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

BMC Anesthesiology

Research Article

Malte Metzner¹  Jose Carbonell²  Carlos Ferrando²  Marina Soro²  Berthold Bein³  Jochen Renner⁴  Matthias Gruenewald⁴  Arne Carstens⁴  Markus Steinfath⁴  Ole Broch⁴  Jan Höcker⁴  Martin Albrecht⁴ 

[1] Christian-Albrechts-University Kiel, Schleswig-Holstein, Germany;Department of Anaesthesiology and Critical Care, University Hospital Valencia, Avenida Blasco Ibanez 17, 46010, Valencia, Spain;Department of Anaesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany;Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, D-24105, Kiel, Germany;

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

DOI  :  10.1186/s12871-015-0153-2

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

来源: Springer

【 摘 要 】

BackgroundLess-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).MethodsSixty-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 (CITPTD) and autocalibrated semi-invasive pulse contour analysis (CIPFX). Percentage changes of CI were also calculated.ResultsThere was only a poor correlation between CITPTD and CIPFX both 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 CITPTD and CIPFX before (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.ConclusionsSemi-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 registrationClinicalTrials.gov: NCT02312505 Date: 12.03.2012

【 授权许可】

CC BY   
© Broch et al. 2015