Estimated continuous cardiac output based on pulse wave transit time in off-pump coronary artery bypass grafting: a comparison with transpulmonary thermodilution

Estimated continuous cardiac output based on pulse wave transit time in off-pump coronary artery bypass grafting: a comparison with transpulmonary thermodilution

To evaluate the accuracy of estimated continuous cardiac output (esCCO) based on pulse wave transit time in comparison with cardiac output (CO) assessed by transpulmonary thermodilution (TPTD) in off-pump coronary artery bypass grafting (OPCAB). We calibrated the esCCO system with non-invasive (Part...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing Vol. 31; no. 2; pp. 361 - 370
Main Authors: Smetkin, Alexey A., Hussain, Ayyaz, Fot, Evgenia V., Zakharov, Viktor I., Izotova, Natalia N., Yudina, Angelika S., Dityateva, Zinaida A., Gromova, Yanina V., Kuzkov, Vsevolod V., Bjertnæs, Lars J., Kirov, Mikhail Y.
Format: Journal Article
Language:English
Published: Dordrecht Springer Netherlands 01-04-2017
Springer Nature B.V
Subjects:
Accuracy
Aged
Anesthesia
Anesthesiology
Arteries
Bias
Blood Pressure
Blood Pressure Determination
Bypasses
Calibration
Cardiac output
Cardiac Output - physiology
Coronary Artery Bypass, Off-Pump
Critical Care Medicine
Female
Grafting
Health Sciences
Humans
Intensive
Male
Medicine
Medicine & Public Health
Middle Aged
Monitoring, Intraoperative - instrumentation
Monitoring, Intraoperative - methods
Monitoring, Physiologic - methods
Original Research
Pulse Wave Analysis
Reproducibility of Results
Statistics for Life Sciences
Thermodilution - methods
Time Factors
Transit time
Vascular Resistance
Intraoperative monitoring
Cardiac output
Hemodynamics
Estimated continuous cardiac output
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Summary:To evaluate the accuracy of estimated continuous cardiac output (esCCO) based on pulse wave transit time in comparison with cardiac output (CO) assessed by transpulmonary thermodilution (TPTD) in off-pump coronary artery bypass grafting (OPCAB). We calibrated the esCCO system with non-invasive (Part 1) and invasive (Part 2) blood pressure and compared with TPTD measurements. We performed parallel measurements of CO with both techniques and assessed the accuracy and precision of individual CO values and agreement of trends of changes perioperatively (Part 1) and postoperatively (Part 2). A Bland–Altman analysis revealed a bias between non-invasive esCCO and TPTD of 0.9 L/min and limits of agreement of ±2.8 L/min. Intraoperative bias was 1.2 L/min with limits of agreement of ±2.9 L/min and percentage error (PE) of 64 %. Postoperatively, bias was 0.4 L/min, limits of agreement of ±2.3 L/min and PE of 41 %. A Bland–Altman analysis of invasive esCCO and TPTD after OPCAB found bias of 0.3 L/min with limits of agreement of ±2.1 L/min and PE of 40 %. A 4-quadrant plot analysis of non-invasive esCCO versus TPTD revealed overall, intraoperative and postoperative concordance rate of 76, 65, and 89 %, respectively. The analysis of trending ability of invasive esCCO after OPCAB revealed concordance rate of 73 %. During OPCAB, esCCO demonstrated poor accuracy, precision and trending ability compared to TPTD. Postoperatively, non-invasive esCCO showed better agreement with TPTD. However, invasive calibration of esCCO did not improve the accuracy and precision and the trending ability of method.
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ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-016-9853-5