Non-invasive cardiac output by transthoracic electrical bioimpedence in post-cardiac surgery patients: Comparison with thermodilution method

Arunodaya R. Gujjar, K. Muralidhar, Sanjay Banakal, Ratan Gupta, Talakad N. Sathyaprabha, P. S. Jairaj

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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.

Original languageEnglish
Pages (from-to)175-180
Number of pages6
JournalJournal of Clinical Monitoring and Computing
Issue number3
Publication statusPublished - Jun 2008



  • Bioimpedance cardiac output
  • Cardiac output
  • Noninvasive cardiac output
  • Thoracic electrical bioimpedance

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Health Informatics
  • Health Information Management

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