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Critical Care  2012 

Cardiac output measurements using the bioreactance technique in critically ill patients

DOI: 10.1186/cc11481

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Abstract:

Measurement of cardiac output (CO) requires use of invasive or minimally invasive devices; the use of noninvasive and minimally invasive devices has gained popularity in recent years. The bioreactance technique is a relatively new, continuous, totally non-invasive technique for measuring CO that is easily implemented. This new technique involves analyzing phase shifts of a delivered oscillating current that occur when the current traverses the thoracic cavity [1], and differs from traditional bioimpedance techniques that rely on analysis of changes in signal amplitude. Most validation studies in critically ill patients have shown good correlation and/or agreement of bioreactance values compared with CO values obtained using other devices in patients admitted after cardiac surgery [2-4]. However, validation in critically ill patients is lacking.As part of the internal evaluation of a bioreactance device before its implementation in the unit (evaluation of new non-invasive monitoring systems before introduction in the unit does not require the approval of the ethics committee in our institution), we compared CO values obtained using the bioreactance technique (NICOM system; Cheetah Medical Inc., Portland, OR, USA) with those measured using semi-continuous cardiac output by thermodilution (CCO) with a pulmonary artery catheter (Vigilance, Edwards LifeSciences, Irvine, CA, USA). In 11 patients the CO values were compared at study inclusion and each time a relevant change in hemodynamics and/or in therapeutics (for example, fluid challenge, inotrope or vasopressor infusions) was observed (Table 1).We recorded bioreactance CO (average of five values over a 5-minute period) just after obtaining the pulmonary artery catheter CCO (average of five CCO values over a 5-minute period). We collected 141 pairs of measurements (3 to 23 per patient); the duration of monitoring was at least 3 hours but never exceeded 24 hours. The pulmonary artery catheter CCO values ranged from 3.9

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