Acta Med. 1999, 42: 19-23

Thoracic Electrical Bioimpedance Versus Thermodilution in Patients Post Open-Heart Surgery

Pavel Žáčeka, Pavel Kuneša, Eva Kobzováb, Jan Dominika

aCharles University in Prague, Faculty of Medicine in Hradec Králové, Department of Cardiac Surgery, Hradec Králové, Czech Republic
bUniversity Teaching Hospital in Hradec Králové, Department of Anaesthesia and Resuscitation, Hradec Králové, Czech Republic

Received January 1, 1999
Accepted April 1, 1999

Thoracic electrical bioimpedance cardiography is a non-invasive, continuous and low-cost method of estimation of cardiac output and other haemodynamic parameters. Though subject to continuous technological refinement controversial opinions exist on its validity in subsets of critically ill patients, patients with heart disease or after cardiac surgery. A comparison study between thermodilution (TD) and bioimpedance (TEB) was performed in 28 patients undergoing elective cardiac surgery (CABG, aortic or mitral valve replacement or combined procedures). 128 pairs of cardiac index estimates at specific time points during 20 hours at the postoperative ICU were evaluated. A poor correlation (r = 0.26, p<0.05, bias -0.07 l.min-1.m2, precision + 1.1 l.min-1.m-2, 95% limits of agreement -2.27 - 2.13 l.min-1.m-2) between TD and TEB cannot support the routine use of TEB monitoring in early postoperative period after open-heart surgery. Possible reasons of lack of agreement in this population are discussed. Further studies with technically improved bioimpedance cardiographs will be needed.


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