New Insights into Cardiovascular Monitoring: Continuous Arterial Thermodilution and Intrathoracic Blood Volume
The measurement of cardiac output (CO) is often done when the patient is in need of advanced haemodynamic monitoring. The current method for measurement of cardiac output is by thermodilution and necessitates the insertion of a pulmonary artery catheter (PAC), a procedure which is associated with a number of known complications, including a possible increase in mortality in critically ill patients. In addition, the CO that is derived from the PAC is influenced by the significant respiratory variations, and hence from the phase of the mechanical breath in which the injection is made. Mechanical ventilation was also shown to cause a high incidence of significant tricuspid insufficiency and mild to severe vena caval backward flow, which, like other valvular regurgitations, may reduce the accuracy of CO measured by PAC thermodilution (TD) .
KeywordsMean Transit Time Stroke Volume Variation Extravascular Lung Water Cardiac Preload Pulmonary Blood Volume
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- 2.Bek JC et al (1989) Cardiac output measurement using femoral artery thermodilution in patients. J Crit Care 4:105–111Google Scholar
- 4.Weyland A et al (1994) Application of a transpulmonary double indicator dilution method for postoperative assessment of cardiac index, pulmonary vascular resistance index, and extravascular lung water in children undergoing total cavo-pulmonary anastomosis: Preliminary results in six patients. J Cardiothorac Vase Anesth 8:636–641CrossRefGoogle Scholar
- 5.Lewis FR et al (1982) The measurement of extravascular lung water by the thermal-green dye indicator dilution. Ann NY Acad Sci, pp 394–410Google Scholar
- 7.Hoeft A (1995) Transpulmonary indicator dilution: An alternative approach for hemo-dynamic monitoring. In: Yearbook of Intensive Care and Emergency Medicine, Springer, pp 594–605Google Scholar
- 20.Huttermann E et al (1996) Intrathoracic blood volume versus echocardiographic parameters in surgical patients. Clin Intens Care Med [Suppl]7:20Google Scholar
- 21.Pfeiffer UJ et al (1990) Sensitivity of central venous pressure, pulmonary capillary wedge pressure, and intrathoracic blood volume as indicators for acute and chronic hypovolemia. In: Lewis FR, Pfeiffer UJ (eds) Practical applications of fiberoptics in critical care monitoring. Springer, pp 25–31Google Scholar
- 25.Sturm JA (1990) Development and significance of lung water measurement in clinical and experimental practice. In: Lewis FR, Pfeiffer UJ (eds) Practical applications of fiberoptics in critical care monitoring, pp 129–139Google Scholar