Errors in thermodilution cardiac output measurement were quantitated to determine the order of accuracy of routine measurements performed by unskilled personnel. In vitro and in vivo studies were undertaken to examine factors affecting the volume and temperature of the injectate, catheter thermistor and computer performance, effect of respiration, use of cold (0-4 °C) versus ambient temperature (20-25 °C) injectate, and the interpretation of measurements. Ambient temperature injectate incurred unacceptably large errors; cold injectate (injections were timed with respiration) produced variations in performance by equipment and personnel which accounted for only 2% of the variation between successive measurements. Real changes in cardiac output and inherent variability of the downslope of the thermal curve, necessitating an empirically based calculation, account for up to 10% variation between successive measurements. When cold injectate was used, and the average of three corrected measurements taken, thermodilution cardiac output measurements were within 10% of a simultaneous dye dilution measurement.
WeilM.H.Measurement of cardiac output. (Editorial) Crit Care Med1977; 5(2): 117–119.
4.
KohannaF.H., CunninghamJNJr.. Monitoring of cardiac output by thermodilution after open heart surgery. J Thorac Cardiovasc Surg1977; 73(3): 451–457.
5.
AikawaN., MartynJ.A., BurkeJ.F.Pulmonary artery catheterization and thermodilution cardiac output determination in the management of critically burned patients. Am J Surg1978; 135(6): 811–817.
6.
RuncimanW.B.Cardiorespiratory support of the septic patient. In “Infection in Surgery”, WattsJMcK, McDonaldP.J., O'BrienP.E., MarshallV.R., Finlay JonesJ.J. (eds.). Churchill Livingstone1980; Ch.21, 163–169.
7.
DauchotP.J., dePalmaR., GrumD., ZanellaJ.Detection and prevention of cardiac dysfunction during aortic surgery. J Surg Res1979; 26: 574–580.
8.
ForresterJ.J., DiamondG., McHughT.J., SwanH.J.C.Filling pressures in the right and left sides of the heart in acute myocardial infarction. New Engl J Med1971; 285: 190–193.
9.
KrauszM.M., PerelA., EimerlD., CotevS.Cardiopulmonary effects of volume loading in patients in septic shock. Ann Surg1977; 185: 429–434.
ShoemakerW.C., MontgomeryE.S., KaplanE., ElwynD.H.Physiologic patterns in surviving and non-surviving shock patients. Arch Surg1973; 106: 630–637.
12.
ShoemakerW.C., ChangP., CzerL., BlandR., ShabotM., StateD.Cardiorespiratory monitoring in postoperative patients. I: Prediction of outcome and severity of illness. Crit Care Med1979; 7(5): 237–249.
13.
KlinkeW.P., GilbertJ.A.L.Diazoxide in primary pulmonary hypertension. New Engl J Med1980; 302: 91–92.
14.
BloomfieldD.A. (ed.). Dye curves. The theory and practice of indicator dilution.University Park Press, Maryland U.S.A.1974; 255.
15.
KelmanG.R.Errors in the processing of dye dilution curves. Circ Res1966; 18: 543–549.
LevettJ.M., ReplogleR.L.Thermodilution cardiac output: a critical analysis and review of the literature. J Surg Res1979; 27: 392–404.
25.
FischerA.P., BenisA.M., JuradoR.A., SeelyE., TeirsteinP., LitwakR.S.Analysis of errors in measurement of cardiac output by simultaneous dye and thermal dilution in cardiothoracic surgical patients. Cardiovasc Res1978; 12(3): 190–199.
26.
HoelB.L.Some aspects of the clinical use of thermodilution in measuring cardiac output. Scand J Clin Lab Invest1978; 38: 383–388.
27.
WesselH.U., PaulM.H., JamesG.W.Limitations of thermal dilution curves for cardiac output determination. J Appl Physiol1971; 30: 643–652.
28.
HendriksF.F.A., SchipperheynJ.J., QuanjerPhH. Thermal dilution measurement of cardiac output in dogs using an analog computer. Basic Res Cardiol1978; 73: 459–468.
29.
RuncimanW.B., IlsleyA.H., MatherL.E.A method for evaluating the influences of haemodynamic disturbances on drug disposition. Proc Aust Physiol Pharmacol Soc1979; 10(2): 260.
30.
Prys-RobertsC.The measurement of cardiac output. Br J Anaesth1969; 41: 751–760.
31.
BranthwaiteM.A., BradleyR.D.Measurement of cardiac output by thermal dilution in man. J Appl Physiol1968; 24: 434–438.
32.
EnghoffE., MichaelsonM., PavekK.Comparison between the thermal dilution method and the direct Fick and the dye dilution methods for cardiac output measurements in man. Acta Soc Med Upsalla1970; 75: 157–170.
33.
VandermotenP., BernardR., deHemptinneJ., GilletJ.M., LenaersA.Cardiac output monitoring during the acute phase of myocardial infarction: accuracy and precision of the thermodilution method. Cardiology1977; 62: (4-6): 291–295.
34.
PelletierC.Cardiac output measurement by thermodilution. Can J Surg1979; 22(4): 347–350.
35.
GanzW., DonosoR., MarcusH.S.A new technique for measurement of cardiac output by thermodilution in man. Am J Cardio1971; 27: 392–396.
36.
WeiselR.D., BergerR.L., HechtmanH.B.Measurement of cardiac output by thermodilution. New Engl J Med1975; 292: 682–683.
37.
SorensenM.B., Bille-BraheN.E., EngellH.C.Cardiac output measurement by thermal dilution. Ann Surg1976; 183: 67–72.
38.
WoodsM., ScottR.N., HarkenA.H.Practical considerations for the use of a pulmonary artery thermistor catheter. Surg1976; 79(4): 469.
39.
DizonC.T., GezariW.A., BarashP.G., CrittendenJ.F.Hand held thermodilution cardiac output injector. Crit Care Med1977; 5(4): 210–212.
