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1998, Number 2

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Med Crit 1998; 12 (2)

Early extubation algorhitm in postoperative cardiac surgery patients

Sánchez VLD

Language: Spanish
References: 30
Page: 54-60
PDF size: 160.87 Kb.


ABSTRACT

Objective: To compare the results of cardiac output measurements obtained by thermodilution techniques (BTD) with two equations.
Design: Case series, observational study.
Setting: Two ICUs of Mexico City.
Patients: Fifty four consecutive patients (mean age 58.7 ± 21.5 yr) requiring hemodynamic monitoring. The diagnosis were: shock (n = 20), ARDS (n = 10), acute pulmonary edema (n = 7), sepsis (n = 5), pancreatitis (n = 3) and other (n = 9).
Interventions: Cardiac output was measured three times in each patient using BTD and simultaneously it was estimated through two equations: 1) f1CO = CO = ([C(a-v)]O2 x 100)/ [CaO2/ [C(a-v)O2]) and 2) (f2CO) = CO = (BS x 140)/C(a-v)O2, where: CO = estimated cardiac output, C(a-v)O2 = arterio-venous oxygen content difference, CaO2 = arterial oxygen content, BS = body surface area and 140 = constant.
Measurements and main results: A set of 534 measu- rements were made in all the patients. ICU stay was 13.1 ± 12.4 days and APACHE II Score was 19.6 ± 8.1. The correlation coefficients between BTD-f1CO was 0.15 and BTD-f1CO was 0.33. The mean of the differences (bias) were 0.001 (TDB-f1CO) and -1.4 (TDB-f2CO).
Conclusion: Equations to assess CO are no substitutes for the BTD method due to the measure- ments have an important discrepancy.


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