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

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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.

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References

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  14. Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135–60.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, University of Oslo, Oslo, Norway

    Lars Øivind Høiseth & Knut Arvid Kirkebøen

  2. Department of Anesthesiology, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway

    Lars Øivind Høiseth, Ingrid Elise Hoff, Ove Andreas Hagen, Svein Aslak Landsverk & Knut Arvid Kirkebøen

  3. Norwegian Air Ambulance Foundation, Drøbak, Norway

    Ingrid Elise Hoff

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  1. Lars Øivind Høiseth
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  2. Ingrid Elise Hoff
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  3. Ove Andreas Hagen
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  4. Svein Aslak Landsverk
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  5. Knut Arvid Kirkebøen
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Correspondence to Lars Øivind Høiseth.

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Høiseth, L.Ø., Hoff, I.E., Hagen, O.A. et al. Agreement between stroke volume measured by oesophageal Doppler and uncalibrated pulse contour analysis during fluid loads in severe aortic stenosis. J Clin Monit Comput 29, 435–441 (2015). https://doi.org/10.1007/s10877-015-9666-y

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  • DOI: https://doi.org/10.1007/s10877-015-9666-y

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