Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T03:09:31.988Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparison of FloTrac™ cardiac output monitoring system in patients undergoing coronary artery bypass grafting with pulmonary artery cardiac output measurements

Published online by Cambridge University Press:  01 October 2007

M. Cannesson ,
Y. Attof ,
P. Rosamel ,
P. Joseph ,
O. Bastien  and
J.-J. Lehot
M. Cannesson*
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
Y. Attof
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
P. Rosamel
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
P. Joseph
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
O. Bastien
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
J.-J. Lehot
Affiliation:
Hospives Civils de Lyon, Hôpital Louis Pradel, Department of Anesthesiology, Bron, France
*
Financial support: None.Correspondence to: Maxime Cannesson, Hôpital Louis Pradel, Service d’Anesthésie Reanimation et ERI22, 28 Avenue du Doyen Lépine, 69500 Bron, France. E-mail: [email protected]; Tel: +33 4 7211 8958; Fax: +33 4 7235 7314
Get access

Summary

Background

Arterial pulse waveform analysis has been proposed for cardiac output (CO) determination and monitoring without calibration or thermodilution (FloTrac™/Vigileo™; Edwards Lifesciences, Irvine, CA, USA). The accuracy and clinical applicability of this technology has not been fully evaluated. We designed this prospective study to compare the accuracy of the FloTrac™ system (COFT) vs. pulmonary artery catheter standard bolus thermodilution (COPAC) in patients undergoing coronary artery bypass grafting.

Methods

We studied 11 patients referred for coronary artery bypass grafting. COFT and COPAC were determined at six time points in the operating room including before and 5 min after volume expansion (500 mL 6% hetastarch). Measurements were performed on arrival in the intensive care unit and every 4 h afterwards. Bland–Altman analysis was used to assess the agreement between COFT and COPAC.

Results

COPAC ranged from 2.0 to 7.6 L min−1 and COFT ranged from 1.9 to 8.2 L min−1. There was a significant relationship between COPAC and COFT (r = 0.662; P < 0.001). Agreement between COPAC and COFT was −0.26 ± 0.87 L min−1. Volume expansion induced a significant increase in both COPAC and COFT (from 3.4 ± 0.8 to 4.4 ± 1.0 L min−1; P < 0.001 and from 3.9 ± 1.2 to 5.0 ± 1.1 L min−1; P < 0.001, respectively) and there was a significant relationship between percent change in COPAC and COFT following volume expansion (r = 0.722; P = 0.01).

Conclusion

We found clinically acceptable agreement between COFT and COPAC in this setting. This new device has potential clinical applications.

