Flow dependency of error in thermodilution measurement of cardiac output during acute tricuspid regurgitation

Paul M. Heerdt, George A. Blessios, Michael L. Beach, Charles W. Hogue

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the effect of variable degrees of tricuspid regurgitation on thermodilution cardiac output measurements during changes in venous return. Design: Prospective, controlled animal study. Setting: University laboratory. Participants: Eight anesthetized mongrel dogs instrumented for simultaneous measurement of cardiac output by thermodilution and ascending aortic electromagnetometry. Interventions: Data were collected before and after induction of moderate and severe tricuspid regurgitation. Under each condition, measurements were obtained at baseline and after opening 2 peripheral arteriovenous shunts to increase venous return. Measurements and Main Results: Baseline electromagnetic flow ranged from 1.74 to 3.62 L/min (median 2.73 L/min). Moderate and severe regurgitation reduced median electromagnetic flow values by 31% and 51%. Applying generalized estimating equations to model thermodilution cardiac output as a function of electromagnetic flow, arteriovenous shunt, and severity of tricuspid regurgitation revealed that (1) moderate and severe regurgitation changed the slope and intercept of the thermodilution/electromagnetic regression, but the differences between them were not significant, and (2) arteriovenous shunt alone had no effect under any condition. A simplified model independent of shunt and containing just 2 levels of tricuspid regurgitation (none or present) crossed with electromagnetic flow was applied. This analysis showed that regurgitation caused thermodilution to significantly underestimate electromagnetic flow at cardiac outputs >2.27 L/min (99 mL/kg/min) and overestimate it at flows

Original languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume15
Issue number2
DOIs
StatePublished - 2001
Externally publishedYes

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Thermodilution
Tricuspid Valve Insufficiency
Electromagnetic Phenomena
Cardiac Output
Dogs

Keywords

  • Cardiac output
  • Right ventricle
  • Thermodilution
  • Tricuspid valve

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Flow dependency of error in thermodilution measurement of cardiac output during acute tricuspid regurgitation. / Heerdt, Paul M.; Blessios, George A.; Beach, Michael L.; Hogue, Charles W.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 15, No. 2, 2001, p. 183-187.

Research output: Contribution to journalArticle

Heerdt, Paul M. ; Blessios, George A. ; Beach, Michael L. ; Hogue, Charles W. / Flow dependency of error in thermodilution measurement of cardiac output during acute tricuspid regurgitation. In: Journal of Cardiothoracic and Vascular Anesthesia. 2001 ; Vol. 15, No. 2. pp. 183-187.
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