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Objective
To evaluate the ability of the third-generation (3.01) of FloTrac/Vigileo monitor (Edwards Lifesciences, Irvine, CA) to follow variations in cardiac output (鈭咰O) using the new polar plot approach.
Design
Prospective interventional study.
Setting
Single hospital university study.
Participants
Twenty-five patients referred for cardiac surgery.
Interventions
CO was measured simultaneously by 3 to 5 bolus thermodilution (COtd measurements), using a pulmonary artery catheter and by arterial pulse contour analysis, using the FloTrac/Vigileo (COvi). Data were collected at eight time points: before incision, after sternotomy, before and after protamine sulfate infusion, at the start of sternal closure, at the end of surgery, on arrival to intensive care unit, and after a standardized volume expansion with 500 mL of hetastarch 6%.
Measurements and Main Results
One-hundred thirty-five pairs of CO data were collected; the mean bias of all CO measurements corrected for repeated measures was 0.2 L/min with limits of agreements of 鈭?.3 L/min and +2.9 L/min. The percentage error was 66.5%. The polar plot analysis included 71 significant 鈭咰O and showed a mean polar angle of 鈭?.4 degrees with 95% polar percentage error equivalent limits of 鈭?1 to 55; 69% of analysed data points fell within the 30-degree limits and provided a correct polar concordance rate.
Conclusions
Third-generation FloTrac/Vigileo software still lacks the accuracy to reliably detect changes in cardiac output (鈭咰O) in cardiac surgery. Improvements to FloTrac/Vigileo CO algorithm and software still are needed in this particular setting.
