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Pulse contour analysis of arterial waveform in a high fidelity human patient simulator

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Abstract

The measurement of cardiac output (CO) may be useful to improve the assessment of hemodynamics during simulated scenarios. The purpose of this study was to evaluate the feasibility of introducing an uncalibrated pulse contour device (MostCare, Vytech, Vygon, Padova, Italy) into the simulation environment. MostCare device was plugged to a clinical monitor and connected to the METI human patient simulator (HPS) to obtain a continuous arterial waveform analysis and CO calculation. In six different simulated clinical scenarios (baseline, ventricular failure, vasoplegic shock, hypertensive crisis, hypovolemic shock and aortic stenosis), the HPS-CO and the MostCare-CO were simultaneously recorded. The level of concordance between the two methods was assessed by the Bland and Altman analysis. 150-paired CO values were obtained. The HPS-CO values ranged from 2.3 to 6.6 L min−1 and the MostCare-CO values from 2.8 to 6.4 L min−1. The mean difference between HPS-CO and MostCare-CO was − 0.3 L min−1 and the limits of agreement were − 1.5 and 0.9 L min−1. The percentage of error was 23%. A good correlation between HPS-CO and MostCare-CO was observed in each scenario of the study (r = 0.88). Although MostCare-CO tended to underestimate the CO over the study period, good agreements were found between the two methods. Therefore, a pulse contour device can be integrated into the simulation environment, offering the opportunity to create new simulated clinical settings.

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Abbreviations

CO:

Cardiac output

HPS:

Human patient simulator

PAC:

Pulmonary artery catheter

PRAM:

Pressure recording analytical method

SV:

Stroke volume

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Authors and Affiliations

  1. Emergency Department, Azienda Ospedaliera di Padova, Via V. Gallucci 13, 35121, Padova, Italy

    Paolo Persona, Elisabetta Saraceni, Enrico Petranzan, Fabio Baratto & Sandra Rossi

  2. Department of Medicine-DIMED, University of Padova, Padova, Italy

    Francesca Facchin & Carlo Ori

  3. Department of Anesthesia, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

    Matteo Parotto

Authors
  1. Paolo Persona
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  2. Elisabetta Saraceni
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  3. Francesca Facchin
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  4. Enrico Petranzan
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  5. Matteo Parotto
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  6. Fabio Baratto
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  7. Carlo Ori
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  8. Sandra Rossi
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Correspondence to Paolo Persona.

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Conflict of interest

P. Persona has received unrestricted educational support in the form of payment of conferences registration fees (ISICEM, Brussels − 2013, 2015, 2016) from Vygon–Vytech, the manufacturer of the MostCare device. He does not have any financial relationship with this nor other companies. The remaining authors have no conflict of interest to declare.

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Persona, P., Saraceni, E., Facchin, F. et al. Pulse contour analysis of arterial waveform in a high fidelity human patient simulator. J Clin Monit Comput 32, 677–681 (2018). https://doi.org/10.1007/s10877-017-0066-3

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  • DOI: https://doi.org/10.1007/s10877-017-0066-3

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