PubMed · 1118798
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A L Rosen, H Gilbert, G S Moss. 1975. Methods for evaluating myocardial contractility.. https://doi.org/10.1016/s0039-6109(16)40531-1
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OBJECTIVE: To investigate the relationship between end-tidal Pco2 (P(ET)CO(2)) and cardiac output (CO) during hepatectomy. METHOD: Swan-Ganz catheter was inserted into the right jugular vein of twenty-one patients undergoing hepatectomy to observe the hemodynamic parameters. Cardiac output (CO) was examined by thermodilution technique. Mechanical ventilation was performed after anaesthesia induction, and P(ET) CO(2) was monitored continuously. The relationship between CO and P(ET)CO(2) was analyzed. RESULTS: A strong positive correlation was found between P(ET)CO(2) and CO, r =0.90, P < 0.05. CONCLUSION: P(ET)CO(2) can be used as a predictor of CO. This technique is safe, simple and can be used in hemodynamic unstable patients during the major surgical procedure and in patient with poor cardiac function.
OBJECTIVE: To determine the relationship between the degree of tricuspid regurgitation (TR) and accuracy of cardiac output measurement by thermodilution in mechanically ventilated patients. DESIGN AND SETTING. Prospective observational study in a 20-bed general intensive care unit in the university hospital. PATIENTS: We examined 27 patients (not undergoing cardiac surgery): 8 with no or 1st degree TR, 9 with 2nd degree, and 10 with 3rd degree TR. INTERVENTIONS: All patients were measured twice using simultaneously transesophageal echocardiography and pulmonary artery catheter for cardiac output. MEASUREMENTS AND RESULTS: Continuous Doppler measurements were taken in the left ventricular outflow tract at the level of the aortic valve. Cardiac output was calculated by multiplying the velocity-time integral by aortic valve area and heart rate. Simultaneous pulmonary artery catheter measurements were taken averaging the results of the three 10-cc boluses of iced saline. The difference between the methods was 0.5+/-1.1 l/min (mean +/-2 SD) in patients with no or 1st degree TR (r=0.96), 0.8+/-2.0 l/min in those with 2nd degree TR (r=0.92), and 1.9+/-2.3 l/min in those with 3rd degree TR (r=0.69). CONCLUSIONS: A high degree of TR is associated with underestimation of cardiac output measured by thermodilution.
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