Haemodynamic and Metabolic Evaluations by Rebreathing Methods

  • M. Girardis
  • C. Lombardini
  • A. Pasetto
Conference paper


Cardiac output (CO) is a key parameter to assess the haemodynamic status, the cardiac performance and the therapeutic management in critical patients. In anaesthesia and intensive care practice, the methods most often used to measure CO are the classical thermodilution by a pulmonary artery catheter and the transpulmonary thermodilution by a femoral artery catheter [1, 2]. These methods are invasive and require a time period for catheter positioning. Therefore, they can not be used in low-risk patients and in emergency wards. Trans-esophageal echo-Doppler, even if less invasive, is expensive and requires high skilled personnel [2]. To solve the above limitations, new methods have been proposed to measure CO at the bedside. Rebreathing methods seem to be ideal in mechanically ventilated patients because they are non-invasive, continuous, not time consuming and inexpensive. The physiological basis, the different techniques and the clinical application of rebreathing methods will be discussed in the following paragraphs.


Single Breath Transpulmonary Thermodilution Mixed Venous Blood Alveolar Dead Space Rebreathing Method 
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  1. 1.
    Nilsson LB, Eldrup N, Berthelsen PG (2001) Lack of agreement between thermodiluition and carbon dioxide-rebreathing cardaic output. Acta Anaestesiol Scand 45(6): 680–685CrossRefGoogle Scholar
  2. 2.
    Binder JC, Parkin WG (2001) Non-invasive cardiac output determination: comparison of a new partial-rebreathing technique with thermodilution Anesth Intensive Care 29(1): 19–23Google Scholar
  3. 3.
    Sackner MA (1968) Measurement of cardiac output by alveolar gas exchange. Hand of physiology-The respiratory system IV, chapter 13: 233–255Google Scholar
  4. 4.
    de Abreu MG, Quintel M, Ragaller M, Albrecht DM (1997) Partial carbon dioxide rebreathing: a reliable technique for noninvasive measurement of non shunted pulmonary capillary blood flow. Grit Care Med Apr 25(4): 675–683CrossRefGoogle Scholar
  5. 5.
    Cerretelli E, Cruz JC, Farhi LE, Rahn H (1996) Determination of mixed venous O2 and CO2 tension and cardiac output by a rebreathing method. Resp Physiol 1: 258–264CrossRefGoogle Scholar
  6. 6.
    Farhi LE, Nesarajah MS, Olszowka AJ et al (1976) Cardiac output determination by simple one-step rebreathing technique. Respir Physiol 28: 141–159PubMedCrossRefGoogle Scholar
  7. 7.
    Knowles JE, Newman W, Fenn WO (1960) Determination of oxygenated mixed venous blood CO2 tension by a breath holding method. J Appl Physiol 32: 782–787Google Scholar
  8. 8.
    Kim TS, Rahn H, Farhi LE (1966) Estimation of the true venous and arterial PCO2 by gas analysis of a single breath. J Appl Physiol 21: 1338–1344PubMedGoogle Scholar
  9. 9.
    Arnold JH, Stenz RI, Thomson JH, Arnold LW (1996) Noninvasive determination of cardiac output using single breath CO2 analysis. Crit Care Med 24: 1071–1705Google Scholar
  10. 10.
    Mahler DA, Matthay RA, Snyder PE et al (1985) Determination of cardiac output at rest and during exercise by carbon dioxide rebreathing method in obstructive airway disease. Am Rev Respir Dis 131: 73–78PubMedGoogle Scholar
  11. 11.
    Clausen JP, Larsen OA, Trap-Jensen J (1970) Cardiac output in middle-aged patients determined with CO2 rebreathing method. J Appl Physiol 28: 337–342PubMedGoogle Scholar
  12. 12.
    Davis CC, Jones NL, Seales BJ (1978) Measurements of cardiac output in seriously ill patients using a CO2 rebreathing method. Chest 73: 167–172PubMedCrossRefGoogle Scholar
  13. 13.
    Binder JC, Parkin WG (2001) Non-invasive cardiac output determination: comparison of a new partial-rebreathing technique with thermodilution Anesth Intensive Care 29(1): 19–23Google Scholar
  14. 14.
    Gedeon A, Forstund L, Hedenstierna G et al (1980) A new method for non-invasive bedside determination of pulmonary blood flow. Med Biol Eng Comput 18: 411–418PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2002

Authors and Affiliations

  • M. Girardis
    • 1
  • C. Lombardini
    • 1
  • A. Pasetto
    • 1
  1. 1.Department of Anaesthesia and Intensive CareModena General HospitalModenaItaly

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