A New Non-Invasive Continuous Cardiac Output Trend Solely Utilizing Routine Cardiovascular Monitors

Ishihara, Hironori; Okawa, Hirobumi; Tanabe, Ken; Tsubo, Toshihito; Sugo, Yoshihiro; Akiyama, Takayuki; Takeda, Satoshi

doi:10.1007/s10877-005-2452-5

Cited by 64 publications

(51 citation statements)

References 18 publications

(20 reference statements)

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“…In contrast, studies using both a pulmonary artery catheter and invasive continuous arterial pressure for external calibration showed a good correlation between absolute values of CO measurements. 7,8 Even so, the need for external invasive calibration significantly limits the applicability of esCCO as a complete noninvasive monitoring tool. Unfortunately, implementing an automated exclusion algorithm with the esCCO device seems unable to improve its reliability.…”

Section: Discussionmentioning

confidence: 99%

“…Two proof-of-concept studies using an external calibration with bolus pulmonary artery thermodilution and invasive arterial pressure showed encouraging results. 7,8 Another study conducted in the intensive care unit (ICU) to compare noninvasive esCCO without external CO calibration with TTE was less straightforward. 9 Further validation studies using different comparators and conducted in various subgroups of high-risk patients are highly desirable before recommending a wider use of esCCO at the bedside, in the ICU, or in the operating room.…”

Section: Résumémentioning

confidence: 99%

“…14 The highest value of CO esCCO was recorded during the period ranging from the beginning of the PLR to two minutes after the highest value of CO TTE , in accordance with the fact that PWTT was calculated by averaging 64 consecutive heart beats. 7 The Fig. 1 Example of a systolic still-frame image of the heart in the apical five-chamber view illustrating the Doppler recording sub-aortic velocity-time integral and the presence of the two quality criteria necessary to include the patient: the Doppler click of the aortic valve closure (large arrow) and a dual spectrum of VTI SA (fine arrow).…”

Section: Study Protocolmentioning

confidence: 99%

See 2 more Smart Citations

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Fischer

Balaire

Kergal

et al. 2013

Can J Anesth/J Can Anesth

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Purpose Estimated continuous cardiac output (esCCO) is a new and noninvasive cardiac output (CO) monitoring device using pulse wave transit time. The aim of this study was to assess rapid changes in CO using esCCO (DCO esCCO ) without invasive calibration and to compare the results with those using transthoracic Doppler echocardiography (DCO TTE ). Methods Fifty-four consecutive patients were enrolled in this study following elective cardiac surgery. The CO esCCO and CO TTE were collected during four consecutive steps: 1) at baseline, 2) during passive leg raising (PLR), 3) at return to baseline, and 4) after a fluid challenge. The relationship between DCO esCCO and DCO TTE induced by PLR and a fluid challenge was assessed and a polar plot analysis was performed. Relationship, Bland-Altman analysis, and percentage error for absolute values of CO esCCO and CO TTE were also performed. Results Twenty-four patients were excluded from the analysis. No correlation was found between DCO esCCO and DCO TTE during PLR (r = 0.07; P = 0.732; n = 30) and after a fluid challenge (r = 0.24; P = 0.394; n = 14). The polar plot analysis showed that 21 data points (87%) of significant changes in CO were above the 30°radial sector lines and confirmed that esCCO was unable to track changes in CO. A weak positive relationship was found between absolute values of CO esCCO and CO TTE (r = 0.28; P = 0.004). Bias, precision, and limits of agreement were 0.25 LÁmin -1 , 2.4 LÁmin -1 , and -4.4 to 4.9 LÁmin -1 , respectively. The percentage error was 80%. Conclusions Estimated continuous cardiac output without external calibration seems unable to assess rapid changes in CO following cardiac surgery and was not interchangeable with transthoracic Doppler echocardiography.

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Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

See 1 more Smart Citation

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Fischer

Balaire

Kergal

et al. 2013

Can J Anesth/J Can Anesth

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“…22 Ishihara et al explored the use of PTT to ''correct'' noninvasive cardiac output monitors for changes in peripheral tone. 26 The relationship between PTT and peripheral tone is further supported by the fact that decreased PTT (i.e., increased PWV) has been related to mortality after kidney transplantation. Specifically, in a cohort of 330 patients followed over an average of 3.8 years after renal transplantation, increased PWV was associated with a significant increase in age, systolic blood pressure, and pulse pressure.…”

Section: Physiology Of the Ppgmentioning

confidence: 96%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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“…The technique is novel and has been recently incorporated into a patient monitor (Nihon Kohden, Tokyo, Japan). The esCCO method has been well studied and validated by Ishihara and colleagues from Japan [11]. The study is unusual because densitometry using indocyanine green dye dilution was used as the reference cardiac output method.…”

Section: Evaluation Of Haemodynamic Alterations and Fluid Responsivenessmentioning

confidence: 99%

Year in review in journal of clinical monitoring and computing 2014: cardiovascular and hemodynamic monitoring

Bendjelid

Rex

Scheeren

et al. 2015

J Clin Monit Comput

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A New Non-Invasive Continuous Cardiac Output Trend Solely Utilizing Routine Cardiovascular Monitors

Abstract: The results demonstrate that esCO has a close correlation with the CCOpa, even though the two methods are not interchangeable. The results suggest that esCO method has potential of being an alternative non-invasive cardiac output trend, unless there are apparent arrhythmias.

Cited by 64 publications

References 18 publications

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Advances in photoplethysmography: beyond arterial oxygen saturation

Year in review in journal of clinical monitoring and computing 2014: cardiovascular and hemodynamic monitoring

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