Response Time of Different Methods of Cardiac Output Monitoring During Cardiopulmonary Resuscitation and Recovery

Abstract

partial pressure (PETCO2) and mixed venous hemoglobin oxygen saturation (SvO2) also were continuously monitored and recorded. During the laparotomy, hypotension and tachycardia were noted and were accompanied by facial flushing. This was diagnosed as mesenteric traction syndrome and was treated with fluid administration and intermittent intravenous ephedrine. During this period, high cardiac output was recorded with all devices. The maximal values recorded were 6.9 L/min, 9.2 L/min, 17.4 L/min, and 17.9 L/min via the EDM, NICO, STAT CCO, and trend CCO monitors, respectively. At this point, the SvO2 was 89% and VCO2 was 137 mL/min. These symptoms eventually disappeared, and the patient’s CO subsequently stabilized (measured as 5.5 L/min, 5.1 L/min, 10.1 L/min, and 11.3 L/min via the EDM, NICO, STAT CCO, and CCO monitors, respectively; SvO2 85%, VCO2 126 mL/min. The CO at this point as measured with a bolus thermodilution was 7.0 L/min. During surgical exposure of the aortic aneurysm, a sudden onset of ventricular premature contraction was followed by sustained ventricular tachycardia (VT). Because initial DC cardioversion failed to stop the VT, phenylephrine, lidocaine, nitroglycerin, and epinephrine were administered while closed-chest compression was provided. During CPR, the patient was manually ventilated to ensure adequate ventilation. The minute volume provided during CPR was between 11 L/min and 12 L/min. The third DC cardioversion finally restored the patient to sinus rhythm. The duration of VT was 9 minutes, and chest compression provided a systolic pressure of more than 60 mmHg and diastolic pressure of more than 20 mmHg during CPR. The trend for the EDM, NICO, STAT CCO, and trend CCO monitors are summarized in Figure 1, along with PETCO2 and SvO2 during the CPR period. The CO measured with EDM varied from 0 to 2.5 L/min, and the signal of descending aortic blood flow caused by chest compression was clearly visible during this event using EDM. Three rebreathing cycles were used with a NICO monitor during CPR. The first rebreathing cycles were applied at 2 minutes after the onset of VT and the CO and VCO2 were reported as 2.9 L/min and 104 mL/min, respectively. The second cycle was applied 5 minutes after the onset of VT and failed to estimate the CO. The third rebreathing cycle was applied at 8 minutes after the onset of VT, and the CO and VCO2 were