• M M Hirschl, M Binder, M Gwechenberger, H Herkner, A Bur, H Kittler, and A N Laggner.
• Department of Emergency Medicine, University of Vienna, New General Hospital, Austria.
• Crit. Care Med. 1997 Nov 1;25(11):1909-14.

ObjectiveTo assess whether the measurement of cardiac output by computer-assisted analysis of the finger blood pressure waveform can substitute for the thermodilution method in critically ill patients.DesignProspective data collection.SettingEmergency department in a 2000-bed inner city hospitalPatientsForty-six critically ill patients requiring invasive monitoring for clinical management were prospectively studied.InterventionsUnder local anesthesia a 7-Fr pulmonary artery catheter was inserted via the central subclavian or jugular vein. Cardiac output was determined by the use of a cardiac output computer and injections of 10 mL ice-cold glucose 5%. Noninvasive cardiac output was calculated from the finger blood pressure waveform by the use of the test software program.Measurements And Main ResultsThree hundred twenty-three pairs of invasive and noninvasive hemodynamic measurements were collected in intervals of 30 mins from 46 patients (mean age 61.9 +/- 12.4 yrs; 35 male, 11 female). The average cardiac index during the study period was 2.83 L/min/m2 (range 0.97 to 5.56). The overall discrepancy between both measurements was 0.14 L/min/m2 (95% confidence interval: 0.10-.018, p < .001). Seventy-five (23.2%) measurements had an absolute discrepancy > +/- 0.50 L/min/m2. Noninvasive and invasive comparisons of mean differential cardiac output were out of phase for 9.7% of all readings.ConclusionComputer-assisted analysis of finger blood pressure waveform to assess cardiac output is not a substitute for the thermodilution method due to a high percentage (23.2%) of inaccurate readings; however, it may be a useful tool for the detection of relative hemodynamic trends in critically ill patients.

26 keywords...

hide…