Comparison Between Doppler-Echocardiography and Uncalibrated Pulse Contour Method for Cardiac Output Measurement: A Multicenter Observational Study*

Scolletta, Sabino; Franchi, Federico; Romagnoli, Stefano; Carla, R. Sipert; Donati, Abele; Fabbri, Lea Paola; Forfori, Francesco; Alonso-Íñigo, J.M.; Laviola, Silvia; Mangani, Valerio; Maj, Giulia; Martinelli, Giampaolo; Mirabella, Lucia; Morelli, Andrea; Persona, Paolo; Payen, Didier

doi:10.1097/ccm.0000000000001663

Cited by 44 publications

(28 citation statements)

References 36 publications

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“…From SV, cardiac output could be calculated. A good correlation was found between Doppler-based estimations and non-invasive uncalibrated pulse-contour assessments of cardiac output [5]. CO = SV x HR = HR (bpm) x AVA (cm 2 ) x TVI (cm) Doppler-based SV methodology can also be utilized when aortic valve stenosis is present.…”

Section: Ventricular Systolic Functionmentioning

confidence: 83%

Cardiac ultrasound: a true haemodynamic monitor?

Poelaert

Malbrain²

2018

Anaesthesiol Intensive Ther

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Cardiac ultrasound has been used in the critically ill for more than thirty years. The technology has made enormous progression with respect to image quality and quantity, various Doppler techniques, as well as connectivity, the transfer of data and offline calculations. Some consider cardiac ultrasound as the stethoscope of the Twenty-first century. The potential of eye-balling moving cardiac structures gives undeniable power to this diagnostic and monitoring tool. The main shortcoming is the discontinuous mode of monitoring and the fact that optimal information acquisition can only be obtained when one is well-trained and experienced. Cardiac ultrasound has become an indispensable tool, especially in haemodynamically unstable patients. This review summarizes some important aspects of cardiac ultrasound with use of Doppler monitoring for assessment of the three most important pillars of haemodynamics, namely cardiac preload, afterload and contractile function.

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Section: Ventricular Systolic Functionmentioning

confidence: 83%

Cardiac ultrasound: a true haemodynamic monitor?

Poelaert

Malbrain²

2018

Anaesthesiol Intensive Ther

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“… Romagnoli et al (2013) also analyzed TTE-CO in comparison with two different pulse contour devices. In a multicenter study by Scolletta et al (2016) Doppler TTE was used as a comparison method to pulse contour device, and they could demonstrate a good correlation between TTE-CO and the CO estimated from a pulse contour device ( r = 0.85; p < 0.0001). Our findings are in line with Wagner et al (2015) who demonstrated that the applanation tonometry technology provides CO values with reasonable accuracy and precision of agreement compared with intermittent pulmonary artery thermodilution measurements.…”

Section: Discussionmentioning

confidence: 95%

“…Measuring hemodynamics with TTE has some limitations: the need for a trained sonographer, poor acoustic window, inaccurate diameter calculations, and difficulty maintaining the angle of insonation ( Expert Round Table on Echocardiography in ICU, 2014 ; Narasimhan, Koenig & Mayo, 2014 ). Although the PAC still the gold standard, echocardiography has been used to test newer hemodynamic monitoring systems ( Gola et al, 1996 ; Romagnoli et al, 2013 ; Scolletta et al, 2016 ) and it has been recommended by international consensus as a reliable method for CO estimation ( Cecconi et al, 2014 ). During the last decade, several non- or minimal invasive techniques have been presented, such as pulse wave transit time, non-invasive pulse contour analysis, arterial tonometry, oscillometry, oesophageal Doppler devices, the partial carbon dioxide rebreathing technique, and transthoracic electrical bio-impedance ( Peyton & Chong, 2010 ; Sato et al, 1993 ; Thiele, Bartels & Gan, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison between radial artery tonometry pulse analyzer and pulsed-Doppler echocardiography derived hemodynamic parameters in cardiac surgery patients: a pilot study

Zayat

Goetzenich

Lee

et al. 2017

PeerJ

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BackgroundBedside non-invasive techniques, such as radial artery tonometry, to estimate hemodynamic parameters have gained increased relevance as an attractive alternative and efficient method to measure hemodynamics in outpatient departments. For our pilot study, we sought to compare cardiac output (CO), and stroke volume (SV) estimated from a radial artery tonometry blood pressure pulse analyzer (BPPA) (DMP-Life, DAEYOMEDI Co., Gyeonggi-do, South Korea) to pulsed-wave Doppler (PWD) echocardiography derived parameters.MethodsFrom January 2015 to December 2016, all patients scheduled for coronary artery bypass (CABG) surgery at our department were screened. Exclusion criteria were, inter alia, moderate to severe aortic- or Mitral valve disease and peripheral arterial disease (PAD) > stage II. One hundred and seven patients were included (mean age 66.1 ± 9.9, 15 females, mean BMI 27.2 ± 4.1 kg/m2). All patients had pre-operative transthoracic echocardiography (TTE). We measured the hemodynamic parameters with the BPPA from the radial artery, randomly before or after TTE. For the comparison between the measurement methods we used the Bland-Altman test and Pearson correlation.ResultsMean TTE-CO was 5.1 ± 0.96 L/min, and the mean BPPA-CO was 5.2 ± 0.85 L/min. The Bland-Altman analysis for CO revealed a bias of −0.13 L/min and SD of 0.90 L/min with upper and lower limits of agreement of −1.91 and +1.64 L/min. The correlation of CO measurements between DMP-life and TTE was poor (r = 0.501, p < 0.0001). The mean TTE-SV was 71.3 ± 16.2 mL and the mean BPPA-SV was 73.8 ± 19.2 mL. SV measurements correlated very well between the two methods (r = 0.900, p < 0.0001). The Bland-Altman analysis for SV revealed a bias of −2.54 mL and SD of ±8.42 mL and upper and lower limits of agreement of −19.05 and +13.96 mL, respectively.ConclusionOur study shows for the first time that the DMP-life tonometry device measures SV and CO with reasonable accuracy and precision of agreement compared with TTE in preoperative cardiothoracic surgery patients. Tonometry BPPA are relatively quick and simple measuring devices, which facilitate the collection of cardiac and hemodynamic information. Further studies with a larger number of patients and with repeated measurements are in progress to test the reliability and repeatability of DMP-Life system.

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“…Echocardiography allows physicians to estimate CO noninvasively in critically ill patients (1). Briefly, stroke volume (SV) can be calculated as the product of the aortic valve area [cross sectional area (CSA)] by the velocity time integral (VTI) of aortic blood flow (ABF) (6). To obtain CSA, the diameter of the left ventricular out-flow tract (LVOT) from the parasternal window is used.…”

Section: Echocardiography To Assess Comentioning

confidence: 99%

“…However, there are conflicting opinions regarding the use of echocardiography as a reference tool for the measurement of CO (13,22). While not uncontroversial (23), the pulmonary artery catheter (PAC) is still considered the gold standard technique for assessing CO by means of the classic thermodilution (ThD) method (6). However, the ThD method does not provide SV on a beat-by-beat basis.…”

Section: Variations In Venae Cavae Diametermentioning

confidence: 99%

Echocardiography to guide fluid therapy in critically ill patients: check the heart and take a quick look at the lungs

Franchi¹,

Vetrugno²,

Scolletta³

2017

J. Thorac. Dis.

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Comparison Between Doppler-Echocardiography and Uncalibrated Pulse Contour Method for Cardiac Output Measurement: A Multicenter Observational Study*

Abstract: Our results suggest that MostCare could be an alternative to echocardiography to assess cardiac output in ICU patients with a large spectrum of clinical conditions.

Cited by 44 publications

References 36 publications

Cardiac ultrasound: a true haemodynamic monitor?

Cardiac ultrasound: a true haemodynamic monitor?

Comparison between radial artery tonometry pulse analyzer and pulsed-Doppler echocardiography derived hemodynamic parameters in cardiac surgery patients: a pilot study

Echocardiography to guide fluid therapy in critically ill patients: check the heart and take a quick look at the lungs

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