DARWIN Digitale Dissertationen German Version Strich

FU Berlin
Digitale Dissertation

Marcus Gründel :
Monitoring of cardiac output during cardiac surgery: comparison of Lithium indicator dilution and thermodilution techniques
Monitoring des Herzzeitvolumens mit dem LiDCO System während herzchirurgischer Eingriffe: Vergleich mit dem klinischen Standard der Bolusthermodilutionsmethode

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|Abstract| |Table of Contents| |More Information|

Abstract

Cardiac output is a important parameter in assessing patients hemodynamic status. Recently, a novel lithium indicator dilution technology for the measurement of cardiac output (LIDCO system) has been developed. The aim of this work was to compare LIDCO with two different thermal based systems to obtain cardiac output (CO) in patients undergoing coronary artery bypass grafting (CABG). After ethical approval and written informed consent, 25 patients scheduled for CABG were studied at three predefined points: A: pre cardiopulmonary bypass (CPB), B: 10 min after CPB, C: 10 min after chest closure. In each case LIDCO (LIDCO, Ltd., London, UK), bolus CO (BCO) and continuous CO (CCO; Baxter Edwards Critical-Care, Irvine, CA) were determined simultaneously. Statistical analysis was performed by linear regression and Bland-Altman plots. When comparing the three methods, correlation r get higher when LiDCO was involved: LiDCO vs BCO r=0,81, LiDCO vs CCO r= 0,79, BCO vs CCO r=0.68 Bland-Altman analysis shows that the two thermodilution techniques generally overestimated CO in comparison with LiDCO The higher correlation seen between LiDCO and either thermodilution system strongly suggests that it is the more precise estimate of CO in patients undergoing CABG. The relatively wide limits of agreement could be explained by the fact that neither thermodilution technique represents the gold standard for CO determination. These findings confirm earlier work where LiDCO was shown to be more precise than thermodilution in comparison with a control electromagnetic flow probe . The lithium dilution method is quick to set up, not affected by thermal changes, avoids pulmonary artery catheterisation with all its risks and gives reliable CO values under the condition of CABG.

Table of Contents

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0. Titelseite und Inhaltsverzeichnis
1. Einleitung
2. Materialien und Methoden
3. Ergebnisse
4. Diskussion
5. Zusammenfassung
6. Anhang

More Information:

Online available: http://www.diss.fu-berlin.de/2001/273/indexe.html
Language of PhDThesis: german
Keywords: cardiac output, monitoring, swan-ganz-catheter
DNB-Sachgruppe: 33 Medizin
Date of disputation: 14-Dec-2001
PhDThesis from: Fachbereich Humanmedizin, Freie Universität Berlin
First Referee: Prof. Axel Pries
Second Referee: Prof. Jürgen Link
Contact (Author): gruendel@dhzb.de
Contact (Advisor): mappes@dhzb.de
Date created:21-Jan-2002
Date available:23-Jan-2002

 

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