Intra-operative evaluation of a continuous versus intermittent bolus thermodilution technique of cardiac output measurement in cardiac surgical patients

Abstract

The purpose of this study was to analyse the clinical agreement between cardiac output measurements, obtained using a newly available continuous thermodilution technique, and the conventional intermittent bolus technique. Twenty-four cardiac surgical patients were intra-operatively monitored using both techniques. Additionally, two different averaging modes for the continuous thermodilution technique, either the previous 6 min (group 1) or 3 min (group 2) were compared. The mean difference between the continuous thermodilution technique and the intermittent bolus technique (bias), were calculated at eight selected time points. These ranged from −0.09 to 0.42 litres min⁻¹ in group 1 and from −0.02 to 0.18 litres min⁻¹ in group 2. There were significant differences at any time point between the groups. The relative error between continuous thermodilution and intermittent bolus techniques was <15% for the majority of measurements and was significantly higher in group 1 compared with group 2 just prior to cardiopulmonary bypass. Thus, the continuous thermo-dilution technique produced a clinically acceptable level of accuracy compared with the intermittent bolus technique measurements, especially when using an averaging mode for the previous 3 min.