Table III.
Study setting | Eligibility criteria and patient group | Sample size | Method | R | Results and conclusions |
---|---|---|---|---|---|
Heart failure ICU18 | Stable clinical condition: no respiratory distress, no increase in drug therapy | 33 | TD vs ICG | 0.89 | ICG gave good correlation with TD, but 21% of interpatient CO measurements differed by >15%. |
Heart failure catheterization laboratory53 | Ischemic and nonischemic cardiomyopathy | 59 | TD vs ICG Fick vs ICG (n = 28) |
0.76 0.73 |
ICG correlates with TD and Fick for CO and CI, but ICG gives no correlation between thoracic fluid and PA wedge pressure. 62% sensitivity, 79% specificity to CO by TD. |
Catheterization laboratory54 | Pulmonary artery hypertension, clinically stable | 39 | TD vs ICG Fick vs ICG |
0.8 0.84 |
Similar 3-way correlation of ICG with TD and Fick. 1.01 L/min precision, −0.43 L/min bias to CO by TD. |
ICU university hospital14 | NYHA stage IV, LVEF <30%, ischemic and dilated cardiomyopathy, transplant evaluation, no pacemaker, no renal failure | 44 | TD vs ICG | 0.51 | Only 31% of CO measurements were within ±0.5 L/min to TD, large interpatient variation from 0.2% to 133% difference. Caused by larger body size, more dyspnea, mitral/tricuspid valve regurgitation, not dependable for severe heart failure. |
Heart hospital55 | Ischemic cardiomyopathy, no pulmonary disease, no hypertension, no NYHA class IV (n = 25) | 25 | TD vs ICG | 0.89 | Similar high correlation to CO at rest and during exercise, hemodynamic changes in high-intensity exercise may reduce precision. Low 0.9% interpatient variation. |
Hospital ICU56 | Acute heart failure | 31 | TD vs ICG | 0.85 | Similar good correlation to CI at baseline and follow-up with vasodilation therapy. High correlation for whole-body impedance, 1.4 L/min precision. |
Heart surgery ICU10 | Within 24 h of post-CABG surgery | 53 | TD vs ICG | 0.81 | ICG agrees with TD for CO, better intrapatient correlation than TD. |
Hospital ICU57 | Post-CABG or valve surgery | 20 | TD vs ICG | 0.93 | All ICG data correlate to TD within ±20%, 0.4 L/(min m2) precision. |
ICU university hospital58 | Post-CABG or mitral valve surgery, no aortic valve defect | 34 | TD vs ICG | 0.34 | Good agreement preoperative CI measurement (R = 0.88), poor correlation for postoperative (R = 0.34). Large interpatient variation in bias (0.02–0.21 L/[min m2]) and precision (1.06–1.52 L/[min m2]). Variations caused by low flow, low mean arterial pressure, increased fluid and SVR. |
Hospital ICU59 | Post-CABG | 50 | TD vs ICG | 0.49 | Very high −0.33 L/min bias and 6.2 L/min precision. Better agreement with normal body dimensions and without mechanical ventilation (R = 0.65), worse correlation with deviation from normal anatomy and poor timing with ECG. |
ICU, Intensive care unit; CABG, coronary artery bypass graft; TD, thermodilution; CO, cardiac output; CI, cardiac index; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; PA, pulmonary artery.