Background: In the partial CO2 rebreathing method, monitored changes in CO2 elimination and end-tidal CO2 in response to a brief rebreathing period are used to estimate cardiac output. However, dynamic changes in CO2 production during ischemia and reperfusion may affect the accuracy of these estimates. This study was designed to compare measurements of cardiac output as produced by the partial CO2 rebreathing (NICO), bolus (BCO), and continuous thermodilution (CCO) methods of monitoring cardiac output. Methods: Cardiac output was continuously monitored using both NICO and CCO in 28 patients undergoing aortic reconstruction. BCO measurements were taken at the following intervals when hemodynamic stability was achieved: (1) after anesthetic induction; (2) during aortic cross-clamp; (3) at reperfusion of the iliac artery; and, (4) during peritoneal closure. Results: The bias and precision (1 SD) derived from all the measurements between NICO and BCO was -0.58 ± 0.9 1/min, whereas for CCO and BCO it was 0.38 ± 1.17 1/min. The bias between NICO and BCO was small after anesthetic induction and during cross-clamp, but increased following reperfusion. The bias between CCO and BCO was relatively small until reperfusion but increased significantly at peritoneal closure. Conclusions: Results indicate that in aortic reconstruction surgery the performance of NICO monitoring is comparable with that of CCO; however, the direction of bias in these continuous measurement devices is the opposite.
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine