Cardiac Output Monitoring With Estimated Continuous Cardiac Output (esCCO) vs. Transpulmonary Thermodilution (TPTD)

Continuous Cardiac Output Monitoring Using esCCO: a Validation vs. Transpulmonary Thermodilution in Off-pump Coronary Artery Bypass Grafting

The main goal of our study is to assess the accuracy and reproducibility of continuous beat-to-beat cardiac output (CO) measurement using pulse wave transit time in patients undergoing off-pump coronary artery bypass grafting.

Using appropriate statistical methods the cardiac index values obtained via pulse wave transit time with esCCO system will be compared with traditional transpulmonary thermodilution technique.

Inclusion Criteria:

• Elective isolated off-pump coronary arteries bypass grafting.
• Age > 18 years and < 80 yrs.
• Preoperative echocardiographic ejection fraction > 0.35

Exclusion Criteria:

• Simultaneous operation (carotid endarterectomy, ventricular aneurysm resection, etc.).
• Constant form of atrial fibrillation.
• Severe valve dysfunction.
• Peripheral vascular disease (including significant peripheral arteriopathy" which precludes the use of peripheral plethysmography).
• The surgical requirement to harvest both radial arteries.
• Intraaortic balloon pump.

Discontinuation Criteria:

• Transfer to cardiopulmonary bypass (on-pump CABG).
• The PEEP test will be discontinued before standard duration in patients with PEEP-induced profound MAP decrease below 50 mm Hg, bradycardia (< 50/min) or CIPCA < 1.9 l/min/m2 exceeding 1 minute.