Comparison of noninvasive continuous arterial waveform analysis (Nexfin) with transthoracic Doppler echocardiography for monitoring of cardiac output

Spoel, Anna G.E. van der; Voogel, A. J.; Folkers, Anja; Boer, Christa; Bouwman, R. Arthur

doi:10.1016/j.jclinane.2011.09.008

Cited by 66 publications

(41 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…23) Another noninvasive arterial waveform analysis can be obtained using a Nexfin (BMEYE, Amsterdam, The Netherlands). 24) Compared to transthoracic Doppler echocardiography, the r correlation coeffi cient was 0.68 and appeared to be in line with our result. However, the bias was lower, only 0.51 L/minute and the 95% limit of agreement ranged from -1.6 to 2.6 L/minute.…”

Section: Discussionsupporting

confidence: 89%

Can We Obtain a Noninvasive and Continuous Estimation of Cardiac Output? Comparison Between Three Noninvasive Methods

et al. 2013

View full text Add to dashboard Cite

SummaryCardiac output (CO) is often desirable for assessing the hemodynamic condition of a patient, especially in critically ill cardiac patients. Various noninvasive methods are available for this purpose. Inert gas rebreathing (IGR) and 2D-Doppler echocardiography methods have been validated. Based on the relationship between pulse wave transit time and stroke volume, the VISMO ® provides an estimated continuous cardiac output (esCCO) measurement using only an electrocardiogram, pulse oximeter wave, and cuff arterial blood pressure. Doppler echocardiography is being currently used in every day practice in this setting and IGR is a validated method, thus we wanted to assess the agreement between these 3 methods for noninvasive CO calculation and reproducibility of esCCO. Patients followed in our cardiology department received on the same day a CO analysis by esCCO, Doppler echocardiography and IGR. Thirty-four patients were included (16 women, mean age 65 ± 15 years). Bland and Altman plots showed a good agreement between IGR and 2D-Doppler echocardiography (bias = 0.31 L/minute). Though there was also an agreement between esCCO and the other 2, the bias was rather large: 1.18 L/minute with IGR and 1.51 L/min with 2D-Doppler echo. The intraclass correlation coeffi cient was poor whatever the methods. However, esCCO had a satisfactory reproducibility and accuracy compared rather well with the other 2. This method could be suitable for patient screening and monitoring. (Int Heart J 2013; 54: 395-400)

show abstract

Section: Discussionsupporting

confidence: 89%

Can We Obtain a Noninvasive and Continuous Estimation of Cardiac Output? Comparison Between Three Noninvasive Methods

et al. 2013

View full text Add to dashboard Cite

show abstract

“…We did not perform a level of agreement analysis of our findings, obtained by the Nexfin monitor, with a gold standard. However, we and others previously showed that Nexfin arterial blood pressure and cardiac output showed good agreement with intra-arterial or oesophageal Doppler measurements [17,30,31].…”

Section: Discussionsupporting

confidence: 55%

“…In this study, we used the non-invasive Nexfin monitor for haemodynamic measurements. It measures continuous arterial blood pressure and subsequently calculates CO [5,13,[16][17][18][19][20][21][22] and PPV [5,11,13,23,24] from the arterial pressure waveform. It is restricted to patients with normal peripheral perfusion, and several studies have reported on its limited value in critically ill patients or during septic shock [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…The measurements under supine steady state conditions, forced breathing and the Valsalva manoeuvre were repeated directly after blood donation. Arterial blood pressure measurements were performed using a non-invasive continuous arterial blood pressure measurement device (Nexfin; BMEYE Edwards Life Sciences, Amsterdam, the Netherlands) as previously described [11,17]. Using an inflatable finger cuff, beat-to-beat arterial pressure waveforms were determined by photo plethysmography.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Detection of volume loss using the Nexfin device in blood donors

et al. 2015

View full text Add to dashboard Cite

SummaryWe investigated which haemodynamic parameters derived from Nexfin non-invasive continuous arterial blood pressure measurements are optimal to detect controlled volume loss in spontaneously breathing subjects. Haemodynamic monitoring was performed in 40 whole-blood donors. Mean arterial pressure, cardiac index, systemic vascular resistance index and pulse pressure variation were recorded during controlled breathing, and a Valsalva manoeuvre was performed before and after blood donation. Blood donation resulted in a reduction in cardiac index (from 3.96 AE 0.84 l.min .m 2 ; p < 0.001) and an increase in pulse pressure variation (from 13.4 AE 5.1 to 15.3 AE 5.4%; p = 0.02). The area under the receiver operating characteristic curve to detect volume loss was highest for cardiac index (0.94, 95% CI 0.88-0.99) and systemic vascular resistance (0.90, 95% CI 0.82-0.99). Nexfin is a non-invasive haemodynamic monitor that can feasibly detect volaemic changes in spontaneously breathing subjects.

show abstract

“…Other studies have also reported favourably on the Nexfin's ability to measure cardiac output accurately, e.g., compared with rebreathing methods, 111 or with transthoracic Doppler. 112 These results contrast with other studies that reported far inferior performance of the Nexfin device when comparing the noninvasively derived cardiac output measurements with thermodilution in critically ill patients 113,114 and cardiac ultrasound. 115 It is important to point out that, relative to other noninvasive cardiac output devices (e.g., over 3,000 patients in 16 studies comparing the FloTrac [uncalibrated] with thermodilution, over 1,400 patients in nine studies comparing the PiCCO [calibrated] with thermodilution, and almost 400 patients in three studies comparing the LiDCO [calibrated] with thermodilution), 107 there are very few data comparing volume-clamp-based estimates of SV or cardiac output with gold standards.…”

Section: Technologic Principlescontrasting

confidence: 60%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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.

show abstract

Comparison of noninvasive continuous arterial waveform analysis (Nexfin) with transthoracic Doppler echocardiography for monitoring of cardiac output

Abstract: Considering limits of precision of CO measurements with Doppler echocardiography (± 30%), the agreement between noninvasive CO measurement with the Nexfin and TTE is reasonable.

Cited by 66 publications

References 27 publications

Can We Obtain a Noninvasive and Continuous Estimation of Cardiac Output? Comparison Between Three Noninvasive Methods

Can We Obtain a Noninvasive and Continuous Estimation of Cardiac Output? Comparison Between Three Noninvasive Methods

Detection of volume loss using the Nexfin device in blood donors

Advances in photoplethysmography: beyond arterial oxygen saturation

Contact Info

Product

Resources

About