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Calbet JAL, Mortensen SP, Munch GDW, Curtelin D, Boushel R. Constant infusion transpulmonary thermodilution for the assessment of cardiac output in exercising humans. Scand J Med Sci Sports 2015; 26:518-27. [PMID: 25919489 DOI: 10.1111/sms.12473] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2015] [Indexed: 12/29/2022]
Abstract
To determine the accuracy and precision of constant infusion transpulmonary thermodilution cardiac output (CITT-Q) assessment during exercise in humans, using indocyanine green (ICG) dilution and bolus transpulmonary thermodilution (BTD) as reference methods, cardiac output (Q) was determined at rest and during incremental one- and two-legged pedaling on a cycle ergometer, and combined arm cranking with leg pedaling to exhaustion in 15 healthy men. Continuous infusions of iced saline in the femoral vein (n = 41) or simultaneously in the femoral and axillary (n = 66) veins with determination of temperature in the femoral artery were used for CITT-Q assessment. CITT-Q was linearly related to ICG-Q (r = 0.82, CITT-Q = 0.876 × ICG-Q + 3.638, P < 0.001; limits of agreement ranging from -1.43 to 3.07 L/min) and BTD-Q (r = 0.91, CITT-Q = 0.822 × BTD + 4.481 L/min, P < 0.001; limits of agreement ranging from -1.01 to 2.63 L/min). Compared with ICG-Q and BTD-Q, CITT-Q overestimated cardiac output by 1.6 L/min (≈ 10% of the mean ICG and BTD-Q values, P < 0.05). For Q between 20 and 28 L/min, we estimated an overestimation < 5%. The coefficient of variation of 23 repeated CITT-Q measurements was 6.0% (CI: 6.1-11.1%). In conclusion, cardiac output can be precisely and accurately determined with constant infusion transpulmonary thermodilution in exercising humans.
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Affiliation(s)
- J A L Calbet
- Department of Physical Education, Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - S P Mortensen
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - G D W Munch
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The Centre of Inflammation and Metabolism, Centre for Physical Activity Research, Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - D Curtelin
- Department of Physical Education, Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Emergency Medicine Department, Insular Universitary Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Boushel
- Copenhagen Muscle Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Åstrand Laboratory, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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Calbet JAL, Boushel R. Assessment of cardiac output with transpulmonary thermodilution during exercise in humans. J Appl Physiol (1985) 2015; 118:1-10. [DOI: 10.1152/japplphysiol.00686.2014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The accuracy and reproducibility of transpulmonary thermodilution (TPTd) to assess cardiac output (Q̇) in exercising men was determined using indocyanine green (ICG) dilution as a reference method. TPTd has been utilized for the assessment of Q̇ and preload indexes of global end-diastolic volume and intrathoracic blood volume, 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 Q̇ by TPTd and ICG concentration during incremental one- and two-legged pedaling on a cycle ergometer and combined arm cranking with leg pedaling to exhaustion. There was a close relationship between TPTd-Q̇ and ICG-Q̇ ( r = 0.95, n = 151, standard error of the estimate: 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-Q̇ and ICG-Q̇ increased linearly with oxygen uptake with similar intercepts and slopes. Both methods had mean coefficients of variation close to 5% for Q̇, global end-diastolic volume, and intrathoracic blood volume. The mean coefficient of variation of EVLW, assessed with both indicators (ICG and thermal) was 17% and was sensitive enough to detect a reduction in EVLW of 107 ml when changing from resting supine to upright exercise. In summary, TPTd with bolus injection into the femoral vein is an accurate and reproducible method to assess Q̇ during exercise in humans.
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Affiliation(s)
- José A. L. Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, Las Palmas de Gran Canaria, Spain
- Research Institute of Biomedical and Health Sciences, IUIBS, University of Las Palmas de Gran Canaria, Canary Island, Spain
- Copenhagen Muscle Research Center, Heart & Circulatory Section, Department of Biomedical Sciences, University of Copenhagen, and Department of Anaesthesia, Bispebjerg Hospital, Copenhagen, Denmark; and
| | - Robert Boushel
- Copenhagen Muscle Research Center, Heart & Circulatory Section, Department of Biomedical Sciences, University of Copenhagen, and Department of Anaesthesia, Bispebjerg Hospital, Copenhagen, Denmark; and
- Åstrand Laboratory, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
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