Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension
Background: Exact and simultaneous measurements of mean pulmonary artery pressure (mPAP) and cardiac output (CO) are crucial to calculate pulmonary vascular resistance (PVR), which is essential to define pulmonary hypertension (PH). Simultaneous measurements of mPAP and CO are not feasible using the...
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2021
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oai:doaj.org-article:794abfbf1ed841418b6356132e99f6982021-11-30T12:10:09ZComparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension2296-858X10.3389/fmed.2021.776956https://doaj.org/article/794abfbf1ed841418b6356132e99f6982021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.776956/fullhttps://doaj.org/toc/2296-858XBackground: Exact and simultaneous measurements of mean pulmonary artery pressure (mPAP) and cardiac output (CO) are crucial to calculate pulmonary vascular resistance (PVR), which is essential to define pulmonary hypertension (PH). Simultaneous measurements of mPAP and CO are not feasible using the direct Fick (DF) method, due to the necessity to sample blood from the catheter-tip. We evaluated a modified DF method, which allows simultaneous measurement of mPAP and CO without needing repetitive blood samples.Methods: Twenty-four patients with pulmonary arterial or chronic thromboembolic PH had repetitive measurements of CO at rest and end-exercise during three phases of a crossover trial. CO was assessed by the original DF method using oxygen uptake, measured by a metabolic unit, and arterial and mixed venous oxygen saturations from co-oximetry of respective blood gases served as reference. These CO measurements were then compared with a modified DF method using pulse oximetry at the catheter- and fingertip.Results: The bias among CO measurements by the two DF methods at rest was −0.26 L/min with limits of agreement of ±1.66 L/min. The percentage error was 28.6%. At the end-exercise, the bias between methods was 0.29 L/min with limits of agreement of ±1.54 L/min and percentage error of 16.1%.Conclusion: Direct Fick using a catheter- and fingertip pulse oximetry (DFp) is a practicable and reliable method for assessing CO in patients with PH. This method has the advantage of allowing simultaneous measurement of PAP and CO, and frequent repetitive measurements are needed during exercise.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02755259, identifier: NCT02755259.Milos DuknicMilos DuknicMona LichtblauMona LichtblauStéphanie SaxerStéphanie SaxerCharlotte BerlierCharlotte BerlierSimon R. SchneiderSimon R. SchneiderEsther I. SchwarzEsther I. SchwarzArcangelo F. CartaArcangelo F. CartaMichael FurianMichael FurianKonrad E. BlochKonrad E. BlochSilvia UlrichSilvia UlrichFrontiers Media S.A.articlecardiac outputdirect Fickpulse oximetryexercisepulmonary hypertensionMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021) |
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cardiac output direct Fick pulse oximetry exercise pulmonary hypertension Medicine (General) R5-920 |
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cardiac output direct Fick pulse oximetry exercise pulmonary hypertension Medicine (General) R5-920 Milos Duknic Milos Duknic Mona Lichtblau Mona Lichtblau Stéphanie Saxer Stéphanie Saxer Charlotte Berlier Charlotte Berlier Simon R. Schneider Simon R. Schneider Esther I. Schwarz Esther I. Schwarz Arcangelo F. Carta Arcangelo F. Carta Michael Furian Michael Furian Konrad E. Bloch Konrad E. Bloch Silvia Ulrich Silvia Ulrich Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| description |
Background: Exact and simultaneous measurements of mean pulmonary artery pressure (mPAP) and cardiac output (CO) are crucial to calculate pulmonary vascular resistance (PVR), which is essential to define pulmonary hypertension (PH). Simultaneous measurements of mPAP and CO are not feasible using the direct Fick (DF) method, due to the necessity to sample blood from the catheter-tip. We evaluated a modified DF method, which allows simultaneous measurement of mPAP and CO without needing repetitive blood samples.Methods: Twenty-four patients with pulmonary arterial or chronic thromboembolic PH had repetitive measurements of CO at rest and end-exercise during three phases of a crossover trial. CO was assessed by the original DF method using oxygen uptake, measured by a metabolic unit, and arterial and mixed venous oxygen saturations from co-oximetry of respective blood gases served as reference. These CO measurements were then compared with a modified DF method using pulse oximetry at the catheter- and fingertip.Results: The bias among CO measurements by the two DF methods at rest was −0.26 L/min with limits of agreement of ±1.66 L/min. The percentage error was 28.6%. At the end-exercise, the bias between methods was 0.29 L/min with limits of agreement of ±1.54 L/min and percentage error of 16.1%.Conclusion: Direct Fick using a catheter- and fingertip pulse oximetry (DFp) is a practicable and reliable method for assessing CO in patients with PH. This method has the advantage of allowing simultaneous measurement of PAP and CO, and frequent repetitive measurements are needed during exercise.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02755259, identifier: NCT02755259. |
| format |
article |
| author |
Milos Duknic Milos Duknic Mona Lichtblau Mona Lichtblau Stéphanie Saxer Stéphanie Saxer Charlotte Berlier Charlotte Berlier Simon R. Schneider Simon R. Schneider Esther I. Schwarz Esther I. Schwarz Arcangelo F. Carta Arcangelo F. Carta Michael Furian Michael Furian Konrad E. Bloch Konrad E. Bloch Silvia Ulrich Silvia Ulrich |
| author_facet |
Milos Duknic Milos Duknic Mona Lichtblau Mona Lichtblau Stéphanie Saxer Stéphanie Saxer Charlotte Berlier Charlotte Berlier Simon R. Schneider Simon R. Schneider Esther I. Schwarz Esther I. Schwarz Arcangelo F. Carta Arcangelo F. Carta Michael Furian Michael Furian Konrad E. Bloch Konrad E. Bloch Silvia Ulrich Silvia Ulrich |
| author_sort |
Milos Duknic |
| title |
Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| title_short |
Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| title_full |
Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| title_fullStr |
Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| title_full_unstemmed |
Comparison of Repetitive Cardiac Output Measurements at Rest and End-Exercise by Direct Fick Using Pulse Oximetry vs. Blood Gases in Patients With Pulmonary Hypertension |
| title_sort |
comparison of repetitive cardiac output measurements at rest and end-exercise by direct fick using pulse oximetry vs. blood gases in patients with pulmonary hypertension |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/794abfbf1ed841418b6356132e99f698 |
| work_keys_str_mv |
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