Comparison between continuous non-invasive estimated cardiac output by pulse wave transit time and thermodilution method

Autor: Preet Mohinder Singh, Gerald Dubowitz, Ashish C. Sinha, Mansoor M. Aman, Navneet K Grewal
Rok vydání: 2014
Předmět:
Adult
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Cardiac output
medicine.medical_treatment
Thermodilution
Pulse Wave Analysis
Standard deviation
law.invention
lcsh:RD78.3-87.3
Young Adult
law
Internal medicine
Monitoring
Intraoperative

Continuous cardiac output monitor
Non-invasive cardiac output measurement
Pulse wave transit time
Pulse Wave Transit Time
medicine
Humans
Prospective Studies
Cardiac Output
Aged
Monitoring
Physiologic

Aged
80 and over

business.industry
Non invasive
Pulmonary artery catheter
Reproducibility of Results
General Medicine
Gold standard (test)
Middle Aged
Intensive care unit
Confidence interval
Surgery
Anesthesiology and Pain Medicine
lcsh:Anesthesiology
lcsh:RC666-701
Catheterization
Swan-Ganz

Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Annals of Cardiac Anaesthesia, Vol 17, Iss 4, Pp 273-277 (2014)
ISSN: 0974-5181
Popis: Aims and Objectives: Cardiac output (CO) measurement is essential for many therapeutic decisions in anesthesia and critical care. Most available non-invasive CO measuring methods have an invasive component. We investigate "pulse wave transit time" (estimated continuous cardiac output [esCCO]) a method of CO measurement that has no invasive component to its use. Materials and Methods: After institutional ethical committee approval, 14 adult (21-85 years) patients undergoing surgery and requiring pulmonary artery catheter (PAC) for measuring CO, were included. Postoperatively CO readings were taken simultaneously with thermodilution (TD) via PAC and esCCO, whenever a change in CO was expected due to therapeutic interventions. Both monitoring methods were continued until patients′ discharge from the Intensive Care Unit and observer recording values using TD method was blinded to values measured by esCCO system. Results: Three hundred and one readings were obtained simultaneously from both methods. Correlation and concordance between the two methods was derived using Bland-Altman analysis. Measured values showed significant correlation between esCCO and TD ( r = 0.6, P < 0.001, 95% confidence limits of 0.51-0.68). Mean and (standard deviation) for bias and precision were 0.13 (2.27) L/min and 6.56 (2.19) L/min, respectively. The 95% confidence interval for bias was - 4.32 to 4.58 L/min and for precision 2.27 to10.85 L/min. Conclusions: Although, esCCO is the only true non-invasive continuous CO monitor available and even though its values change proportionately to TD method (gold standard) with the present degree of error its utility for clinical/therapeutic decision-making is questionable.
Databáze: OpenAIRE