Cardiac Output Measurement by Bioimpedance and Noninvasive Pulse Contour Analysis Compared With the Continuous Pulmonary Artery Thermodilution Technique
Section snippets
Methods
The study was approved by the institutional review board, and written informed consent was obtained from all patients. A consecutive group of patients undergoing cardiac surgery were included. All patients undergoing elective coronary artery bypass surgery (CABG) and/or valve replacement surgery were included. The exclusion criteria were emergency cardiac surgery and patients under the age of 18. General anesthesia was induced according to standard institutional protocol. After induction, the
Results
Fifty-three consecutive patients were included, and 50 datasets were obtained. In 2 patients, the pulmonary artery catheter was removed because it caused dangerous arrhythmias, and in 1 patient, technical problems with the Vigilance monitor occurred. In Table 1, demographic data are shown. The population included 38 (76.0%) men, and the average age in the study group was 69.8 (48-86) years. Patients underwent coronary artery bypass grafting (n = 42), aortic valve replacement (n = 3), mitral
Discussion
In the present study, the accuracy of 2 noninvasive CO monitors was evaluated in clinical practice. Complications of the use of these systems were not observed. It has been reported that optimizing cardiac output is associated with positive effects on morbidity and length of stay in the intensive care unit.14, 15 The main advantage of the pulmonary artery thermodilution technique is the provision of a large dataset concerning the cardiovascular status of the patient. However, the benefit of
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New Developments in Continuous Hemodynamic Monitoring of the Critically Ill Patient
2023, Canadian Journal of CardiologyComparing the Mutual Interchangeability of ECOM, FloTrac/Vigileo, 3D-TEE, and ITD-PAC Cardiac Output Measuring Systems in Coronary Artery Bypass Grafting
2021, Journal of Cardiothoracic and Vascular AnesthesiaBest practice & research clinical anaesthesiology: Advances in haemodynamic monitoring for the perioperative patient: Perioperative cardiac output monitoring
2019, Best Practice and Research: Clinical AnaesthesiologyCitation Excerpt :In a very well-controlled study in patients undergoing cardiac surgery, PE of ClearSight (compared to pulmonary artery thermodilution) was below 30% during stable haemodynamics; performance during periods of haemodynamic instability, however, was unacceptable [6]. Several studies showed a fair ability of the ClearSight device in tracking changes in CO [37,81,82,84–86]. Presently, the use of the ClearSight device may be most beneficial in the OR and the PACU, especially in patients at intermediate risk who normally would not be equipped with a CO monitoring device.
Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery: An Observational Study
2018, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :The Nexfin calculates the CO based on SV values obtained after the pulsatile unloading of the vasculature in the finger using the CO-trek algorithm.12 Others previously showed a large variation in the agreement between Nexfin and PAC cardiac index measurements, with a bias ranging from –0.1 to 4.6 L/min/mm2 and percentage errors that exceeded 50%.17–20 Although the present study found substantially lower percentages of error for Nexfin CO monitoring, the moderate LoA between CO may have exerted a significant influence on the agreement between invasive and minimally invasive DO2 and VO2 measurements.