electrical bioimpedance cardiac output compares favorably with thermodilution method among post-cardiac surgery patients. Further studies are indicated with this instrument to validate its efficacy in various clinical situations and utility in monitoring hemodynamic interventions.
KW - Bioimpedance cardiac output
KW - Cardiac output
KW - Noninvasive cardiac output
KW - Thoracic electrical bioimpedance
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U2 - 10.1007/s10877-008-9119-y
DO - 10.1007/s10877-008-9119-y
M3 - Article
C2 - 18418719
AN - SCOPUS:45849152599
SN - 1387-1307
VL - 22
SP - 175
EP - 180
JO - Journal of Clinical Monitoring and Computing
JF - Journal of Clinical Monitoring and Computing
IS - 3
ER -