Accuracy of Noninvasive Estimated Continuous Cardiac Output (esCCO) Compared to Thermodilution Cardiac Output: A Pilot Study in Cardiac Patients

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• 作者：Timothy R. Ball ; Anthony P. Tricinella ; B. Alex Kimbrough ; Sarah Luna ; David F. Gloyna ; Frank J. Villamaria ; William C. Culp Jr
• 关键词：cardiac output ; noninvasive monitoring ; pulmonary artery catheter ; cardiac surgery
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：December, 2013
• 年：2013
• 卷：27
• 期：6
• 页码：1128-1132
• 全文大小：222 K

文摘

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Objective

To compare the noninvasive estimated continuous cardiac output (esCCO), device-derived cardiac output (CO) to simultaneous pulmonary artery catheter (PAC) thermodilution (TD) CO.

Design

A prospective study comparing pulse wave transit time (estimated continuous cardiac output, esCCO; Nihon Kohden, Tokyo, Japan) to intermittent TD CO.

Setting

One academic hospital.

Participants

Patients presenting for cardiac surgery.

Interventions

Intraoperative CO measurements at 4 distinct time points (after induction, after sternotomy, after cardiopulmonary bypass, and after chest closure).

Measurements and Main Results

The study population consisted of American Society of Anesthesiologists (ASA) IV subjects, 27 (77%) males and 8 (23%) females, with a mean age of 64.6卤12.2 years. Data points from esCCO and TD were collected simultaneously and means per time point compared using Bland-Altman, Pearson R coefficient, and percent error. Mean TD CO for the study was 5.4 L/min. The Pearson R coefficient, percent error, and bias in L/min were: 0.57, 44%, 0.66 (after induction); 0.54, 51%, 0.88 (after sternotomy); 0.60, 60%, 0.95 (after cardiopulmonary bypass); and 0.57, 60%, 0.75 (after chest closure) respectively.

Conclusions

esCCO is easy to use and provides continuous CO measurements, but has wide limits of agreement and large percentage errors with a consistently positive bias in comparison to TD.