Advertisement

Capnography and Cardiac Output Determination

  • G. Murias
  • A. Villagra
  • L. Blanch
Conference paper

Abstract

Since gas transfer across the alveolar capillary wall does not depend on active transport, the lung may be used as an aerotonometer, allowing the alveolar gas to equilibrate with the mixed venous blood. The analysis of this alveolar gas provides an indirect method for measuring mixed venous carbon dioxide tension (pvCO2). The equilibration method, using a bag containing a high concentration of carbon dioxide in oxygen, has been shown to accurately measure oxygenated pvCO2 and application of this method has led to the development of the non-invasive determination of cardiac output (CO) by the CO2 rebreathing. Several studies have demonstrated the validity of this indirect Fick method in healthy subjects, in patients with cardiac dysfunction, in patients with obstructive airway disease, and in patients receiving mechanical ventilation [1, 2, 3, 4, 5].

Keywords

Cardiac Output Pulmonary Artery Catheter Rebreathing Method Cardiac Output Determination Rebreathing Technique 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Franciosa JA (1977) Evaluation of the CO2 rebreathing cardiac output method in seriously ill patients. Circulation 55: 449–455PubMedCrossRefGoogle Scholar
  2. 2.
    Neviere R, Mathieu D, Riou Y, et al (1994) Carbon dioxide rebreathing method of cardiac output measurement during acute respiratory failure in patients with chronic obstructive pulmonary disease. Crit Care Med 22: 81–85PubMedCrossRefGoogle Scholar
  3. 3.
    Davis CC, Jones NL, Sealy BJ (1978) Measurements of cardiac output in seriously ill patients using a CO2 rebreathing method. Chest 73: 167–172PubMedCrossRefGoogle Scholar
  4. 4.
    Blanch L, Fernandez R, Benito S, et al (1988) Accuracy of an indirect carbon dioxide Fick method in determination of the cardiac output in critically ill mechanically ventilated patients. Intensive Care Med 14: 131–135PubMedCrossRefGoogle Scholar
  5. 5.
    van Heerden PV, Baker S, Lim SI, et al (2000) Clinical evaluation of the noninvasive cardiac output (NICO) monitor in the intensive care unit. Anaesth Intensive Care 28: 427–430PubMedGoogle Scholar
  6. 6.
    Ganz W, Donoso R, Marcus HS, et al (1971) A new technique for measurement of cardiac output by thermodilution in man. Am J Cardiol 27: 392–396PubMedCrossRefGoogle Scholar
  7. 7.
    Gore JM, Goldberg RJ, Spodick DH, et al (1987) A community-wide assessment of the use of pulmonary artery catheters in patients with acute myocardial infarction. Chest 92: 721–727PubMedCrossRefGoogle Scholar
  8. 8.
    Connors AF, Speroff T, Dawson NV, et al (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 276: 889–897PubMedCrossRefGoogle Scholar
  9. 9.
    Robin DE (1985) The cult of Swan-Ganz catheter: overuse and abuse of pulmonary flow catheters. Ann Intern Med 103: 445PubMedGoogle Scholar
  10. 10.
    Robin DE (1987) Death by pulmonary artery flow-directed catheter. Chest 92: 727PubMedCrossRefGoogle Scholar
  11. 11.
    Dalen JE, Bone RC (1996) Is it time to pull the pulmonary artery catheter? JAMA 276: 916–918PubMedCrossRefGoogle Scholar
  12. 12.
    Jaffe MB (1999) Partial CO2 rebreathing cardiac output—Operating principles of the NICO system. J Clin Monit 15: 387–401CrossRefGoogle Scholar
  13. 13.
    Capek JM, Roy RJ (1988) Nonivasive measurement of cardiac output using partial CO2 rebreathing. IEEE TransBiomed Engin 35: 653–661CrossRefGoogle Scholar
  14. 14.
    Villagra A Murias G Vatua S et al 2000 Evaluation of the n-invasive CO2 partial rebreathing method for cardiac output measurement in critical care. Intensive Care Med 26S31Google Scholar
  15. 15.
    Snyder JV, Powner DJ (1982) Effects of mechanical ventilation on the measurement of cardiac output by thermodilution. Crit Care Med 10: 677–682CrossRefGoogle Scholar
  16. 16.
    Stevens JH, Raffin TA, Mihm FG, et al (1985) Thermodilution cardiac output measurement. Effects of the respiratory cycle on its reproducibility. JAMA 253: 2240–2242PubMedCrossRefGoogle Scholar
  17. 17.
    Harris AP, Miller CF, Beattie C, et al (1985) The slowing of sinus rhythm during thermodilution cardiac output determinations and the effect of altering injectate temperature. Anesthesiology 63: 540–541PubMedCrossRefGoogle Scholar
  18. 18.
    Elkayam U, Berkley R, Azen S, et al (1983) Cardiac output by thermodilution technique. Effect of injectate’s volume and temperature on accuracy and reproducibility in the critically 111 patient. Chest 84: 418–422PubMedCrossRefGoogle Scholar
  19. 19.
    Bazaral MG, Petre J, Novoa R (1992) Errors in thermodilution cardiac output measurements caused by rapid pulmonary artery temperature decreases after cardiopulmonary bypass. Anesthe-siology 77: 31–37CrossRefGoogle Scholar
  20. 20.
    Wessel HU, James GW, Paul MH (1966) Effects of respiration and circulation on central blood temperature of the dog. J Appl Physiol 211: 1403–1412Google Scholar
  21. 21.
    Chatburn RL (1995) Measurement theory: accuracy issues in monitoring. In: Levine RL, From RE (eds) Critical care monitoring: from pre hospital to the ICU. Mosby Yearbook, St Louis, pp 17–42.Google Scholar

Copyright information

© Springer-Verlag Italia 2002

Authors and Affiliations

  • G. Murias
    • 1
  • A. Villagra
    • 1
  • L. Blanch
    • 1
  1. 1.Critical Care Centre, Sabadell HospitalParc Taulí University InstituteSabadellSpain

Personalised recommendations