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Ideal Measurement of Cardiac Output: Is Impedance Cardiography the Answer?

Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York

Joseph M. Van De Water, M.D.

Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York

Xiang Wang, Ph.D.

Drexel University of Philadelphia, Pennsylvania

The ideal measurement of cardiac output (CO) would be a system that is ac curate, noninvasive, reproducible, continuous, and technician-free. Impedence cardiography (ICG) has the promise of meeting these criteria. The authors have developed a unique ICG system that analyzes the analog signals from an impe dence cardiograph by an original software program. This was compared against standard thermodilution (TD) measurement of CO (CO _TD) in patients in the in tensive care and heart surgical units.

Simultaneous measurements by CO_TD and by CO_ICG were performed in 65 patients. A good correlation was noted between COTD and CO_ICG over a range of 2.4 to 9.7 L/min (r = 0.73, p < 0.002). If patients with factors known to inter fere with ICG were excluded, an improved correlation was found (r = 0.89, p < .002). CO_ICG followed a similar trend as CO_TD even in these excluded pa tients. The reproducibility of the CO_ICG was good (coefficient of variation = 0.071).

The CO_ICG was found to be simple and automatic. The results show that it is reproducible and correlates well with CO_TD. It also has the added advantages of being continuous and noninvasive. Factors such as arrhythmias, severe COPD, and mitral regurgitation were found to interfere with the CO_ICG values. Over all, the versatility of. CO_ICG gives the promise of very good noninvasive monitoring in critical care units and preoperative evaluation in the outpatient setting.

Vascular and Endovascular Surgery, Vol. 25, No. 7, 550-558 (1991)
DOI: 10.1177/153857449102500706


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