초록
Measurement of cardiac output by thermodilution method is easy to perform and can be repeated at very short intervals and offers a number of theoretical and practical advantages. The purpose of this paper is to reevaluate the accuracy and reproducibility of the thermodilution cardiac output by comparing the results with those obtained by the direct Fick technique. From January through April 1981 [4 months], 26 simultaneous cardiac output measurements were made using thermodilution and direct Fick methods in 12 patients in the intensive care unit of Severance Hospital following open heart surgery. The average age of the patients was $34.8{\pm}12.0$ [SD] years [range; 17-57 years]. For cardiac output determination by thermodilution technique [$CO_TD$], a Swan-Ganz Thermodilution Catheter, Model 93A-131-7F [Edwards Laboratories], a Cardiac Output Computer, Model 9520A, and Strip Chart Recorder, Model 9810 [Edwards Laboratories] were used. For the determination of cardiac output by direct Fick principle [$CO_Fick$], a Van Slyke Manometric Apparatus [Thomas] for the measurements of arteriovenous oxygen content difference and a Collin`s Respirometer with Kymograph for the measurement of oxygen consumption were used. The correlation between the simultaneously measured $CO_TD$ and $CO_Fick$ was found to be $CO_Fick$ = 0.95.$CO_TD$ + 0.1073, [r= 0.9777, P < 0.001 ]. For 26 double or triple determinations of $CO_TD$, the values ranged from 1.77 L/min to 6.66 L/min, with a reproducibility of 2.18%. The maximum difference of $CO_TD$ for $CO_Fick$ was between +11.99% and -12,99% [$Mean{\pm}SD$ = $6.07{\pm}3.97$%]. Measurement of cardiac output by thermodilution method provides a simple, rapid, reproducible and highly accurate method for multiple cardiac output measurements suitable for use at the bedside. Comparison of Cardiac Output Determination by Direct Fick and Thermodilution Method in Man.
