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Accuracy of a noninvasive estimated continuous cardiac output measurement under different respiratory conditions: a prospective observational study

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Abstract

Purpose

The estimated continuous cardiac output (esCCO) system was recently developed as a noninvasive hemodynamic monitoring alternative to the thermodilution cardiac output (TDCO). However, the accuracy of continuous cardiac output measurements by the esCCO system compared to TDCO under different respiratory conditions remains unclear. This prospective study aimed to assess the clinical accuracy of the esCCO system by continuously measuring the esCCO and TDCO.

Methods

Forty patients who had undergone cardiac surgery with a pulmonary artery catheter were enrolled. We compared the esCCO with TDCO from mechanical ventilation to spontaneous respiration through extubation. Patients undergoing cardiac pacing during esCCO measurement, those receiving treatment with an intra-aortic balloon pump, and those with measurement errors or missing data were excluded. In total, 23 patients were included. Agreement between the esCCO and TDCO measurements was evaluated using Bland–Altman analysis with a 20 min moving average of the esCCO.

Results

The paired esCCO and TDCO measurements (939 points before extubation and 1112 points after extubation) were compared. The respective bias and standard deviation (SD) values were 0.13 L/min and 0.60 L/min before extubation, and − 0.48 L/min and 0.78 L/min after extubation. There was a significant difference in bias before and after extubation (P < 0.001); the SD before and after extubation was not significant (P = 0.315). The percentage errors were 25.1% before extubation and 29.6% after extubation, which is the criterion for acceptance of a new technique.

Conclusion

The accuracy of the esCCO system is clinically acceptable to that of TDCO under mechanical ventilation and spontaneous respiration.

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Data Availability

The datasets analysed in this study are available from the corresponding author on reasonable request.

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Acknowledgements

Nihon Kohden Corporation, Japan provided the equipment utilized in this study. Illustrations were created using Biorender.com. We thank Sayaka Yamazaki, Yoshiharu Harada, Yoshihiro Sugo, and Motoshi Matsuo from Nihon Kohden Corporation for their professional advice on the estimated continuous cardiac output; they were not involved in the writing of the manuscript. We would also like to thank Editage (www.editage.jp) for English language editing.

Funding

This research did not receive specific grants from public, commercial, or not-for-profit funding agencies.

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Authors and Affiliations

  1. Department of Anesthesiology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Masashi Takakura, Tasuku Fujii, Tomoya Taniguchi & Shogo Suzuki

  2. Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masashi Takakura, Tomoya Taniguchi & Kimitoshi Nishiwaki

Authors
  1. Masashi Takakura
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  2. Tasuku Fujii
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  3. Tomoya Taniguchi
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  4. Shogo Suzuki
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  5. Kimitoshi Nishiwaki
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Contributions

All the authors contributed to the conception and design of the study. SS and KN supervised this study. MT, TF, and TT performed material preparation and data collection. MT and TF performed data analysis. MT wrote the first draft of the manuscript, and all authors commented on previous versions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tasuku Fujii.

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Takakura, M., Fujii, T., Taniguchi, T. et al. Accuracy of a noninvasive estimated continuous cardiac output measurement under different respiratory conditions: a prospective observational study. J Anesth 37, 394–400 (2023). https://doi.org/10.1007/s00540-023-03176-6

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  • DOI: https://doi.org/10.1007/s00540-023-03176-6

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