Heart Diseases Clinical Trial
Official title:
The Impact of Temperature of the Injectate on the Precision (Repeatability) of Cardiac Output Measurements Synchronized With the Respiration (the Temperature Study)
This study tests the reliability of thermodilution cardiac output measurements with
pulmonary artery catheters in immediate connection with heart surgery. In accordance with
our clinical practice, thermal indicator injections are synchronized with respiration. The
impact on measurement repeatability of spontaneous vs artificial ventilation and the effect
of the injectate temperature is tested.
The study hypothesis is that when injections are synchronized with the respiration, only
three injections at room temperature are needed to be within 5 % of the "true" cardiac
output in mechanically ventilated patients.
Bolus thermodilution cardiac output measurements by means of a pulmonary artery catheter
have been a mainstay of monitoring critically ill patients for more than thirty years.
Recent studies have questioned wether the traditional practice of averaging measurements
from tree room temperature thermal indicator injections give sufficient precision.
This study tests the number of indicator injections necessary to be within 5 % of the "true"
cardiac output (taken as the average of 16 injections) when the injection is synchronized
with the respiration. The reliability of the thermodilution measurements are tested A) in
sedated, artificially ventilated cardiac surgical patients and B) in the same patients when
postoperatively awake and spontaneously breathing. We further compare the use of room
temperature and iced thermal indicator injections.
The study hypothesis is that when injections are synchronized with the respiration, only
three injections at room temperature are needed to achieve the desired precision in
mechanically ventilated patients.
Only patients receiving a pulmonary artery catheter according our institution standard
procedure of care will be included.
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