• T Kööbi, S Kaukinen, T Ahola, and V M Turjanmaa.
• Department of Clinical Physiology, Tampere University Hospital, Finland.
• Intensive Care Med. 1997 Nov 1; 23 (11): 113211371132-7.

ObjectiveTo determine the reliability of whole-body impedance cardiography (ICGWB), with electrodes attached to wrists and ankles, in the measurement of cardiac output (CO) on the basis of simultaneous comparison with thermodilution (TD) and direct oxygen Fick (Fick) methods.DesignProspective clinical study.SettingA surgical intensive care unit at a university hospital.PatientsThirty consecutive subjects undergoing a coronary artery bypass surgery were investigated preoperatively.MeasurementsICGWB derived CO was measured simultaneously with the TD and Fick methods to establish the biases and limits of agreement (LA) between the methods.ResultsThe results obtained by ICGWB and the invasive methods showed good agreement. The bias and LA between COTD and COICG were 0.00 l/min: 1.37 and 1.37 l/min, respectively, and were close to those obtained between COTD and COFICK, 0.32 l/min; 1.74 and -1.10 l/min. The bias and LA between the COFICK and COICG were -0.32 l/min; -2.24 and 1.60 l/min respectively. The repeatability value of consecutive single measurements for ICGWB (RVICG = 0.57 l/min) was much better than for the TD method (RVTD = 1.10 l/min).ConclusionThere was close agreement between the results of the three methods in the measurement of CO. In sedated preoperative patients the accuracy of ICGWB is within clinically acceptable limits and its repeatability is excellent. ICGWB provides a useful alternative to the TD and Fick methods in cases where the pressures supplied by the pulmonary artery catheter are not essential.

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