Inverse thermodilution with conventional pulmonary artery catheters for the assessment of cerebral, hepatic, renal, and femoral blood flow

Ganter, Christoph; Buser, Christof; Haenggi, Matthias; Mattes, Hanswilly; Takala, Jukka; Jakob, Stephan (2009). Inverse thermodilution with conventional pulmonary artery catheters for the assessment of cerebral, hepatic, renal, and femoral blood flow. Shock, 32(2), pp. 194-200. Hagerstown, Md.: Lippincott Williams & Wilkins 10.1097/SHK.0b013e318194c73a

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Assessment of regional blood flow changes is difficult in the clinical setting. We tested whether conventional pulmonary artery catheters (PACs) can be used to measure regional venous blood flows by inverse thermodilution (ITD). Inverse thermodilution was tested in vitro and in vivo using perivascular ultrasound Doppler (USD) flow probes as a reference. In anesthetized pigs, PACs were inserted in jugular, hepatic, renal, and femoral veins, and their measurements were compared with simultaneous USD flow measurements from carotid, hepatic, renal, and femoral arteries and from portal vein. Fluid boluses were injected through the PAC's distal port, and temperature changes were recorded from the proximally located thermistor. Injectates of 2 and 5 mL at 22 degrees C and 4 degrees C were used. Flows were altered by using a roller pump (in vitro), and infusion of dobutamine and induction of cardiac tamponade, respectively. In vitro: At blood flows between 400 mL . min-1 and 700 mL . min-1 (n = 50), ITD and USD correlated well (r = 0.86, P < 0.0001), with bias and limits of agreement of 3 +/- 101 mL . min-1. In vivo: 514 pairs of measurements had to be excluded from analysis for technical reasons, and 976 were analyzed. Best correlations were r = 0.87 (P < 0.0001) for renal flow and r = 0.46 (P < 0.0001) for hepatic flow. No significant correlation was found for cerebral and femoral flows. Inverse thermodilution using conventional PAC compared moderately well with USD for renal but not for other flows despite good in vitro correlation in various conditions. In addition, this method has significant technical limitations.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
UniBE Contributor:	Ganter, Christoph, Hänggi, Matthias, Mattes, Hanswilly, Takala, Jukka, Jakob, Stephan
ISSN:	1073-2322
ISBN:	19033887
Publisher:	Lippincott Williams & Wilkins
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:04
Last Modified:	05 Dec 2022 14:19
Publisher DOI:	10.1097/SHK.0b013e318194c73a
PubMed ID:	19033887
Web of Science ID:	000268748400011
URI:	https://boris.unibe.ch/id/eprint/27829 (FactScience: 112359)