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Reproducibility of cardiac output measurement by the nitrous oxide rebreathing technique

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Abstract

Techniques for the measurement of cardiac output from soluble gas uptake by the lungs include the rebreathing method using nitrous oxide. The accuracy of this␣technique is well accepted, but its repeatability of measurement (precision) has not been well documented. We assessed the repeatability of measurements of pulmonary blood flow by the Innocor, a device employing the nitrous oxide rebreathing method. Successive paired measurements of pulmonary blood flow were made separated by a 5 min interval by the nitrous oxide rebreathing method, in 8 patients pre- or post cardiac surgery, and in 8 healthy volunteers. The standard deviation of the difference between first and second measurements was 0.84 l/min in the cardiac surgery group, and 1.25 l/min in the healthy volunteers. There was no significant bias in successive paired measurements of pulmonary blood flow in either the cardiac surgery patients (mean [95%CI] = −0.02 l/min [−0.62 to 0.57] or the healthy volunteers (0.00 l/min [−0.88 to 0.88]). Intra-class correlation coefficients for the␣healthy and cardiac patients were 0.77 and 0.64 respectively. Multiple measurements should be made and averaged when using the inert gas rebreathing technique for pulmonary blood flow determination. When comparing agreement with other methods for cardiac output measurement, the internal consistency of both methods should be considered.

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Authors and Affiliations

  1. Department of Anaesthesia, Austin Hospital, University of Melbourne, Heidelberg, Melbourne, 3084, Australia

    Philip J. Peyton MBBS, MD, FANZCA

  2. Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Australia

    Bruce R. Thompson PhD

  3. Monash University Department of Epidemiology and Preventive Medicine, The Alfred, Melbourne, Australia

    Michael Bailey PhD, MSc(stats), BSc(hons)

Authors
  1. Philip J. Peyton MBBS, MD, FANZCA
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  2. Michael Bailey PhD, MSc(stats), BSc(hons)
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  3. Bruce R. Thompson PhD
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Correspondence to Philip J. Peyton MBBS, MD, FANZCA.

Additional information

Peyton PJ, Bailey M, Thompson BR. Reproducibility of cardiac output measurement by the nitrous oxide rebreathing technique.

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Peyton, P.J., Bailey, M. & Thompson, B.R. Reproducibility of cardiac output measurement by the nitrous oxide rebreathing technique. J Clin Monit Comput 23, 233–236 (2009). https://doi.org/10.1007/s10877-009-9187-7

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  • DOI: https://doi.org/10.1007/s10877-009-9187-7

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