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A novel continuous capnodynamic method for cardiac output assessment in a porcine model of lung lavage
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Hedenstierna laboratory.
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2015 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, no 8, 1022-1031 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundWe have evaluated a new method for continuous monitoring of effective pulmonary blood flow (COEPBF), i.e. cardiac output (CO) minus intra-pulmonary shunt, during mechanical ventilation. The method has shown good trending ability during severe hemodynamic challenges in a porcine model with intact lungs. In this study, we further evaluate the COEPBF method in a model of lung lavage. MethodsCO(EPBF) was compared to a reference method for CO during hemodynamic and PEEP alterations, 5 and 12cmH(2)O, before and after repeated lung lavages in 10 anaesthetised pigs. Bland-Altman, four-quadrant and polar plot methodologies were used to determine agreement and trending ability. ResultsAfter lung lavage at PEEP 5cmH(2)O, the ratio of arterial oxygen partial pressure related to inspired fraction of oxygen significantly decreased. The mean difference (limits of agreement) between methods changed from 0.2 (-1.1 to 1.5) to -0.9 (-3.6 to 1.9)l/min and percentage error increased from 34% to 70%. Trending ability remained good according to the four-quadrant plot (concordance rate 94%), whereas mean angular bias increased from 4 degrees to -16 degrees when using the polar plot methodology. ConclusionBoth agreement and precision of COEPBF were impaired in relation to CO when the shunt fraction was increased after lavage at PEEP 5cmH(2)O. However, trending ability remained good as assessed by the four-quadrant plot, whereas the mean polar angle, calculated by the polar plot, was wide.

Place, publisher, year, edition, pages
2015. Vol. 59, no 8, 1022-1031 p.
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Anesthesiology and Intensive Care
URN: urn:nbn:se:uu:diva-261218DOI: 10.1111/aas.12559ISI: 000359421100009OAI: oai:DiVA.org:uu-261218DiVA: diva2:852172
Stockholm County Council
Available from: 2015-09-08 Created: 2015-08-31 Last updated: 2015-09-08Bibliographically approved

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Sipmann, Fernando Suarez
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Anaesthesiology and Intensive CareHedenstierna laboratory
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