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J Appl Physiol 87: 2266-2273, 1999;
8750-7587/99 $5.00
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Vol. 87, Issue 6, 2266-2273, December 1999

Noninvasive cardiac output measurement in orthostasis: pulse contour analysis compared with acetylene rebreathing

W. J. Stok, R. C. O. Stringer, and J. M. Karemaker

Academic Medical Center, Department of Physiology, University of Amsterdam, 1105AZ Amsterdam, The Netherlands

We tested the reliability of noninvasive cardiac output (CO) measurement in different body positions by pulse contour analysis (COpc) by using a transmission line model (K. H. Wesseling, B. De Wit, J. A. P. Weber, and N. T. Smith. Adv. Cardiol. Phys. 5, Suppl. II: 16-52, 1983). Acetylene rebreathing (COrebr) was used as a reference method. Twelve subjects (age 21-34 yr) were studied: 1) six in whom COrebr and COpc were measured in the standing and 6° head-down tilt (HDT) postures and 2) six in whom CO was measured in the 30° HDT, supine, 30° head up-tilt (HUT), and 70° HUT postures on a tilt table. The COrebr-to-COpc ratio in (near) the supine position during rebreathing was used as the calibration factor for COpc measurements. Calibrated COpc (COcal sup) consistently overestimated CO in the upright posture. The drop in CO with upright posture was underestimated by ~50%. COcal sup and COrebr values did not differ in the 30° HDT position. Changes in the COrebr-to-COpc ratio are highly variable among subjects in response to a change in posture. Therefore, COpc must be recalibrated for each subject in each posture.

Finapres; stroke volume; blood pressure; tilt; standing


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