Thermodilution vs estimated Fick cardiac output measurement in an elderly cohort of patients: A single-centre experience

English version

Autoři: Karl-Patrik Kresoja ^aff001; Alessandro Faragli ^aff001; Dawud Abawi ^aff001; Oliver Paul ^aff001; Burkert Pieske ^aff001; Heiner Post ^aff001; Alessio Alogna ^aff001
Působiště autorů: Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charité–University Medicine, Berlin, Germany ^aff001; Berlin Institute of Health, Berlin, Germany ^aff002; German Cardiovascular Research Centre (DZHK), partner site Berlin, Germany ^aff003; German Heart Center Berlin, Berlin, Germany ^aff004; Department of cardiology and angiology, St. Marien-Hospital Mülheim, Mülheim, Germany ^aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0226561

Souhrn

Aims

Patients referred to the cath-lab are an increasingly elderly population. Thermodilution (TD, gold standard) and the estimated Fick method (eFM) are interchangeably used in the clinical routine to measure cardiac output (CO). However, their correlation in an elderly cohort of cardiac patients has not been tested so far.

Methods

A single, clinically-indicated right heart catheterization was performed on each patient with CO estimated by eFM and TD in 155 consecutive patients (75.1±6.8 years, 57.7% male) between April 2015 and August 2017. Whole Body Oxygen Consumption (VO2) was assumed by applying the formulas of LaFarge (LaF), Dehmer (De) and Bergstra (Be). CO was indexed to body surface area (Cardiac Index, CI).

Results

CI-TD showed an overall moderate correlation to CI-eFM as assessed by LaF, De or Be (r² = 0.53, r² = 0.54, r² = 0.57, all p < .001, respectively) with large limits of agreement (-0.64 to 1.09, -1.07 to 0.77, -1.38 to 0.53 l/m²/min, respectively). The mean difference of CI between methods was 0.22, -0.15 and -0.42 (all p<0.001 for difference to TD), respectively. A rate of error ≥20% occurred with the equations by LaF, De or Be in 40.6%, 26.5% and 36.1% of patients, respectively. A CI <2.2 l/m²min was present in 42.6% of patients according to TD and in 60.0%, 31.0% and in 16.1% of patients according to eFM by the formulas of LaF, De or Be.

Conclusion

Although CI-eFM shows an overall reasonable correlation with CI-TD, the predictive value in a single patient is low. CI-eFM cannot replace CI-TD in elderly patients.

Klíčová slova:

Geriatrics – Elderly – Adipose tissue – Heart failure – Cardiac output – Catheterization – Valvular diseases – Oxygen consumption

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