Journal of Anesthesia

, Volume 25, Issue 2, pp 178–183 | Cite as

Accuracy of arterial pressure waveform analysis for cardiac output measurement in comparison with thermodilution methods in patients undergoing living donor liver transplantation

  • Kozaburo Akiyoshi
  • Tadashi Kandabashi
  • Junko Kaji
  • Ken Yamaura
  • Hayashi Yoshimura
  • Kazuo Irita
  • Sumio Hoka
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

The aim of this study was to assess the accuracy of the first and third versions of arterial pressure waveform cardiac output (APCOv.1.0 and APCOv.3.0) measurements in comparison with thermodilution methods in patients undergoing living donor liver transplantation.

Methods

Twenty patients were anesthetized and mechanically ventilated. A radial arterial line was connected to a dedicated transducer for the APCO evaluation (FloTrac™). A pulmonary artery catheter was placed and connected to a computer system (Vigilance™) to measure intermittent thermodilution cardiac output (COTD) and continuous cardiac output (CCO).

Results

A total of 138 measurements were analyzed. Bland–Altman analysis showed that the mean biases for COTD–APCOv.3.0, COTD–APCOv.1.0, and COTD–CCO were 0.89, 1.73, and −0.79 L/min, and the adjusted percentage errors were 37.5, 30.3, and 43%, respectively. While the variance for COTD–APCOv3.0 was greater, the accuracy (bias) improved by 0.8 L/min as compared with COTD–APCOv1.0. The difference COTD–APCOv.3.0 became apparent when systemic vascular resistance was lower than 1000 dyne × s/cm5, especially below 700 dyne × s/cm5.

Conclusion

These data suggest that the accuracy of APCOv.3.0 has improved compared to APCOv.1.0 due to the updated algorithm, but additional improvements should be evaluated, especially in patients undergoing living donor liver transplantation with low systemic vascular resistance.

Keywords

Cardiac output Arterial pressure waveform cardiac output Thermodilution Systemic vascular resistance 
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Notes

Conflict of interest

Edwards Lifesciences Japan Ltd. provided monitoring instruments that were used throughout this evaluation. We received financial support from Edwards Lifesciences Japan Ltd. to carry out this study.

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Copyright information

© Japanese Society of Anesthesiologists 2011

Authors and Affiliations

  • Kozaburo Akiyoshi
    • 1
  • Tadashi Kandabashi
    • 1
  • Junko Kaji
    • 1
  • Ken Yamaura
    • 1
  • Hayashi Yoshimura
    • 1
  • Kazuo Irita
    • 1
  • Sumio Hoka
    • 1
  1. 1.Department of Anesthesiology and Critical Care MedicineKyushu University HospitalFukuokaJapan

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