Accuracy and trending ability of finger plethysmographic cardiac output monitoring in late pregnancy.

Autor: Bonnin P; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France., Constans B; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France.; Centre Hospitalier de Seclin-Carvin, Service d'Anesthésie, Seclin, France., Duhamel A; Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France.; CHU Lille, Unité de Méthodologie, Biostatistiques et Data Management, Lille, France., Kyheng M; Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France.; CHU Lille, Unité de Méthodologie, Biostatistiques et Data Management, Lille, France., Ducloy-Bouthors AS; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France., Estevez MG; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France., Tavernier B; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France.; Université de Lille, CHU Lille, ULR 2694 METRICS- Evaluation des technologies de santé et des pratiques médicales, Lille, France., Gaudet A; CHU Lille, Pôle d'Anesthésie-Réanimation, Lille, France. alexandre.gaudet@chru-lille.fr.; Department of Intensive Care Medicine, Critical Care Centre, CHU Lille, 59000, Lille, France. alexandre.gaudet@chru-lille.fr.; Université de Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, Lille, France. alexandre.gaudet@chru-lille.fr.
Jazyk: angličtina
Zdroj: Canadian journal of anaesthesia = Journal canadien d'anesthesie [Can J Anaesth] 2022 Nov; Vol. 69 (11), pp. 1340-1348. Date of Electronic Publication: 2022 Aug 04.
DOI: 10.1007/s12630-022-02297-y
Abstrakt: Purpose: Individuals in late pregnancy are at risk of significant hemodynamic variations, especially during Cesarean delivery. Although non-invasive monitoring might enable the early detection of variations in cardiac output (CO), clinical validation is lacking.
Methods: In a prospective, single-center study, we measured CO simultaneously with finger plethysmography and transthoracic echocardiography in 100 third-trimester pregnant individuals in the supine and left lateral decubitus (LLD) positions.
Results: A Bland-Altman analysis revealed a mean (standard deviation) bias of 1.36 (1.04) L·min -1 in the supine position (95% limits of agreement, -0.68 to 3.4 L·min -1 ; percent error, 26.6%), indicating overestimation by finger plethysmography. The intra-class correlation coefficient was 0.43 (95% confidence interval [CI], 0.33 to 0.51). Regarding the changes in CO induced by the supine-to-LLD transition, the concordance rate in a four-quadrant plot was 98.3% (95% CI, 91.1 to 99.9%).
Conclusion: Our study showed a poor reliability of finger plethysmography for static measurement of CO. Nevertheless, finger plethysmography had a reasonably high concordance rate for the detection of CO changes secondary to positional changes in late-pregnant individuals. STUDY REGISTRATION DATE: www.
Clinicaltrials: gov (NCT03735043); registered 8 November 2018.
(© 2022. Canadian Anesthesiologists' Society.)
Databáze: MEDLINE
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