Accuracy of an autocalibrated pulse contour analysis in cardiac surgery patients: a bi-center clinical trial

BMC Anesthesiology

Ole Broch¹  Jose Carbonell³  Carlos Ferrando³  Malte Metzner⁴  Arne Carstens¹  Martin Albrecht¹  Matthias Gruenewald¹  Jan Höcker¹  Marina Soro³  Markus Steinfath¹  Jochen Renner¹  Berthold Bein² 

[1] Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, Kiel, D-24105, Germany

[2] Department of Anaesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany

[3] Department of Anaesthesiology and Critical Care, University Hospital Valencia, Avenida Blasco Ibanez 17, Valencia, 46010, Spain

[4] Christian-Albrechts-University Kiel, Schleswig-Holstein, Germany

关键词: Transpulmonary thermodilution;    Haemodynamic monitoring;    Pulse contour analysis;    Cardiac index;   

Others  :  1234466
DOI  :  10.1186/s12871-015-0153-2

 received in 2015-07-20, accepted in 2015-11-22,  发布年份 2015

【 摘 要 】

Background

Less-invasive and easy to install monitoring systems for continuous estimation of cardiac index (CI) have gained increasing interest, especially in cardiac surgery patients who often exhibit abrupt haemodynamic changes. The aim of the present study was to compare the accuracy of CI by a new semi-invasive monitoring system with transpulmonary thermodilution before and after cardiopulmonary bypass (CPB).

Methods

Sixty-five patients (41 Germany, 24 Spain) scheduled for elective coronary surgery were studied before and after CPB, respectively. Measurements included CI obtained by transpulmonary thermodilution (CI _TPTD ) and autocalibrated semi-invasive pulse contour analysis (CI _PFX ). Percentage changes of CI were also calculated.

Results

There was only a poor correlation between CI _TPTDand CI _PFXboth before (r²  = 0.34, p < 0.0001) and after (r²  = 0.31, p < 0.0001) CPB, with a percentage error (PE) of 62 and 49 %, respectively. Four quadrant plots revealed a concordance rate over 90 % indicating an acceptable correlation of trends between CI _TPTDand CI _PFXbefore (concordance: 93 %) and after (concordance: 94 %) CPB. In contrast, polar plot analysis showed poor trending before and an acceptable trending ability of changes in CI after CPB.

Conclusions

Semi-invasive CI by autocalibrated pulse contour analysis showed a poor ability to estimate CI compared with transpulmonary thermodilution. Furthermore, the new semi-invasive device revealed an acceptable trending ability for haemodynamic changes only after CPB.

Trial registration

ClinicalTrials.gov: NCT02312505 Date: 12.03.2012

【 授权许可】

   
2015 Broch et al.

【 图 表 】

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