Abstract
Uncalibrated semi-invasive continous monitoring of cardiac index (CI) has recently gained increasing interest. The aim of the present study was to compare the accuracy of CI determination based on arterial waveform analysis with transpulmonary thermodilution. Fifty patients scheduled for elective coronary surgery were studied after induction of anaesthesia and before and after cardiopulmonary bypass (CPB), respectively. Each patient was monitored with a central venous line, the PiCCO system, and the FloTrac/Vigileo-system. Measurements included CI derived by transpulmonary thermodilution and uncalibrated semi-invasive pulse contour analysis. Percentage changes of CI were calculated. There was a moderate, but significant correlation between pulse contour CI and thermodilution CI both before (r 2 = 0.72, P < 0.0001) and after (r 2 = 0.62, P < 0.0001) CPB, with a percentage error of 31% and 25%, respectively. Changes in pulse contour CI showed a significant correlation with changes in thermodilution CI both before (r 2 = 0.52, P < 0.0001) and after (r 2 = 0.67, P < 0.0001) CPB. Our findings demonstrated that uncalibrated semi-invasive monitoring system was able to reliably measure CI compared with transpulmonary thermodilution in patients undergoing elective coronary surgery. Furthermore, the semi-invasive monitoring device was able to track haemodynamic changes and trends.
Highlights
Estimation of haemodynamic variables such as left ventricular stroke volume and cardiac index in high-risk patients is a prerequisite for performing individual goal-directed therapy
Our findings demonstrated that uncalibrated semiinvasive monitoring system was able to reliably measure cardiac index (CI) compared with transpulmonary thermodilution in patients undergoing elective coronary surgery
There was a significant correlation between CIWave and CITPTD before (T1) and after (T2) cardiopulmonary bypass (Figure 2)
Summary
Estimation of haemodynamic variables such as left ventricular stroke volume and cardiac index in high-risk patients is a prerequisite for performing individual goal-directed therapy. Determination of cardiac index in the past was mostly related to invasive procedures such as right heart catheterization or femoral access, baring method-related complications and limitations [4,5,6]. In this context, less-invasive techniques based on arterial waveform analysis have gained increasing interest [7,8,9]. This system requires only an arterial line connected to a special transducer (FloTrac) and has been investigated in several studies under various clinical conditions, but its precision to reflect CI is still under debate [12,13,14]
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