CONTINUOUS VERSUS INTERMITTENT THERMODILUTION CARDIAC-OUTPUT MEASUREMENT DURING ORTHOTOPIC LIVER-TRANSPLANTATION

We evaluated intermittent and continuous thermodilution cardiac output data in 12 patients undergoing orthotopic liver transplantation. Meas urements were performed at 16 predefined time points between induction of anaesthesia and 3 h after reperfusion of the liver graft. Cardiac output measurements yielded 192 data pairs (intermittent cardiac outpu t range: 1.8-18.91.min(-1), continuous cardiac output range: 3.3-20.01 .min(-1)). During most of the procedure the correlation between interm ittent and continuous cardiac output measurements was significant (r = 0.87, p < 0.0001), accompanied with a bias of -0.2401.min(-1) and a d egree of precision of 1.7891.min(-1) ( < 10.01.min(-1) : 1.1371.min(-1 ), greater than or equal to 10.01.min(-1) : 2.2201.min(-1)). However, in the early phases after caval clamping and after reperfusion, accura cy was not acceptable. Only during these phases did the difference bet ween the mean values of pulmonary artery blood temperature and rectal temperature increase (after caval clamping) or decrease (after reperfu sion). In conclusion, despite acceptable levels of accuracy and precis ion between intermittent and continuous cardiac output measurement und er stable conditions, both methods showed markedly decreased accuracy and precision in the early phases after caval damping and after reperf usion, possibly owing to increased thermal noise.