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Comparison of Cardiac Output Determined by Bioimpedance, Thermodilution, and the Fick Method

• Background Cardiac output can be determined by using a variety of methods.

• Objectives To determine the precision and bias between 3 methods for determining cardiac output: bioimpedance, thermodilution, and the Fick method.

• Methods Cardiac output was determined by using bioimpedance via neck and thorax patches and thermodilution via pulmonary artery catheter in 46 patients in the intensive care unit. A subset of 15 patients also had cardiac output determined by using the Fick method.

• Results Mean (SD) cardiac output in all patients was 6.3 (2.2) L/min by thermodilution and 5.6 (2.0) L/min by bioimpedance. In the 15 patients in whom all 3 methods were used, mean cardiac output was 6.0 (1.7) L/min by thermodilution, 5.3 (1.7) L/min by bioimpedance, and 8.6 (4.5) L/min by the Fick method. Bias and precision (mean difference ± 2 SDs) were 0.7 ± 2.9 L/min between thermodilution and bioimpedance, 1.7 ± 3.8 L/min between the Fick method and thermodilution, and 2.4 ± 4.7 L/min between the Fick method and bioimpedance.

• Conclusion Bioimpedance, thermodilution, and Fick determinations of cardiac outputs are not interchangeable in a heterogenous population of critically ill patients.

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				H. Keren, D. Burkhoff, and P. Squara Evaluation of a noninvasive continuous cardiac output monitoring system based on thoracic bioreactance Am J Physiol Heart Circ Physiol, July 1, 2007; 293(1): H583 - H589. [Abstract] [Full Text] [PDF]