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Validity of Hemodynamic Monitoring Using Inert Gas Rebreathing Method in Patients With Chronic Heart Failure and Those Implanted With a Left Ventricular Assist Device

Lookup NU author(s): Dr Nduka Okwose, Dr Aaron Koshy, Dr Adam McDiarmid, Dr Gareth Parry, Dr Guy MacGowanORCiD, Professor Djordje JakovljevicORCiD


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© 2020 Elsevier Inc. Objective: The present study assessed agreement between resting cardiac output estimated by inert gas rebreathing (IGR) and thermodilution methods in patients with heart failure and those implanted with a left ventricular assist device (LVAD). Methods and Results: Hemodynamic measurements were obtained in 42 patients, 22 with chronic heart failure and 20 with implanted continuous flow LVAD (34 males, aged 50 ± 11 years). Measurements were performed at rest using thermodilution and IGR methods. Cardiac output derived by thermodilution and IGR were not significantly different in LVAD (4.4 ± 0.9 L/min vs 4.7 ± 0.8 L/min, P =.27) or patients with heart failure (4.4 ± 1.4 L/min vs 4.5 ± 1.3 L/min, P =.75). There was a strong relationship between thermodilution and IGR cardiac index (r = 0.81, P =.001) and stroke volume index (r = 0.75, P =.001). Bland–Altman analysis showed acceptable limits of agreement for cardiac index derived by thermodilution and IGR, namely, the mean difference (lower and upper limits of agreement) for patients with heart failure –0.002 L/min/m2 (–0.65 to 0.66 L/min/m2), and –0.14 L/min/m2 (–0.78 to 0.49 L/min/m2) for patients with LVAD. Conclusions: IGR is a valid method for estimating cardiac output and should be used in clinical practice to complement the evaluation and management of chronic heart failure and patients with an LVAD.

Publication metadata

Author(s): Okwose NC, Bouzas-Cruz N, Fernandez OG, Koshy A, Green T, Woods A, Robinson-Smith N, Tovey S, Mcdiarmid A, Parry G, Schueler S, Macgowan GA, Jakovljevic DG

Publication type: Article

Publication status: Published

Journal: Journal of Cardiac Failure

Year: 2021

Volume: 27

Issue: 4

Pages: 414-418

Print publication date: 01/04/2021

Online publication date: 06/10/2020

Acceptance date: 29/09/2020

ISSN (print): 1071-9164

ISSN (electronic): 1532-8414

Publisher: Elsevier


DOI: 10.1016/j.cardfail.2020.09.479

PubMed id: 33035686


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