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Comparison of cardiac output monitoring with the Pulse Wave Transit Time technique versus arterial waveform analysis


Authors: M. Chobola;  J. Hruda;  M. Lukeš;  J. Klimeš;  V. Šrámek;  P. Suk
Authors‘ workplace: Anesteziologicko-resuscitační klinika, Fakultní nemocnice u sv. Anny v Brně, Centrum mezinárodního klinického výzkumu ICRC, Masarykova univerzita
Published in: Anest. intenziv. Med., 28, 2017, č. 6, s. 339-345
Category: Intensive Care Medicine - Original Paper

Overview

Objective:
The aim of the study was to compare the esCCO Vismo (Nihon Kohden, Japan) monitor to the routinely used LiDCOrapid (LiDCO Group, Great Britain) monitor in patients undergoing abdominal surgery.

Design:
Observational study.

Setting:
General surgery operating theatres in a University Hospital.

Materials and methods:
ASA III patients scheduled for elective major abdominal surgery with expected operation duration over 90 minutes were included in the study. Cardiac output measurements by esCCO and LiDCOrapid were recorded before induction of anaesthesia, every 15 min throughout the surgery and after extubation. The agreement and trending ability of the two methods were tested with the Bland-Altman analysis and polar plot, respectively.

Results:
A total of 141 paired readings from 10 patients were collected. The Bland-Altman analysis corrected for repeated measures showed a bias of +1.2 l/min, limits of agreement ±2.6 l/min and percentage error of 57 %. The direction of change between consecutive esCCO measurements and the corresponding LiDCOrapid measurements showed a concordance rate of 80 %. In the polar plot, the angular bias was +11° with radial limits of agreement from -40° to +62°.

Conclusion:
Hemodynamic monitoring with esCCO yields cardiac output values different from those measured by LiDCOrapid. esCCO cannot be currently recommended as a reliable surrogate for LiDCOrapid.

keywords:
pulse wave transit time – cardiac output – esCCO – LiDCO – haemodynamics – perioperative care


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Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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