A comparison of endotracheal bioimpedance cardiography and transpulmonary thermodilution in cardiac surgery patients

Jean-Luc Fellahi, Marc-Olivier Fischer, Olivier Rebet, Massimo Massetti, Jean-Louis Grard, Jean-Luc Hanouz

Risultato della ricerca: Contributo in rivistaArticolo in rivista

21 Citazioni (Scopus)


OBJECTIVES: The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness. DESIGN: A prospective observational study. SETTING: A teaching university hospital. PARTICIPANTS: Twenty-five adult patients. INTERVENTIONS: Admission to the intensive care unit after conventional cardiac surgery and investigation before and after a fluid challenge. MEASUREMENTS AND MAIN RESULTS: Simultaneous comparative CI data points were collected from transpulmonary thermodilution (TD) and ECOM. Correlations were determined by linear regression. Bland-Altman analysis was used to compare the bias, precision, and limits of agreement. The percentage error was calculated. Pulse-pressure variations (PPVs) and stroke-volume variations (SVVs) before fluid challenge were collected to assess their discrimination in predicting fluid responsiveness. A weak but statistically significant relationship was found between CI(TD) and CI(ECOM) (r = 0.31, p = 0.03). Bias, precision, and limits of agreement between CI(TD) and CI(ECOM) were 0.08 L/min/m(2) (95% confidence interval, -0.11 to 0.27), 0.68 L/min/m(2), and -1.26 to 1.42 L/min/m(2), respectively. The percentage error was 51%. A nonsignificant positive relationship was found between percent changes in CI(TD) and CI(ECOM) after fluid challenge (r = 0.37, p = 0.06). Areas under the ROC curves for both PPV and SVV to predict fluid responsiveness were 0.86 (95% confidence interval, 0.67-1.06) and 0.89 (95% confidence interval, 0.74-1.04, respectively; p = 0.623). CONCLUSIONS: Continuous measurements of CI under dynamic conditions are consistent and easy to obtain with ECOM although not interchangeable with transpulmonary thermodilution. SVV given by ECOM is a dynamic parameter that predicts fluid responsiveness with good accuracy and discrimination.
Lingua originaleEnglish
pagine (da-a)217-222
Numero di pagine6
RivistaJournal of Cardiothoracic and Vascular Anesthesia
Stato di pubblicazionePubblicato - 2012


  • Aged
  • Cardiac Output
  • Cardiac Surgical Procedures
  • Cardiography, Impedance
  • Electric Impedance
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Thermodilution


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