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Iced temperature injectate for thermodilution cardiac output determination causes minimal effects on cardiodynamics.

Abstract：

OBJECTIVES:Controversy exists regarding the ideal injectate temperature for measuring cardiac output. Iced temperature injectate gives a higher signal/noise ratio and less variability in the measured cardiac output. Thus, less volume and fewer measurements are required. Advocates of room temperature injectate have suggested that iced temperature injectate may perturb cardiodynamics. This concern has remained largely untested. To help resolve this controversy, we examined the effects of 5 mL iced injectate (0 degrees to 4 degrees) infusions on cardiodynamics. DESIGN:Prospective, randomized, controlled study. SETTING:A critical care research laboratory. SUBJECTS:Five domestic pigs, weighing between 20 to 25 kg. INTERVENTIONS:Under barbiturate anesthesia, pigs underwent placement of a) a thermodilution catheter in the right internal jugular vein; b) a right carotid artery catheter for mean arterial pressure; and c) sonomicrometry crystals for dynamic measurements of left ventricular dimensions. Calculations were made of end-systolic and end-diastolic left ventricular volume and ejection fraction. Six cardiac output measurements were performed in each pig. Data were obtained at baseline (just before iced temperature injectate infusion) and every 3 sec for 9 secs. MEASUREMENTS AND MAIN RESULTS:The only significant effect seen with iced temperature injectate infusion was a small, transient decrease in heart rate (-5.9 +/- 1.1 beats/min from a baseline heart rate of 144.8 +/- 20.6 beats/min). Indices of preload, contractile function, and dynamic cardiac geometry were unaffected. CONCLUSIONS:Iced temperature injectate used in clinically relevant volumes causes transient negative chronotropic effects, but reservations regarding other perturbations of cardiodynamics are unfounded. Thus, the use of iced temperature injectate for cardiac output determination is still a viable alternative to room temperature injectate use, especially when a larger signal/noise ratio is required.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Fang HK,Krahmer RL,Rypins EB,Law WR

doi

10.1097/00003246-199603000-00021

subject

Has Abstract

pub_date

1996-03-01 00:00:00

pages

495-500

issue

eissn

0090-3493

issn

1530-0293

journal_volume

pub_type

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Iced temperature injectate for thermodilution cardiac output determination causes minimal effects on cardiodynamics.