Abstract
The present study was conducted to study the effect of monitoring site, radial or femoral, for arterial pressure waveform derived cardiac output using FloTrac/Vigileo system with third generation software version 3.02 during cardiac surgery. The cardiac output derived from the two sites was also compared to the pulmonary artery catheter (PAC) derived cardiac output to reevaluate the relation between them using the newer software. The effect of cardiopulmonary bypass (CPB) was also studied by doing the sub analysis before and after bypass. Forty patients undergoing coronary artery bypass surgery with cardiopulmonary bypass were enrolled in the study. Cardiac output derived from radial artery (RADCO), femoral artery (FEMCO) using FloTrac/Vigileo system with third generation software version 3.02 and cardiac output using pulmonary artery catheter (PACCO) at predefined nine time points were recorded. Three hundred and forty two cardiac output data triplets were analysed. The Bland–Altman analysis of RADCO and FEMCO revealed a mean bias of −0.28 with percentage error of 20%. The pre CPB precision of both RADCO and FEMCO was 1.25 times as that of PACCO. The post CPB precision of FEMCO was 1.2 times of PACCO while that of RADCO was 1.7 times of PACCO. The third generation of FloTrac/Vigileo system shows good correlation between the radial and femoral derived cardiac outputs in both pre and post bypass periods. The newer software correlates better to PAC derived cardiac output in the post bypass period for femoral artery than radial artery.
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References
Swan HJC, Ganz W, Forrester J, et al. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med. 1970;283:447–51.
De Waal EEC, De Rossi L, Buhre W. Pulmonary artery catheter in anaesthesiology and intensive care. Anaesthesist. 2006;55:713–30.
Connors AF Jr, Castele RJ, Farhat NZ, et al. Complications of right heart catheterization. A prospective autopsy study. Chest. 1985;88:567–72.
Peters SG, Afessa B, Decker PA, et al. Increased risk associated with pulmonary artery catheterization in the medical intensive care unit. J Crit Care. 2003;18:166–71.
Robin ED. Death by pulmonary artery flow-directed catheter. Time for a moratorium? Chest. 1987;92:727–31.
Chaney JC, Derdak S. Minimally invasive hemodynamic monitoring for the intensivist: current and emerging technology. Crit Care Med. 2002;30:2338–45.
Langewouters GJ, Wesseling KH, Goedhard WJ. The pressure dependent dynamic elasticity of 35 thoracic and 16 abdominal human aortas in vitro described by a five-component model. J Biomech. 1985;18:613–20.
Cannesson M, Attof Y, Rosamel P, et al. Comparison of FloTrac cardiac output monitoring system in patients undergoing coronary artery bypass grafting with pulmonary artery cardiac output measurements. Eur J Anaesthesiol. 2007;24:832–9.
Button D, Weibel L, Reuthebuch O, et al. Clinical evaluation of the FloTrac/Vigileo system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery. Br J Anaesth. 2007;99:329–36.
Prasser C, Bele S, Keyl C, et al. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration. BMC Anesthesiol. 2007;7:9.
Hamm JB, Nguyen BV, Kiss G, et al. Assessment of a cardiac output device using arterial pulse waveform analysis, Vigileo, in cardiac surgery compared to pulmonary arterial themodilution. Anaesth Intensive Care. 2010;38:295–301.
Peyton PJ, Chong SW. Minimally invasive measurement of cardiac output during surgery and critical care a meta-analysis of accuracy and precision. Anesthesiology. 2010;113:1220–35.
Schramm S, Albrecht E, Frascarolo P, et al. 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;24:250–6.
Bland JM, Altman DG. Statistical method for assessing agreement between two methods of clinical measurements. Lancet. 1986;8476:307–10.
Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15:85–91.
Cecconi M, Rhodes A, Poloniecki J, et al. 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;13:201.
Mohr R, Lavee J, Goor DA. Inaccuracy of radial artery pressure measurement after cardiac operations. J Thorac Vasc Surg. 1987;94:286–90.
Manecke GR Jr, Parimucha M, Stratmann G, et al. Deep hypothermic circulatory arrest and the femoral-to-radial arterial pressure gradient. J Cardiothor Vasc Anesth. 2004;18:175–9.
Manecke GR Jr, Auger WR. Cardiac output determination from the arterial pressure wave: Clinical testing of a novel algorithm that does not require calibration. J Cardiothorac Vasc Anesth. 2007;21:3–7.
Lorsomradee S, Lorsomradee SR, de Hert SG, et al. Uncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effects of alterations in arterial waveform. J Cardiothorac Vasc Anesth. 2007;21:636–43.
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Vasdev, S., Chauhan, S., Choudhury, M. et al. Arterial pressure waveform derived cardiac output FloTrac/Vigileo system (third generation software): comparison of two monitoring sites with the thermodilution cardiac output. J Clin Monit Comput 26, 115–120 (2012). https://doi.org/10.1007/s10877-012-9341-5
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DOI: https://doi.org/10.1007/s10877-012-9341-5