• D C Wallace and E H Winslow.
• Saint Joseph Hospital, Fort Worth, Texas.
• Heart Lung. 1993 Jan 1;22(1):55-63.

ObjectiveTo determine the effect of injectate temperature (iced or room temperature) on cardiac output values in critically ill adults with low and high cardiac outputs.DesignQuasi-experimental.SettingsTwo multidisciplinary intensive care units in two large, metropolitan, private, nonprofit hospitals in Texas.SubjectsA convenience sample of 21 critically ill men and women who averaged 61 years of age (range 31 to 82 years) and whose most recent cardiac output measured with room temperature injectate was low (< or = 3.5 L/min) or high (> or = 8.0 L/min).InterventionIced injectate and room temperature injectate (randomly ordered) were used to measure cardiac output in each subject.Outcome MeasuresCardiac output value with iced injectate versus cardiac output value with room temperature injectate.ResultsWe found significant differences between cardiac output measurements with room temperature and those with iced injectate in eleven critically ill patients with low cardiac outputs (< or = 3.5 L/min) and in ten critically ill patients with high cardiac outputs (> or = 8.0 L/min). In the low cardiac output group, cardiac outputs using room temperature injectate averaged 0.37 L/min (range 0.1 to 1.10 L/min) higher than cardiac outputs using iced injectate (p = 0.001). In the high cardiac output group, measurements with room temperature injectate averaged 1.17 L/min L/min (range 0.3 to 3.0 L/min) higher than cardiac outputs with iced injectate (p = 0.005). Percent differences between room temperature and iced injectate values averaged 13% (range 3% to 27%) in patients with low cardiac outputs and 11% (range 3% to 29%) in patients with high cardiac outputs. Seven (77%) of the patients in the low cardiac output group and four (40%) of the patients in the high cardiac group had a 10% or greater difference--which many clinicians describe as a clinically significant difference--between room temperature and iced injectate cardiac output values.ConclusionAlthough research is clearly needed to substantiate these findings, we suggest that nurses use iced injectate in patients with low and high cardiac outputs (< or = 3.5 L/min or > or = 8.0 L/min) to ensure accurate measurement of cardiac output.

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