• Giorgio Della Rocca, Maria Gabriella Costa, Paolo Chiarandini, Gaia Bertossi, Manuela Lugano, Livia Pompei, Cecilia Coccia, Mauricio Sainz-Barriga, and Paolo Pietropaoli.
• Department of Anesthesia and Intensive Care Medicine, University of Udine, Udine, Italy.
• J. Cardiothorac. Vasc. Anesth. 2008 Oct 1;22(5):681-7.

ObjectiveThis study aimed to compare continuous cardiac output (CCO) obtained using the arterial pulse wave (APCO) measurement with a simultaneous measurement of the intermittent cardiac output (ICO) and CCO obtained with a pulmonary artery catheter (PAC) in liver transplant patients.DesignA prospective, single-center evaluation.SettingA university hospital intensive care unit.PatientsEighteen patients after liver transplantation.InterventionsPulmonary artery catheters were placed in all patients, and ICO and CCO were determined using thermodilution. APCO measurements were made with the Vigileo System (Edwards Lifesciences, Irvine, CA).Measurements And Main ResultsThe authors obtained 126 data pairs of ICO and APCO and 864 pairs of CCO and APCO. ICO data were collected after intensive care unit admission and every 8 hours until the 48th postoperative hour. CCO and APCO data were collected every hour from admission until the 48th postoperative hour. Bias and precision were 0.95 +/- 1.41 L/min for ICO versus APCO and 1.29 +/- 1.28 L/min for CCO and APCO. Bias and precision for cardiac output (CO) data pairs less than 8 L/min were 0.32 +/- 1.14 L/min between ICO and APCO and 0.71 +/- 0.98 L/min between CCO and APCO. For CO data pairs higher than 8 L/min, bias and precision were 1.79 +/- 1.54 L/min between ICO and APCO and 2.25 +/- 1.14 L/min between CCO and APCO.ConclusionsAPCO enables the assessment of CO with clinically acceptable bias and precision. At higher CO levels, APCO underestimates PAC measurements and it is not as reliable as thermodilution in hyperdynamic liver transplant patients.

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