Comparison of pulmonary artery catheter, echocardiography, and arterial waveform analysis monitoring in predicting the hemodynamic state during and after cardiac surgery
| Autor: | Michael Bailey, Simon Gower, Paul Power, Allison Bone, Cheng-Hon Yap, Nicholas Simpson |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Population Hemodynamics Critical Care and Intensive Care Medicine hemodynamic monitoring law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law Intensive care Internal medicine Medicine Anesthesia education intensive care education.field_of_study business.industry Public Health Environmental and Occupational Health Pulmonary artery catheter 030208 emergency & critical care medicine Perioperative Intensive care unit humanities Cardiac surgery Cardiothoracic surgery Emergency Medicine Cardiology Original Article business cardiaothoracic |
| Zdroj: | International Journal of Critical Illness and Injury Science |
| ISSN: | 2229-5151 |
| DOI: | 10.4103/2229-5151.214411 |
| Popis: | Objective: The aim of this trial was to determine whether Flotrac Vigileo™ (FV™) provides a reliable representation of the hemodynamic state of a cardiac surgical patient population when compared to pulmonary artery catheter (PAC) and echocardiography in the peril-operative period. Design: This was a prospective observational trial comparing perioperative hemodynamic states using transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), FV™ and PAC during and post cardiothoracic surgery. Setting: Tertiary regional hospital Intensive Care Unit (ICU). Participants: 50 consecutive adult cardiothoracic patients with written consent provided. Intervention: Comparison of the perioperative hemodynamic states using echocardiography, FV™ and PAC was performed. Evaluation of the hemodynamic state (HDS) was performed using TEE, TTE, PAC and FV™ during and after cardiac surgery. Data were compared between the three hemodynamic assessment modalities. Main Outcome Measure: Predicted hemodynamic state. Results: FV™ and PAC were shown to correlate poorly with TEE/TTE assessment of the hemodynamic state. Both PAC and FV™ showed significant discordance with echocardiographic assessment of the hemodynamic state. Conclusions: In this trial, FV™ and PAC were shown to agree poorly with TTE/TEE assessment of the HDS in an adult cardiothoracic population. Agreement between the FV™ and PAC was also poor. Caution is recommended in interpreting isolated hemodynamic monitoring data. All hemodynamic monitoring devices have inherent sources of error. Caution is advised in interpreting any single device or measurement as a gold standard. We suggest that hemodynamic measuring devices such as FV™/PAC may act as triggers for a global hemodynamic assessment including consideration of TTE/TEE. |
| Databáze: | OpenAIRE |
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