The Consistency of Cardiac Output Measured by Pulmonary Artery Catheter and LiDCO in Cardiac Surgical Patients

Study Overview
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Brief Summary
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To evaluate the consistency of cardiac output measured by pulmonary artery catheter and LiDCO in cardiac surgical patients To evaluate whether different hemodynamic monitoring methods can accurately detect the trend of cardiac output changes

Detailed Description
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Close monitoring of cardiac output (CO), especially in patients before and after intervention(such as volume expansion, diuresis, vasoconstriction, vasodilation therapy), could help to adjust the treatment strategy in cardiac surgical patients. Pulmonary artery catherization (PAC) has been used for hemodynamic monitoring for more than four decades. In spite of its invasiveness, it remains the clinical reference method for the assessment of CO at the bedside. Nowadays, many less invasive alternatives, such as LiDCO Rapid Pulse Contour Analysis System (LiDCO Ltd., Cambridge, United Kingdom), are already available on market. However, consistency between different hemodynamic monitoring results still raise concern. And whether hemodynamic monitoring could accurately detect the changes of these parameters before and after intervention is an important issue in clinical practice. In this study, the investigators are going to collect CO and changes of CO from PAC and LiDCO before and after intervention (passive leg raising and dobutamine stress test) in cardiac surgical patients. Our resulst could provide important reference for cardiac surgical patients how to choose appropriate hemodynamic monitoring tools and how to interpret the results of hemodynamic monitoring.

Official Title
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The Consistency of Cardiac Output Measured by Pulmonary Artery Catheter and LiDCO in Cardiac Surgical Patients

Conditions
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Cardiac Surgery, Cardiac Output

Intervention / Treatment
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* Diagnostic Test: Passive Leg Raising
* Diagnostic Test: Dobutamine stress test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: cardiac surgery hemodynamic monitoring (PAC, LiDCO) mechanical ventilation Exclusion Criteria: cardiac arrhythmia moderate to severe aortic, mitral and tricuspid regurgitation IABP ECMO

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Passive Leg Raising<br>Passive leg raising (PLR) test is used to predict fluid responsiveness, which is performed by raising the legs of the patient to 45°. Cardiac output will be collected from both PAC and LiDCO before and after PLR. | Diagnostic Test: Passive Leg Raising<br>* Passive leg raising is induced by rasing the legs of patients to 45° from horizontal position.<br>|
| Experimental: Dobutamine stress test<br>Dobutamine is a selective beta 1 receptor agonist. It [<10 ug/(kg.min)] can effectively increase myocardial contractility. | Diagnostic Test: Dobutamine stress test<br>* Dobutamine was infused intravenously at the initial dose of 2.5 ug/kg/min. hemodynamic data were recorded from PAC and LiDCO after 5-10 minutes of continuous infusion.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Baseline Cardiac Output measurement | Cardiac Output measured at baseline position (horizontal position) | within1 minute at baseline position | 
| Cardiac Output measurement after PLR | Cardiac Output measured after PLR | 1 minute after PLR | 
| Cardiac Output measurement after Dobutamine stress test | Cardiac Output measured after dobutamine stress test | 5 minutes after dobutamine stress test | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hemodynamic Monitoring, Pulmonary artery catherization, LiDCO