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Cardiac output monitoring: aortic transpulmonary thermodilution and pulse contour analysis agree with standard thermodilution methods in patients undergoing lung transplantation

[Le monitorage du débit cardiaque : la thermodilution aortique transpulmonaire et l’analyse de la conformation du pouls concordent avec les méthodes de thermodilution normalisées chez des patients qui subissent une greffe pulmonaire]

Giorgio Della Rocca, MD^*, Maria Gabriella Costa, MD^*, Cecilia Coccia, MD^*, Livia Pompei, MD^*, Pierangelo Di Marco, MD, Vincenzo Vilardi, MD and Paolo Pietropaoli, MD

^* From the Clinica di Anestesia, University of Udine, Udine;
and the Departments of Anesthesia, University of Rome "Tor Vergata",
and the University of Rome "La Sapienza", Rome, Italy.

Address correspondence to: Dr. Giorgio Della Rocca, C.so Trieste 169/A, 00198 Rome, Italy. Phone: +39-3281-675649; Fax: +39-0432-545526; E-mail: giorgio.dellarocca{at}dsc.uniud.it

Purpose: The PiCCO System is a relatively new device allowing intermittent cardiac output monitoring by aortic transpulmonary thermodilution technique (Aorta intermittent) and continuous cardiac output monitoring by pulse contour analysis (Aorta continuous). The objective of this study was to assess the level of agreement of Aorta intermittent and Aorta continuous with intermittent (PA intermittent) and continuous cardiac output (PA continuous) measured through a special pulmonary artery catheter (Vigilance System SvO₂/CCO Monitor) in patients undergoing single- or double-lung transplantation.

Methods: Measurements were obtained in 58 patients: at four time points in patients undergoing single-lung transplantation and at six time points in those undergoing double-lung transplantation. Bland and Altman and correlation analyses were used for statistical evaluation.

Results: We found close agreement between the techniques. Mean bias between Aorta intermittent and PA intermittent and between Aorta continuous and PA continuous was 0.18 L•min^-1 (2SD of differences between methods = 1.59 L•min^-1) and -0.07 L•min^-1 (2SD of differences between methods = 1.46 L•min^-1) respectively. Mean bias between PA continuous and PA intermittent and Aorta continuous and PA intermittent was 0.15 L•min^-1 (2SD of differences between methods = 1.39 L•min^-1) and 0.08 L•min^-1 (2SD of differences between methods = 1.43 L•min^-1).

Conclusion: Measurements with the aortic transpulmonary thermodilution technique give continuous and intermittent values that agree with the pulmonary thermodilution method which is still the current clinical standard.

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