Cardiac output monitoring using a brachial arterial catheter during off-pump coronary artery bypass grafting.

OBJECTIVE: To investigate the accuracy of cardiac output measurements by transpulmonary thermodilution and pulse contour analysis using a brachial arterial catheter.

STUDY DESIGN: Criterion standard study.

SETTING: University hospital, single institution.

POPULATION: Twenty-three adult patients undergoing off-pump coronary artery bypass grafting.

MEASUREMENTS AND MAIN RESULTS: Cardiac output was measured with a thermistor-tipped brachial arterial catheter using pulse contour analysis (COpc) and transpulmonary thermodilution (COba), which serves to calibrate COpc in the system tested. Both methods were compared separately with standard pulmonary artery thermodilution (COpa). COba was closely correlated with COpa (r = 0.93, p < 0.001). Bland-Altman analysis showed a bias of 0.91 L/min with limits of agreement of +/-0.98 L/min. COpc was also closely correlated (r = 0.80, p < 0.001) with COpa and was found to have a bias of 1.08 L/min with limits of agreement of +/-1.50 L/min. During the surgical procedure, changes in COpa from baseline were closely correlated with changes in COba (r = 0.90, p < 0.01) and COpc (r = 0.81, p < 0.01).

CONCLUSIONS: The brachial arterial access allows a reliable assessment of cardiac output by transpulmonary thermodilution and pulse contour analysis in patients undergoing off-pump coronary artery bypass grafting.