Measuring cardiac output during dobutamine infusion after off-pump coronary artery bypass: comparison of transesophageal echo-Doppler and thermodilution

Ino Husedzinović, Stjepan Barisin, Dinko Tonković, Sinisa Sostarić
Croatian Medical Journal 2002, 43 (6): 680-4

AIM: To compare transesophageal echo-Doppler with thermodilution method for measuring cardiac output during dobutamine infusion after off-pump coronary artery bypass.

METHOD: Using transesophageal echo-Doppler and thermodilution methods, we measured cardiac output in 30 patients after off-pump coronary artery bypass, immediately before and 5, 15, and 30 min after the introduction of continuous dobutamine infusion (3 microg/kg/min). Paired t-test and Bland-Altman analysis were used to compare the results obtained by two methods in this prospective study.

RESULTS: Significant increase in cardiac output during dobutamine infusion was detected by both thermodilution (from 3.9 +/- 1.0 to 4.6 +/- 1.1 L/min; p < 0.001) and transesophageal echo-Doppler (from 3.8 +/- 1.2 to 4.8 +/- 1.4 L/min; p < 0.001). Initial measurement results of thermodilution and transesophageal echo-Doppler techniques showed clinically acceptable agreement, with a mean difference of only + 0.09 L/min (95% confidence interval (CI), 0.42 to + 0.61). Subsequently repeated measurements after 5, 15, and 30 min showed almost the same agreement between the methods. The highest mean difference between the initial and repeated measurements was found at 5 min after the introduction of dobutamine infusion (-0.29 L/min, 95% CI, -1.06 to + 0.48).

CONCLUSION: Transesophageal echo-Doppler and thermodilution can be interchangeable as methods for measuring cardiac output after off-pump coronary artery bypass.


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