• Yatin Mehta, Rajesh Kumar Chand, Ravindra Sawhney, Milind Bhise, Ajmer Singh, and Naresh Trehan.
• Department of Anaesthesiology and Critical Care, Escorts Heart Institute and Research Centre, New Delhi, India. yatinmehta@hotmail.com
• J. Cardiothorac. Vasc. Anesth. 2008 Jun 1;22(3):394-9.

ObjectiveTo analyze the clinical agreement between the conventional intermittent bolus thermodilution (TD) technique and a new arterial pressure waveform analysis (APCO) technique (FloTrac; Edward Lifesciences, Irvine, CA) for cardiac output (CO) estimation.DesignProspective observational clinical study.SettingCardiac surgery operating room of a tertiary care cardiac center.ParticipantsTwelve patients undergoing elective off-pump coronary artery bypass (OPCAB) surgery.Measurements And Main ResultsCO was determined by 2 different methods: TD and APCO at 8 time points (preinduction, postinduction, poststernotomy, left internal mammary artery to left anterior descending artery anastomosis, left [obtuse marginal/diagonal] anastomosis, right [right coronary/posterior descending coronary artery] anastomosis, postprotamine administration, and poststernal closure) in 12 patients undergoing elective OPCAB surgery. The mean bias and limits of agreement (2 standard deviations) expressed in liters per minute at respective points of measurement were -0.54 +/- 1.12, -0.37 +/- 1.0, -0.42 +/- 1.50, -0.25 +/- 1.18, -0.31 + 1.28, +/-0.41 +/- 1.0, 0.06 +/- 1.50, and 0.09 +/- 1.40.ConclusionGood agreement was found between the CO values obtained by the APCO and TD techniques throughout the intraoperative period including the period of coronary artery graft surgery.

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