Advertisement

Journal of Clinical Monitoring and Computing

, Volume 29, Issue 4, pp 435–441 | Cite as

Agreement between stroke volume measured by oesophageal Doppler and uncalibrated pulse contour analysis during fluid loads in severe aortic stenosis

  • Lars Øivind HøisethEmail author
  • Ingrid Elise Hoff
  • Ove Andreas Hagen
  • Svein Aslak Landsverk
  • Knut Arvid Kirkebøen
Original Research

Abstract

The purpose of this analysis was to study agreement and trending of stroke volume measured by oesophageal Doppler and 3rd generation Vigileo during fluid loads in patients with severe aortic stenosis. Observational study in 32 patients (30 analyzed) scheduled for aortic valve replacement due to severe aortic stenosis. After induction of anesthesia and before start of surgery, hemodynamic registrations for 1 min were obtained before and after a fluid load. Agreement between stroke volume measured by oesophageal Doppler (SVOD) and Vigileo (SVVig) was evaluated in Bland–Altman plot and trending in four-quadrant and polar plots. Bias ± limits of agreement (LOA) between SVOD and SVVig was 24 ± 37 ml (percentage error 45 %). Concordance of the two methods from before to after a fluid load was 100 %. Angular bias ± LOA was 12° ± 28°. Absolute values of SVOD and SVVig agreed poorly, but changes were highly concordant during fluid loads in aortic stenosis patients. The angular agreement indicated acceptable trending. The two measurement methods are not interchangeable in patients with aortic stenosis.

Keywords

Stroke volume Aortic valve stenosis Diagnostic techniques Cardiovascular 

Notes

Conflict of interest

The authors declare no conflicts of interest.

