Non-invasive measurement of cardiac output during coronary artery bypass grafting

Objective: A new device, using whole body bioresistance measurements and a new equation for calculating stroke volume has been developed. Using this equation, an attempt was made to correlate whole body bioresistance cardiac output with thermodilution cardiac output in patients undergoing coronary artery bypass grafting. Methods: Thirty-one adults undergoing elective coronary artery bypass grafting were studied prospectively. Simultaneous paired cardiac output measurements by whole body bioresistance and thermodilution were made at five time points during coronary artery bypass grafting: in anesthetized patients before incision (T-1), after sternotomy (T-2), after opening the pericardium (T-3), ten min post bypass (T-4), and in the intensive care unit (T-5). The patients had a mean of three thermodilution cardiac outputs compared with a mean of three bioimpedance measurements at each time point. The bias and precision between the methods were calculated. Results: There was good correlation between bioresistance cardiac output (nCO) and thermodilution cardiac output (ThCO) measurements in both groups for all recorded times. The patients' mean ThCO and nCO, as well as bias and precision between methods were calculated. Mean ThCO ranged between 4.14 and 5.06 1/min; mean nCO ranged between 4.12 and 4.97 1/ min. Bias calculations ranged between -0.072 and 0.104 1/min. Precision (2 SD) calculations ranged between 0.873 and 1.228 1/min for 95% confidence intervals. Pearson's correlation ranged from 0.919 to 0.938. Conclusions: Cardiac output measured with the new device correlates well with the thermodilution measurements of cardiac output during and immediately following coronary artery bypass grafting. The overall agreement between the two methods was good. The new device is an accurate non-invasive method of measuring cardiac output during coronary artery bypass grafting. (C) 1998 Elsevier Science B.V, All rights reserved.