In vitro determination of accuracy of cardiac output measurements by thermal dilution

The accuracy of cardiac output (C.O.) measurements by the thermodilution method was evaluated in an in vitro model within a flow range from 1 to 5 liters/min. For C.O. determinations, a 5F Swan-Ganz balloon-tipped thermodilution catheter and a 9520 Edwards computer were used. We made 420 measurements at known flow rates. In serial determinations, we achieved an overall accuracy of 86 to 93% compared to the reference flow; for single determinations, the accuracy ranged from 75 to 85%. The indicator volume (3, 5, or 10 cc) had no influence on the results. The thermodilution determinations at each flow rate were reproducible at between 2.5 and 8.5%. There was no difference in accuracy or reproducibility when ice-cold or room temperature saline was used. Caution in the interpretation of single C.O. determinations in low-flow states, i.e., in pediatric patients, is recommended.