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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

01.01.2014 | Reports of Original Investigations

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

verfasst von: Marc-Olivier Fischer, MD, Xavier Balaire, MD, Charles Le Mauff de Kergal, MD, Clément Boisselier, MD, Jean-Louis Gérard, MD, Jean-Luc Hanouz, MD, PhD, Jean-Luc Fellahi, MD, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 1/2014

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Abstract

Purpose

Estimated continuous cardiac output (esCCO) is a new and noninvasive cardiac output (CO) monitoring device using pulse wave transit time. The aim of this study was to assess rapid changes in CO using esCCO (ΔCO_esCCO) without invasive calibration and to compare the results with those using transthoracic Doppler echocardiography (ΔCO_TTE).

Methods

Fifty-four consecutive patients were enrolled in this study following elective cardiac surgery. The CO_esCCO and CO_TTE were collected during four consecutive steps: 1) at baseline, 2) during passive leg raising (PLR), 3) at return to baseline, and 4) after a fluid challenge. The relationship between ΔCO_esCCO and ΔCO_TTE induced by PLR and a fluid challenge was assessed and a polar plot analysis was performed. Relationship, Bland-Altman analysis, and percentage error for absolute values of CO_esCCO and CO_TTE were also performed.

Results

Twenty-four patients were excluded from the analysis. No correlation was found between ΔCO_esCCO and ΔCO_TTE during PLR (r = 0.07; P = 0.732; n = 30) and after a fluid challenge (r = 0.24; P = 0.394; n = 14). The polar plot analysis showed that 21 data points (87%) of significant changes in CO were above the 30° radial sector lines and confirmed that esCCO was unable to track changes in CO. A weak positive relationship was found between absolute values of CO_esCCO and CO_TTE (r = 0.28; P = 0.004). Bias, precision, and limits of agreement were 0.25 L·min⁻¹, 2.4 L·min⁻¹, and −4.4 to 4.9 L·min⁻¹, respectively. The percentage error was 80%.

Conclusions

Estimated continuous cardiac output without external calibration seems unable to assess rapid changes in CO following cardiac surgery and was not interchangeable with transthoracic Doppler echocardiography.

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Titel: The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography
verfasst von: Marc-Olivier Fischer, MD
Xavier Balaire, MD
Charles Le Mauff de Kergal, MD
Clément Boisselier, MD
Jean-Louis Gérard, MD
Jean-Luc Hanouz, MD, PhD
Jean-Luc Fellahi, MD, PhD
Publikationsdatum: 01.01.2014
Verlag: Springer US
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 1/2014
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-013-0055-z

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The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography