Clinical Comparison of an Echocardiograph-Derived Versus Pulse Counter–Derived Cardiac Output Measurement in Abdominal Aortic Aneurysm Surgery

Kusaka, Yusuke; Yoshitani, Kenji; Irie, Tomoya; Inatomi, Yuzuru; Shinzawa, Masahide; Ohnishi, Yoshihiko

doi:10.1053/j.jvca.2011.07.011

Cited by 28 publications

(9 citation statements)

References 12 publications

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“…17 Changes in PP with aortic clamping and declamping may alter Flotrac/Vigileo TM CO but not that measured by echocardiography. 54 Changes in Flotrac/Vigileo TM CO during large alterations in vascular tone may less well correlate to those measured by a reference technique than during fluid loading or passive leg raising, particularly in hyperdynamic conditions and in spite of most recent software. 17 26 55 56 Indeed, concordance of measurements with the reference standard seemed high during and after cardiac surgery 23 41 55 57 but moderate (60-75% or r 2 ,0.50) in patients with an impaired left ventricular function 41 58 or with hyperdynamic conditions, including sepsis.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of uncalibrated arterial pressure waveform analysis to determine cardiac output and stroke volume variation

Slagt

Malagon²,

Groeneveld

2014

British Journal of Anaesthesia

134

104

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have been analysed according to underlying patient conditions, that is, general critical illness and surgery as normodynamic conditions, cardiac and (post)cardiac surgery as hypodynamic conditions, and liver surgery and sepsis as hyperdynamic conditions, and subsequently released software versions. Eight studies compared SVV with other dynamic indices. CO, bias, precision, %error, correlation, and concordance differed among underlying conditions, subsequent software versions, and their interactions, suggesting increasing accuracy and precision, particularly in hypo- and normodynamic conditions. The bias and the trending capacity remain dependent on (changes in) vascular tone with most recent software. The SVV only moderately agreed with other dynamic indices, although it was helpful in predicting fluid responsiveness in 85% of studies addressing this. Since its introduction, the performance of uncalibrated FloTrac/Vigileo™ has improved particularly in hypo- and normodynamic conditions. A %error at or below 30% with most recent software allows sufficiently accurate and precise CO measurements and trending for routine clinical use in normo- and hypodynamic conditions, in the absence of large changes in vascular tone. The SVV may usefully supplement these measurements.

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Section: Discussionmentioning

confidence: 99%

Systematic review of uncalibrated arterial pressure waveform analysis to determine cardiac output and stroke volume variation

Slagt

Malagon²,

Groeneveld

2014

British Journal of Anaesthesia

134

104

View full text Add to dashboard Cite

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“…On the other hand, it appears that the CO calculated by the FloTrac/Vigileo has a less accurate correlation with the one derived by the PAC when changes are induced by norepinephrine administration [10], and also tends to be overestimated compared to a continuous cardiac output calculation with a PAC when used in off-pump coronary artery bypass surgery (CABG) [11]. A discrepancy in measurements also appears when the FloTrac/Vigileo is used to calculate hemodynamic parameters in open aortic abdominal aneurysm (AAA) repair [12] compared with echocardiography derived measurements.…”

Section: Reviewmentioning

confidence: 99%

Less invasive methods of advanced hemodynamic monitoring: principles, devices, and their role in the perioperative hemodynamic optimization

et al. 2013

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The monitoring of the cardiac output (CO) and other hemodynamic parameters, traditionally performed with the thermodilution method via a pulmonary artery catheter (PAC), is now increasingly done with the aid of less invasive and much easier to use devices. When used within the context of a hemodynamic optimization protocol, they can positively influence the outcome in both surgical and non-surgical patient populations. While these monitoring tools have simplified the hemodynamic calculations, they are subject to limitations and can lead to erroneous results if not used properly. In this article we will review the commercially available minimally invasive CO monitoring devices, explore their technical characteristics and describe the limitations that should be taken into consideration when clinical decisions are made.

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“…Concha et al compared transoesophageal echocardiography with Vigileo in patients undergoing laparoscopic surgery, reporting a bias ± SD of 1.17±1.6 l/minute and LOA of -2.02 to 4.37 19 . Similar investigation has been performed in patients undergoing abdominal aortic aneurysm surgery, with improved bias (0.12 l/minute) and LOA (-1.66 to 1.90 l/minute) 20 . Others have also reported comparable findings in perioperative patients receiving vasopressor and fluid therapy 21 .…”

Section: Discussionmentioning

confidence: 58%

A Comparison of Pulse Contour Wave Analysis and Ultrasonic Cardiac Output Monitoring in the Critically Ill

Udy

Altukroni

Jarrett

et al. 2012

Anaesth Intensive Care

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Cardiac output (CO) is a key determinant of major organ blood flow and solute delivery to drug eliminating organs. As such, CO assessment is a key covariate in understanding altered drug handling in the critically ill. Newer minimally-invasive devices are providing unique platforms for such an application, although comparison data are currently lacking. In this study we evaluated the Vigileo ® (Edwards Lifesciences, Irvine, CA, USA) and USCOM ® (USCOM Ltd, Sydney, NSW) devices in 62 critically ill patients requiring antibacterial therapy. The mean CO Vigileo and CO USCOM for the first paired measurements were 8.20±2.65 l/minute and 6.84±2.57 l/minute respectively (P <0.001). A significant correlation was evident in all patients (r=0.537, P <0.001), although the recorded bias was large (1.36±2.51 l/minute, limits of agreement-3.6 to +6.3 l/minute). The overall percentage error was 65%. There was an improved correlation in those admitted with sepsis (r=0.639, P <0.001) compared to trauma (r=0.373, P=0.066), although bias, precision and percentage error were similar in both subgroups. In 54 patients a second paired assessment was obtained at three hours. A weak, although significant correlation (r=0.377, P=0.005) was observed suggesting that gross trends over time were similar. In conclusion, our findings demonstrate poor agreement between these techniques suggesting that these devices are not simply interchangeable when assessing CO in a research or clinical setting.

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Clinical Comparison of an Echocardiograph-Derived Versus Pulse Counter–Derived Cardiac Output Measurement in Abdominal Aortic Aneurysm Surgery

Cited by 28 publications

References 12 publications

Systematic review of uncalibrated arterial pressure waveform analysis to determine cardiac output and stroke volume variation

Systematic review of uncalibrated arterial pressure waveform analysis to determine cardiac output and stroke volume variation

Less invasive methods of advanced hemodynamic monitoring: principles, devices, and their role in the perioperative hemodynamic optimization

A Comparison of Pulse Contour Wave Analysis and Ultrasonic Cardiac Output Monitoring in the Critically Ill

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