Evaluation of the Fourth-Generation FloTrac/Vigileo System in Comparison With the Intermittent Bolus Thermodilution Method in Patients Undergoing Cardiac Surgery
| Autor: | Toshiaki Minami, Fumihiro Ohchi, Yusuke Kusaka |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Cardiac output medicine.medical_treatment Thermodilution Hemodynamics Blood Pressure Femoral artery 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law Monitoring Intraoperative medicine.artery Internal medicine medicine Cardiopulmonary bypass Humans Prospective Studies Cardiac Output Cardiac Surgical Procedures Aged Cardiopulmonary Bypass business.industry Pulmonary artery catheter Intensive care unit Cardiac surgery Pulse pressure Anesthesiology and Pain Medicine Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 33:953-960 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2018.06.017 |
| Popis: | Objectives The aim of this study was to evaluate the accuracy, precision, and trending ability of the fourth-generation FloTrac/Vigileo system (version 4.00; Edwards Lifesciences, Irvine, CA) by comparing cardiac output derived from FloTrac/Vigileo system (COAP) with that measured by a pulmonary artery catheter (COTD), and to determine the effects of hemodynamic variables on the bias between COTD and COAP. Design A prospective study. Setting University hospital. Participants Thirty patients undergoing elective cardiac surgery using cardiopulmonary bypass. Interventions Including hemodynamic variables, COTD and COAP were measured simultaneously at the following 10 time points: after the induction of anesthesia, at the start of operation, after sternotomy, before and after the administration of heparin, before and after the administration of protamine, at the start of sternal closure, at the end of operation, and on arrival to intensive care unit. Measurements and Main Results In total, 280 pairs of datasets were obtained. Bland-Altman analysis showed a bias of −0.41 L/min, a precision of 0.72 L/min, and limits of agreement of −1.85 and 1.03 L/min, with a percentage error of 37.1%. The concordance rate determined by 4-quadrant plot analysis and the polar concordance rate were 76% and 79%, respectively. The linear mixed-effect model revealed that the bias was influenced strongly by the difference in pulse pressure between the radial and femoral artery (p Conclusion The fourth-generation FloTrac/Vigileo system still lacks accuracy and trending ability in cardiac surgery, and the discrepancy in cardiac output measurement depends on the peripheral vascular tone. Further improvement of this system is needed. |
| Databáze: | OpenAIRE |
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