Comparison of cardiac output assessment by thermodilution and oesophageal doppler technique in patients with distal aortic disease

COMPUTERIZED INTEGRATED TRIPLE OXIMETRY IN ASSESSMENT AND OXYGEN TRANSPORT DURING OPEN HEART SURGERY E. Flerov, Research

A. Bankov, S. Arseniev, Centre of Surgery,

Abrikosovsky

per., 2, Moscow,

M. Kiselev

Russian Russia

Introduction. Combined usage of the fiberoptic oximetry and pulse oximetry (dual oximetry) together with analysis of the inspiratory and expiratory gas mixture (triple oximetry) should bring additional advantages in treatment of patients with severe cardiac failure. Methods. The system developed in our Research Centre includes Hempr02 fiberoptic oximeter (Viggo-Spectramed, Sweden), Capnomac Ultima respiration monitor (Datex, Finland) and surgical monitor “MX 04” (Russia) (ECG, cardiac output, three pressure and two temperature data) which all are interfaced via multiple W-232’s with an IBM PC. Cooxymeter 0SM3 (Radiometer) was used for in vitro analysis of SvO2. After ethics committee approval and with informed patient consent, 109 patient undergoing open heart surgery were studied. Results. Our study showed the strong correlation between the changes in SvO2 and D02/V02 ratio in cardiac surgery patients (fig.1, r=-0.96, SEE=0.03). Continuous measurement of the SvO2 in the mixed venous blood by fiberoptic oximetry alone can provide therefore relevant information with acceptable accuracy during anaesthesia of cardiac patients (fig.2, r=0.93, SEE=4.65%). Besides automated anaesthesia record keeping this system enables real-time calculation of the VC02, V02, estimation of the oxygen extraction and cardiac output according to Fick principle. (Fig. 3 comparison of the Fick and thermo-dilution CO). Correction of the CO values for haematocrit changes is being made via intermittent thermodilution measurements. Conclusion. Our system has been used for anaesthesia support and has proven to be clinically feasible especially in patients with a low D02/V02 ratio, fixed) cardiac

i.e. patients output, as

OF HAEMODYNAMICS

with a low (and by severe valve

Academy

of

Medical

Science,

Fig. 1. 002/vo2 OOI/VOI

119874,

vs. svo2

Fig2.SvO2Fiberopticvs. SvO2in vitro 5~0~HemwOz

Erectramed)

50s

OSMJ

IRadIometer

Fig3. Fick CO vs. Thermodilution CO CO Fick Olmln)

Fig. 4

Fragment of anaestksis Increase of oxygen enract,on

%

3

.---

-

record pt. ID 200069 during hyperie”sIve rc?actlo”

ETCOZ

0

stenosis

50

(Fig. 4, Pt. ID 200069).

Journal of Cardiothoraoc and Vascular Anesthesia, Vol 8. No 5, Suppl EACTA 94 Abstracts: Cardiovascular Pharmacology

3 (October),

1994