Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients

Abstract

Background: Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS™ with the thermodilution technique using pulmonary artery catheter in post-operative cardiac surgical patients. Materials and Methods: This was a prospective observational clinical study conducted at a tertiary care hospital. 23 adult patients in the age range of 18-65 years who had undergone for elective coronary artery bypass grafting were included in the study. Results: Spearman's correlation coefficient of cardiac index between continuous Thermodilution (cTD) and Non-Invasive Cardiac System (NICaS™) showed a good correlation (r = 0.765, 95% confidence interval 0.70 to 0.82, P < 0.0001). There was a good correlation between cTD and NICaS™ for cardiac output (r = 0.759, 95% confidence interval 0.69 to 0.81, P < 0.0001), Bland-Altman plot for cardiac index between cTD and NICaS™ showed a mean bias of −0.66 ± 0.6919 with limits of agreement being −2.02 to 0.6936. Bland-Altman plot for cardiac output between cTD and NICaS™ showed a mean bias of −1.0386 ± 1.17 with limits of agreement being −3.34 to + 1.26. Percentage error for cardiac index and cardiac output were 64.78% and 64% respectively. Polar plot analysis showed an angular bias of 6.32° with radial limits of agreement being −8.114° to 20.75° for cardiac index and angular bias of 5.6682° with radial limits of agreement being −9.1422° to 20.4784° for cardiac output. Conclusion: NICaS™ demonstrated a good trending ability for both CI and CO. However, NICaS™ derived parameters are not interchangeable with the values derived from continuous thermodilution technique.

Impact of vasodilators on diuretic response in patients with congestive heart failure: A mechanistic trial of cimlanod (BMS‐986231)

“…Total peripheral resistance index and cardiac power index were calculated from mean arterial pressure measured by sphygmomanometer and cardiac index measured by whole‐body bioimpedance. Previous studies suggest good correlation (r ∼0.8–0.9) between cardiac index measured non‐invasively using bioimpedance and thermodilution in different clinical settings, 23,24 and that bioimpedance can track changes in cardiac index during infusion of vasodilators 23 . At the end of the infusion, patients were allowed to get out of bed and were weighed and observed in the unit for a further 3.5 h (or overnight if the patient preferred) to ensure safety.…”

Wearable and Noninvasive Device for Integral Congestive Heart Failure Management in the IoMT Paradigm

“…This has limited its presence in the clinical device market. Moreover, the data obtained by bioimpedance are not usually interchangeable with those obtained from other methods, e.g., echocardiographic method in hemodynamic evaluation [ 19 ]. However, these drawbacks are avoided when bioimpedance is used to monitor the progression of the disease in critical patients [ 20 ] and helps physicians to create personalized healthcare plans.…”