Keywords

CARDIAC OUTPUT, measurementCORONARY ARTERY BYPASS GRAFTINGMONITORING PHYSIOLOGIC
Type
EACTA Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 10 , October 2007 , pp. 832 - 839
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.JrConnors, AF, Speroff, T, Dawson, NV et al. . The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 1996; 276: 889–897.CrossRefGoogle ScholarPubMed
2.Richard, C, Warszawski, J, Anguel, N et al. . Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial. JAMA 2003; 290: 2713–2720.CrossRefGoogle ScholarPubMed
3.Harvey, S, Harrison, DA, Singer, M et al. . Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 2005; 366: 472–477.CrossRefGoogle ScholarPubMed
4.Sander, M, von Heymann, C, Foer, A et al. . Pulse contour analysis after normothermic cardiopulmonary bypass in cardiac surgery patients. Crit Care 2005; 9: R729–R734.CrossRefGoogle ScholarPubMed
5.Rauch, H, Muller, M, Fleischer, F et al. . Pulse contour analysis versus thermodilution in cardiac surgery patients. Acta Anaesthesiol Scand 2002; 46: 424–429.CrossRefGoogle ScholarPubMed
6.Buhre, W, Weyland, A, Kazmaier, S et al. . Comparison of cardiac output assessed by pulse-contour analysis and thermodilution in patients undergoing minimally invasive direct coronary artery bypass grafting. J Cardiothorac Vasc Anesth 1999; 13: 437–440.CrossRefGoogle ScholarPubMed
7.Cholley, BP, Payen, D. Noninvasive techniques for measurements of cardiac output. Curr Opin Crit Care 2005; 11: 424–429.CrossRefGoogle ScholarPubMed
8.Della Rocca, G, Costa, MG, Pompei, L et al. . Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth 2002; 88: 350–356.CrossRefGoogle ScholarPubMed
9.de Abreu, MG, Quintel, M, Ragaller, M et al. . Partial carbon dioxide rebreathing: a reliable technique for noninvasive measurement of nonshunted pulmonary capillary blood flow. Crit Care Med 1997; 25: 675–683.CrossRefGoogle ScholarPubMed
10.Tan, HL, Pinder, M, Parsons, R et al. . Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit. Br J Anaesth 2005; 94: 287–291.CrossRefGoogle ScholarPubMed
11.Sander, M, Spies, CD, Grubitzsch, H et al. . Comparison of uncalibrated arterial waveform analysis in cardiac surgery patients with thermodilution cardiac output measurements. Crit Care 2006; 10: R164.CrossRefGoogle ScholarPubMed
12.Penttila, J, Snapir, A, Kentala, E et al. . Estimation of cardiac output in a pharmacological trial using a simple method based on arterial blood pressure signal waveform: a comparison with pulmonary thermodilution and echocardiographic methods. Eur J Clin Pharmacol 2006; 62: 401–407.CrossRefGoogle Scholar
13.Opdam, HI, Wan, L, Bellomo, R. A pilot assessment of the FloTracTM cardiac output monitoring system. Intensive Care Med 2007; 33: 344–349.CrossRefGoogle Scholar
14.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: 523–527.CrossRefGoogle ScholarPubMed
15.Teboul, JL, Besbes, M, Andrivet, P et al. . A bedside index assessing the reliability of pulmonary occlusion pressure measurements during mechanical ventilation with positive end-expiratory pressure. J Crit Care 1992; 7: 22–29.CrossRefGoogle Scholar
16.Heerman, JR, Segers, P, Roosens, CD et al. . 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: H2504–H2511.CrossRefGoogle Scholar
17.Bendjelid, K, Schutz, N, Suter, PM et al. . Continuous cardiac output monitoring after cardiopulmonary bypass: a comparison with bolus thermodilution measurements. Intensive Care Med 2006; 32: 919–922.CrossRefGoogle Scholar
18.Berton, C, Cholley, B. Equipment review: New techniques for cardiac output measurment – oesophageal Doppler, Fick principle using carbon dioxide, and pulse contour analysis. Crit Care 2002; 6: 216–221.CrossRefGoogle ScholarPubMed
19.Kotake, Y, Moriyama, K, Innami, Y et al. . Performance on noninvasive partial CO2 rebreathing cardiac output and continuous thermodilution cardiac output in patients undergoing aortic reconstruction surgery. Anesthesiology 2003; 99: 283–288.CrossRefGoogle ScholarPubMed
20.Godje, O, Hoke, K, Goetz, AE et al. . Reliability of a new algorithm for continuous cardiac output determination by pulse-contour analysis during hemodynamic instability. Crit Care Med 2002; 30: 52–58.CrossRefGoogle ScholarPubMed
21.Monchi, M, Thebert, D, Cariou, A et al. . Clinical evaluation of the Abbot Qvue-OptiQ continuous cardiac output system in critically ill medical patients. J Crit Care 1998; 13: 91–95.CrossRefGoogle Scholar
22.Pittman, J, Bar-Yosef, S, SumPing, J et al. . Continuous cardiac output monitoring with pulse contour analysis: a comparison with lithium indicator dilution cardiac output measurement. Crit Care Med 2005; 33: 2015–2021.CrossRefGoogle ScholarPubMed
23.Valtier, B, Cholley, BP, Belot, J et al. . Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med 1998; 158: 77–83.CrossRefGoogle ScholarPubMed
24.Zollner, C, Haller, M, Weis, M et al. . Beat-to-beat measurement of cardiac output by intravascular pulse contour analysis: a prospective criterion standard study in patients after cardiac surgery. J Cardiothorac Vasc Anesth 2000; 14: 125–129.CrossRefGoogle ScholarPubMed
25.Zollner, C, Goetz, AE, Weis, M et al. . Continuous cardiac output measurements do not agree with conventional bolus thermodilution cardiac output determination. Can J Anaesth 2001; 48: 1143–1147.CrossRefGoogle Scholar
26.Burchell, SA, Yu, M, Takiguchi, SA et al. . Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients. Crit Care Med 1997; 25: 388–391.CrossRefGoogle ScholarPubMed
27.Jacquet, L, Hanique, G, Glorieux, D et al. . Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med 1996; 22: 1125–1129.CrossRefGoogle ScholarPubMed