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M. Klein, L. Minkovich, M. Machina, M. Selzner, V. N. Spetzler, J. M

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Presentation on theme: "M. Klein, L. Minkovich, M. Machina, M. Selzner, V. N. Spetzler, J. M"— Presentation transcript:

1 Non-invasive measurement of cardiac output using an iterative, respiration-based method 
M. Klein, L. Minkovich, M. Machina, M. Selzner, V.N. Spetzler, J.M. Knaak, D. Roy, J. Duffin, J.A. Fisher  British Journal of Anaesthesia  Volume 114, Issue 3, Pages (March 2015) DOI: /bja/aeu377 Copyright © 2015 The Author(s) Terms and Conditions

2 Fig 1 Three possible results of the Q ˙ IT manoeuvre. An acute increase in inspiratory Pco2 (‘bolus') increases baseline P E ′ CO 2   B to P E ′ CO 2   T0 . After the bolus, a Q ˙ estimate Q ˙ E is used to compute the P I CO 2 necessary to maintain P E ′ CO 2   T0 constant for a short test period (shaded area). If the computed P I CO 2 produces a P E ′ CO 2   T that maintains P E ′ CO 2   T0 constant during the test period, then Q ˙ E is equal to the actual Q ˙ ; if not, then a drift upwards (triangles) or downwards (inverted triangles) in P ET CO 2   T indicates over-estimation or under-estimation of Q ˙ , respectively. In any case, sufficient data have been generated to calculate Q ˙ by the DF equation [equation (7)]. British Journal of Anaesthesia  , DOI: ( /bja/aeu377) Copyright © 2015 The Author(s) Terms and Conditions

3 Fig 2 (a–g) All Q ˙ measurements in all seven experiments. Blue dots and lines are Q ˙ IT measurements and green squares are the mean of the last three of four Q ˙ TD measurements. British Journal of Anaesthesia  , DOI: ( /bja/aeu377) Copyright © 2015 The Author(s) Terms and Conditions

4 Fig 3 A sample time series of cardiac output and other measurements during liver transplantation for Subject C, showing the corresponding baseline end-tidal fractions of Fco2 (%); MAP, mean arterial pressure (kPa); HR, heart rate (beats min−1); T, blood temperature (°C); CVP, central venous pressure (kPa); PAP, pulmonary artery pressure (kPa). British Journal of Anaesthesia  , DOI: ( /bja/aeu377) Copyright © 2015 The Author(s) Terms and Conditions

5 Fig 4 A Bland–Altman analysis of the agreement of measurements. Q ˙ IT , iterative cardiac output; Q ˙ TD , bolus thermodilution cardiac output. Colour codes for experiments. British Journal of Anaesthesia  , DOI: ( /bja/aeu377) Copyright © 2015 The Author(s) Terms and Conditions

6 Fig 5 Polar plot analysis of cardiac output measurements during liver transplantation. An exclusion zone of 15% of the mean cardiac output (0.4 litre min−1) was applied. British Journal of Anaesthesia  , DOI: ( /bja/aeu377) Copyright © 2015 The Author(s) Terms and Conditions

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