Abstract 12421: Assessment of Flow Measurements Using a Noninvasive Photoplethysmography-Based Device Compared to Invasive Pulmonary Artery Catheter

Abstract

Introduction: Invasive monitoring is considered the gold standard of hemodynamic monitoring, yet it is associated with inherent risks. We compared advanced hemodynamic measurements taken using a noninvasive wearable photoplethysmography-based (PPG) monitor and an invasive Swan-Ganz catheter (SGC). Methods: Patients with a prior diagnosis of heart failure undergoing right heart catheterization as part of their clinical assessment were recruited. The noninvasive PPG monitor was applied and readings of cardiac output (CO) and stroke volume (SV) commenced in parallel to the invasive hemodynamic study. Bland-Altman plots and Pearson’s correlations were used to assess the accuracy and degree of agreement between techniques. Results: 90 patients (19-89yo, 53 males) were recruited and included in the final analysis. The mean values of the CO measured using the indirect Fick method, the PPG device, and the thermodilution (TD) method was 5.0±1.4 L/min, 4.9±1.3 L/min, and 4.9±1.6 L/min, respectively. Bland-Altman analysis showed that the PPG had a bias of 0.1 L/m (1.7 - -1.5 L/m 95% LOA) and the TD had a bias of 0.2 L/m (2.2 - -1.8 L/m 95% LOA). The mean SV with the indirect Fick method, the PPG device, and the TD method were 63.6±20.2 mL/beat, 62.0±17.0 mL/beat, and 61.3±20.8 mL/beat, respectively. Bland-Altman analysis showed that the PPG device had a bias of 1.6 mL/beat (23.2 - -20.0 mL/beat 95% LOA) and the TD had a bias of 2.3 mL/beat (28.3 - -23.7 mL/beat 95% LOA). Correlations between the indirect Fick method and the PPG device, and between the indirect Fick method and the TD method were 82.5% and 77.7% for CO, and 83.7% and 79.6% for SV, respectively. Conclusions: The PPG device provides CO and SV measurements that highly correlate with the gold standard invasive indirect Fick method, similarly to the invasive thermodilution method.