Assessment of cardiac output with transpulmonary thermodilution during exercise in humans.

• The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q and preload indices of global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBV), as well as extravascular lung water (EVLW) in resting humans. It remains unknown if this technique is also accurate and reproducible during exercise. Sixteen healthy men underwent catheterization of the right femoral vein (for iced saline injection), an antecubital vein (ICG injection) and femoral artery (thermistor) to determine their Q by TPTd and [ICG] during incremental 1 and 2-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion. There was a close relationship between Td-Q and ICG-Q (r=0.95, n=151, SEE: 1.452 L/min, P<0.001; mean difference of 0.06 L/min; limits of agreement -2.98 to 2.86 L/min), and TPTd-Q and ICG-Q increased linearly with VO2 with similar intercepts and slopes. Both methods had mean coefficients of variation (CV) close to 5% for Q, GEDV and ITBV. The mean CV of EVLW, assessed with both indicators (ICG and thermal) was 17%, and was sensitive enough as to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, transpulmonary thermodilution with bolus injection into the femoral vein is an accurate and reproducible method to assess cardiac output during exercise in humans.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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Medicin/Teknik

Medicine/Technology

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