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[Continuous and bolus thermodilution cardiac output measurement during off-pump coronary artery bypass surgery.].

Abstract：

BACKGROUND AND OBJECTIVES:Off-pump CABG surgery is related to major and abrupt hemodynamic changes that may not be immediately detected by continuous cardiac output measurement (CCO). This study aimed at comparing results of cardiac index measurement with pulmonary artery catheter (PAC) with thermal filament (Baxter Edwards Critical Care, Irvine, CA) versus standard bolus thermodilution method during distal coronary anastomosis. METHODS:Participated in this study 10 patients undergoing off-pump CABG who were monitored with PAC with thermal filament. Measurements of cardiac index were obtained in four moments: at anesthetic induction with the chest still closed (M1), after sternotomy (M2), after heart stabilization with the octopus device (M3) and at distal anastomosis completion (M4). RESULTS:There has been significant cardiac index decrease (p < 0.05) during coronary anastomosis, detected when measurements were taken with bolus thermodilution method. Cardiac index has varied 2.8 +/- 0.7 to 2.3 +/- 0.8 L.min.m-2 in the beginning and 2.5 +/- 0.8 L.min.m-2 at the end of anastomosis. This variation was not detected by the continuous method (from 3 +/- 0.6 to 3.2 +/- 0.5 to 3.1 +/- 0.6 L.min.m-2 during anastomosis). CONCLUSIONS:CCO measurement with PAC was late in detecting acute hemodynamic changes due to changes in heart position during off-pump CABG.

journal_name

Rev Bras Anestesiol

journal_title

Revista brasileira de anestesiologia

authors

Kim SM,Oliveira SD,Fonseca US,Malbouisson LM,Auler Júnior JO,Carmona MJ

doi

10.1590/s0034-70942004000300005

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

319-24

issue

3

eissn

0034-7094

issn

1806-907X

pii

S0034-70942004000300005

journal_volume

54

pub_type

杂志文章

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