Sunday January 22, 2006
Arterial pressure-based continuous cardiac output (APCO)

In our quest of finding less and less invasive techniques for our patients, it would be interesting to evaluate arterial pressure based continuous cardiac output (APCO). The whole concept is based on measuring cardiac output simply on arterial pulsatility. Advantages are:

1. It does not require any calibration.
2. Connects to an existing peripheral arterial catheter.
3. No injection of dilutional medium required.

Click here to see video on commercially available device from Edwards Lifesciences.

Some small initial studies have so far shown comparable results with intermittent bolus thermodilution cardiac output (ICO) and continuous thermodilution cardiac output (CCO).1,2,3 But before accepting this modality as a standard we need a good well controlled clinical trial as we don't know the effect of age, gender, vessel's disease state, vessel's compliance with distending pressure, body positioning etc. 4

References: click to get abstrat/article

1. Continuous Cardiac Output Measured by Arterial Pressure Analysis in Surgical Patients - Anesthesiology 2005; 103: A834
2. CARDIAC OUTPUT DETERMINATION USING ARTERIAL PULSE: A COMPARISON OF A NOVEL ALGORITHM AGAINST CONTINUOUS AND INTERMITTENT THERMODILUTION: 166. - Critical Care Medicine: Volume 32(12) Supplement December 2004 p A43
3. Pressure recording analytical method (PRAM) for measurement of cardiac output during various haemodynamic states - British Journal of Anaesthesia 2005 95(2):159-165
4. Continuous cardiac output by pulse contour analysis? - British Journal of Anaesthesia, 2001, Vol. 86, No. 4 467-468