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Intensive Care Medicine

Erschienen in:

01.10.2009 | Special Article

Tracking changes in cardiac output: methodological considerations for the validation of monitoring devices

verfasst von: Pierre Squara, Maurizio Cecconi, Andrew Rhodes, Mervyn Singer, Jean-Daniel Chiche

Erschienen in: Intensive Care Medicine | Ausgabe 10/2009

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Abstract

Background

Until now, tools for continuous cardiac output (CO) monitoring have been validated as if they were tools for snapshot measurements. Most authors have compared variations in cardiac output between two time-points and used Bland–Altman representations to describe the agreement between these variations. The impacts of time and of repetitive measurements over time are not taken into consideration.

Purpose

This special article proposes a conceptual framework for the validation of CO monitoring devices. Four quality criteria are suggested and studied: (1) accuracy (small bias), (2) precision (small random error of measurements), (3) short response time and (4) accurate amplitude response. Because a tolerance is obviously admitted for each of these four criteria, we propose to add as a fifth criterion the ability to detect significant CO directional changes. Other important issues in designing studies to validate CO monitoring tools are reviewed: choice of patient population to be studied, choice of the reference method, data acquisition method, data acceptability checking, data segmentation and final evaluation of reliability.

Conclusion

Application of this framework underlines the importance of precision and time response for clinical acceptability of monitoring tools.

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Titel: Tracking changes in cardiac output: methodological considerations for the validation of monitoring devices
verfasst von: Pierre Squara
Maurizio Cecconi
Andrew Rhodes
Mervyn Singer
Jean-Daniel Chiche
Publikationsdatum: 01.10.2009
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 10/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1570-9

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Tracking changes in cardiac output: methodological considerations for the validation of monitoring devices

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Background

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Conclusion

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