Is the Cardiac Output measurement correct in the case of aortic, mitral or tricuspid valve insufficiency?
In the case of valve insufficiency the valve does not close correctly. Therefore, the thermodilution curve is affected by indicator regurgitation, resulting in a prolonged indicator decay time. In the case of severe aortic insufficiency the curve may ´time out`. However, if a thermodilution curve is obtained, it will accurately reflect the Cardiac Output as the systemic blood flow is measured. In the case of mild aortic insufficiency, if the thermodilution Cardiac Output is compared to Doppler flow measurements, the Doppler measurements will show a higher Cardiac Output because the Doppler only measures instantaneous forward flow, not the regurgitated blood. Thus a higher Cardiac Output is calculated based on forward flow. The PiCCO gives a correct CO based on the measurement of systemic blood flow.