References

  1. 1.
    Stergiopulos N, Young DF, Rogge TR. Computer simulation of arterial flow with applications to arterial and aortic stenoses. J Biomech. 1992;25(12):1477–88.PubMedCrossRefGoogle Scholar
  2. 2.
    Lorsomradee S, Lorsomradee S, Cromheecke S, De Hert SG. Uncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effects of alterations in arterial waveform. J Cardiothorac Vasc Anesth. 2007;21(5):636–43. doi: 10.1053/j.jvca.2007.02.003.PubMedCrossRefGoogle Scholar
  3. 3.
    Staier K, Wiesenack C, Gunkel L, Keyl C. Cardiac output determination by thermodilution and arterial pulse waveform analysis in patients undergoing aortic valve replacement. Can J Anaesth. 2008;55(1):22–8. doi: 10.1007/BF03017593.PubMedCrossRefGoogle Scholar
  4. 4.
    Petzoldt M, Riedel C, Braeunig J, Haas S, Goepfert MS, Treede H, Baldus S, Goetz AE, Reuter DA. Stroke volume determination using transcardiopulmonary thermodilution and arterial pulse contour analysis in severe aortic valve disease. Intensive Care Med. 2013;39(4):601–11. doi: 10.1007/s00134-012-2786-7.PubMedCrossRefGoogle Scholar
  5. 5.
    Manecke GR. Edwards FloTrac sensor and Vigileo monitor: easy, accurate, reliable cardiac output assessment using the arterial pulse wave. Expert Rev Med Devices. 2005;2(5):523–7. doi: 10.1586/17434440.2.5.523.PubMedCrossRefGoogle Scholar
  6. 6.
    Critchley LA. Pulse contour analysis: is it able to reliably detect changes in cardiac output in the haemodynamically unstable patient? Crit Care. 2011;15(1):106. doi: 10.1186/cc9381.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Meng L, Tran NP, Alexander BS, Laning K, Chen G, Kain ZN, Cannesson M. The impact of phenylephrine, ephedrine, and increased preload on third-generation Vigileo–FloTrac and esophageal doppler cardiac output measurements. Anesth Analg. 2011;113(4):751–7. doi: 10.1213/ANE.0b013e31822649fb.PubMedGoogle Scholar
  8. 8.
    Monnet X, Anguel N, Jozwiak M, Richard C, Teboul JL. Third-generation FloTrac/Vigileo does not reliably track changes in cardiac output induced by norepinephrine in critically ill patients. Br J Anaesth. 2012;108(4):615–22. doi: 10.1093/bja/aer491.PubMedCrossRefGoogle Scholar
  9. 9.
    Monge Garcia MI, Gracia Romero M, Gil Cano A, Rhodes A, Grounds RM, Cecconi M. Impact of arterial load on the agreement between pulse pressure analysis and esophageal Doppler. Crit Care. 2013;17(3):R113. doi: 10.1186/cc12785.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Hoiseth LO, Hoff IE, Hagen OA, Landsverk SA, Kirkeboen KA. Dynamic variables and fluid responsiveness in patients for aortic stenosis surgery. Acta Anaesthesiol Scand. 2014;58(7):826–34. doi: 10.1111/aas.12328.PubMedCrossRefGoogle Scholar
  11. 11.
    Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571–82. doi: 10.1080/10543400701329422.PubMedCrossRefGoogle Scholar
  12. 12.
    Critchley LA, Lee A, Ho AM. A critical review of the ability of continuous cardiac output monitors to measure trends in cardiac output. Anesth Analg. 2010;111(5):1180–92. doi: 10.1213/ANE.0b013e3181f08a5b.
  13. 13.
    Critchley LA, Yang XX, Lee A. Assessment of trending ability of cardiac output monitors by polar plot methodology. J Cardiothorac Vasc Anesth. 2011;25(3):536–46. doi: 10.1053/j.jvca.2011.01.003.PubMedCrossRefGoogle Scholar
  14. 14.
    Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135–60.PubMedCrossRefGoogle Scholar
  15. 15.
    Cecconi M, Rhodes A, Poloniecki J, Della Rocca G, Grounds RM. Bench-to-bedside review: the importance of the precision of the reference technique in method comparison studies—with specific reference to the measurement of cardiac output. Crit Care. 2009;13(1):201. doi: 10.1186/cc7129.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Cecconi M, Dawson D, Grounds RM, Rhodes A. Lithium dilution cardiac output measurement in the critically ill patient: determination of precision of the technique. Intensive Care Med. 2009;35(3):498–504. doi: 10.1007/s00134-008-1292-4.PubMedCrossRefGoogle Scholar
  17. 17.
    Suehiro K, Tanaka K, Funao T, Matsuura T, Mori T, Nishikawa K. Systemic vascular resistance has an impact on the reliability of the Vigileo–FloTrac system in measuring cardiac output and tracking cardiac output changes. Br J Anaesth. 2013;111(2):170–7. doi: 10.1093/bja/aet022.PubMedCrossRefGoogle Scholar
  18. 18.
    Sotomi Y, Iwakura K, Higuchi Y, Abe K, Yoshida J, Masai T, Fujii K. The impact of systemic vascular resistance on the accuracy of the FloTrac/Vigileo system in the perioperative period of cardiac surgery: a prospective observational comparison study. J Clin Monit Comput. 2013;27(6):639–46. doi: 10.1007/s10877-013-9481-2.PubMedCrossRefGoogle Scholar
  19. 19.
    Feldheiser A, Hunsicker O, Krebbel H, Weimann K, Kaufner L, Wernecke KD, Spies C. Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological surgery. Br J Anaesth. 2014;113(5):822–31. doi: 10.1093/bja/aeu241.PubMedCrossRefGoogle Scholar
  20. 20.
    Dark PM, Singer M. The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med. 2004;30(11):2060–6. doi: 10.1007/s00134-004-2430-2.PubMedCrossRefGoogle Scholar
  21. 21.
    Monnet X, Chemla D, Osman D, Anguel N, Richard C, Pinsky MR, Teboul JL. Measuring aortic diameter improves accuracy of esophageal Doppler in assessing fluid responsiveness. Crit Care Med. 2007;35(2):477–82. doi: 10.1097/01.CCM.0000254725.35802.17.PubMedCrossRefGoogle Scholar
  22. 22.
    Heerman JR, Segers P, Roosens CD, Gasthuys F, Verdonck PR, Poelaert JI. Echocardiographic assessment of aortic elastic properties with automated border detection in an ICU: in vivo application of the arctangent Langewouters model. Am J Physiol Heart Circ Physiol. 2005;288(5):H2504–11. doi: 10.1152/ajpheart.00368.2004.PubMedCrossRefGoogle Scholar
  23. 23.
    Schramm S, Albrecht E, Frascarolo P, Chassot PG, Spahn DR. Validity of an arterial pressure waveform analysis device: does the puncture site play a role in the agreement with intermittent pulmonary artery catheter thermodilution measurements? J Cardiothorac Vasc Anesth. 2010;24(2):250–6. doi: 10.1053/j.jvca.2009.05.029.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lars Øivind Høiseth
    • 1
    • 2
    Email author
  • Ingrid Elise Hoff
    • 2
    • 3
  • Ove Andreas Hagen
    • 2
  • Svein Aslak Landsverk
    • 2
  • Knut Arvid Kirkebøen
    • 1
    • 2
  1. 1.Faculty of MedicineUniversity of OsloOsloNorway
  2. 2.Department of AnesthesiologyOslo University HospitalOsloNorway
  3. 3.Norwegian Air Ambulance FoundationDrøbakNorway

Personalised recommendations