• Ju-Mei Ng, Mark Y Chow, Pierre C Ip-Yam, Meng-Huat Goh, and Thirugnanam Agasthian.
• Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore. jng1@partners.org
• J. Cardiothorac. Vasc. Anesth. 2007 Oct 1;21(5):655-8.

ObjectiveNoninvasive partial CO2 rebreathing (NICO; Novametrix Medical Systems, Inc, Wallingford, CT) is a relatively new alternative to thermodilution (TDCO) for measurement of cardiac output. This study compares the 2 methods during thoracic surgery and one-lung ventilation.DesignA prospective, observational study.SettingA tertiary hospital.ParticipantsTwelve adult patients undergoing elective thoracotomy and one-lung ventilation in the lateral decubitus position.InterventionsPaired measurements of cardiac output were performed during (1) 2-lung ventilation in the supine position (postinduction of anesthesia), (2) 10 minutes after initiation of one-lung ventilation in the lateral decubitus position with the nondependent chest open, and (3) after 30 minutes on one-lung ventilation. An average of 3 consecutive (10 mL 20 degrees C saline) TDCO measurements made during end-expiration was compared with corresponding NICO measurements.Measurements And Main ResultsThe NICO showed a tendency to underestimate cardiac output compared with TDCO at all measurement times. Overall, bias was -0.29 L/min and limits of agreement -1.69 to 1.43 L/min.ConclusionsThere was a moderate agreement between cardiac output measurements obtained with the NICO and TDCO. The present data suggest that the NICO technique may be useful during thoracic surgery.

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