Abstract
IntroductionThe FloTrac/Vigileo™ (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration. Software modifications were performed in order to eliminate initially observed deficits. The aim of this study was to assess changes in cardiac output determined by the FloTrac/Vigileo™ system (FCO) with an initially released (FCOA) and a modified (FCOB) software version, as well as changes in cardiac output from the PiCCOplus™ system (PCO; Pulsion Medical Systems, Munich, Germany). Both devices were compared with cardiac output measured by intermittent thermodilution (ICO).MethodsCardiac output measurements were performed in patients after elective cardiac surgery. Two sets of data (A and B) were obtained using FCOA and FCOB in 50 patients. After calibration of the PiCCOplus™ system, triplicate FCO and PCO values were recorded and ICO was determined in the supine position and cardiac output changes due to body positioning were recorded 15 minutes later (30° head-up, 30° head-down, supine). Student's t test, analysis of variance and Bland-Altman analysis were calculated.ResultsSignificant changes of FCO, PCO and ICO induced by body positioning were observed in both data sets. For set A, ΔFCOA was significantly larger than ΔICO induced by positioning the head down. For set B, there were no significant differences between ΔFCOB and ΔICO. For set A, increased limits of agreement were found for FCOA-ICO when compared with PCO-ICO. For set B, mean bias and limits of agreement were comparable for FCOB-ICO and PCO-ICO.ConclusionsThe modification of the FloTrac/Vigileo™ system resulted in an improved performance in order to reliably assess cardiac output and track the related changes in patients after cardiac surgery.
Highlights
Introduction TheFloTrac/VigileoTM (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration
In this study we evaluated cardiac output assessed by an initially released and a modified version of the FloTrac/VigileoTM, the PiCCOplusTM system and the bolus thermodilution – as reference technique – during haemodynamic changes induced by body positioning in patients after elective off-pump coronary artery bypass surgery
Our study group showed that perioperative performance of the FloTrac/VigileoTM system, the PiCCOplusTM system and the continuous cardiac output monitoring by the Vigilance monitoring based on the pulmonary artery catheter (Edwards Lifesciences, Irvine, CA, USA) was comparable in 31 patients undergoing elective coronary artery bypass surgery [15]
Summary
Introduction TheFloTrac/VigileoTM (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration. The aim of this study was to assess changes in cardiac output determined by the FloTrac/VigileoTM system (FCO) with an initially released (FCOA) and a modified (FCOB) software version, as well as changes in cardiac output from the PiCCOplusTM system (PCO; Pulsion Medical Systems, Munich, Germany). Both devices were compared with cardiac output measured by intermittent thermodilution (ICO). Inaccurate measurements during haemodynamic changes were observed with the initial pulse contour algorithm [8] and the technique has been modified to better address the aortic compliance in these situations [9,10]
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