• Laurent Muller, Damien Candela, Lambert Nyonzyma, Laurent Mattatia, Carey Suehs, Pascale Fabbro-Peray, Guillaume Louart, Jean E de La Coussaye, Samir Jaber, Marc Leone, Jean-Y Lefrant, and AzuRéa group.
• Department of Anesthesiology, Critical Care, Emergency and Pain, University-Hospital of Nîmes, Anaesthesia and Critical Care, Medical School of Montpellier-Nîmes, Montpellier 1 University, Nimes, France.
• Eur J Anaesthesiol. 2011 Sep 1;28(9):664-9.

Background And ObjectiveThe present prospective study was aimed at assessing the reliability of the pulse contour method for measuring cardiac output (CO) after different routinely used therapeutic interventions that can influence vascular compliance and systemic vascular resistances in ICU patients (fluid challenges, changes in norepinephrine or dobutamine infusion rates and changes in ventilatory settings).MethodsIn ICU patients requiring CO monitoring, transpulmonary thermodilution CO (COTD) and pulse contour CO (COPC) were measured with a PiCCO device after therapeutic manoeuvre-free periods (≤ and >1 h) and after therapeutic interventions without recalibration.ResultsThree hundred fifty-two sets of CO measurement pairs in 63 ICU patients were performed. The biases (and percentage errors) between COPC and COTD for the overall paired measurement, therapeutic manoeuvre-free periods and therapeutic manoeuvres were 0.20 ± 1.09 (33%), -0.01 ± 0.93 (29%) and 0.37 ± 1.18 (34%), respectively. The percentage errors were 36 and 39% for fluid challenges and changes in norepinephrine infusion rate, respectively.ConclusionIn ICU patients requiring therapeutic interventions, COPC is frequently in disagreement with COTD.

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