Pulmonary artery vs. transpulmonary thermodilution for the assessment of cardiac output in mitral regurgitation: a prospective observational study

European Journal of Anaesthesiology
Klaus StaierC Keyl

Abstract

With increasing prevalence of mitral regurgitation, even noncardiac anaesthesiologists will be confronted by this disorder and will need to be familiar with the extended haemodynamic monitoring required. The assessment of cardiac output (CO) measured by transpulmonary thermodilution (COTP) has become an accepted alternative to the CO measured by thermodilution via pulmonary artery catheter (COPAC). However, the integrity of COTP in severe mitral regurgitation requires systematic evaluation. This study was designed to test the hypothesis that transpulmonary thermodilution is compromised by severe mitral regurgitation. Prospective method comparison study. Single university-affiliated hospital. Thirty patients with mitral regurgitation undergoing elective mitral valve repair. COTP and COPAC were determined in triplicate after induction of anaesthesia, and at the end of surgery after closure of the chest. The methods were compared using bias and precision statistics. Echocardiography revealed severe mitral regurgitation in most patients (n  =  27) after induction of anaesthesia. The least significant change in COTP (the minimum change in COTP required to detect a real change with a probability of 95%) was increased under the condit...Continue Reading

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Citations

Mar 20, 2014·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Thomas SchlöglhoferHeinrich Schima
Apr 12, 2014·Current Opinion in Critical Care·Daniel De Backer
Oct 21, 2016·Anesthesia and Analgesia·Philippe Ariès, Thomas Leclerc
Mar 23, 2013·Current Opinion in Critical Care·Daniel De BackerAntoine Herpain
Aug 24, 2017·Annals of Intensive Care·Matthias Peter HiltyMarco Maggiorini
May 20, 2019·Journal of Clinical Monitoring and Computing·Tatsuya AraiRichard J Cohen
Jul 28, 2019·The Journal of Trauma and Acute Care Surgery·Peter P OlivieriSarah B Murthi

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