Comparison of Uncalibrated Arterial Pressure Waveform Analysis with Continuous Thermodilution Cardiac Output Measurements in Patients Undergoing Elective Off-Pump Coronary Artery Bypass Surgery

Jeong, Yong Bo; Kim, Tae Hee; Roh, Young Jin; Choi, In‐Cheol; Suh, Jeong Hun

doi:10.1053/j.jvca.2010.02.006

Cited by 16 publications

(9 citation statements)

References 20 publications

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“…Also, the SVV calculated with this method showed good performance in predicting fluid responsiveness in septic shock patients [9]. 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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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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“…APCO is also considered a clinically applicable method for CO assessment, but this agreement has not been observed in patients under unstable hemodynamic condition. For example, bolus administration of inotropes or vasopressors resulting in a sudden change in vascular tone was found to be associated with the lowest agreement between APCO and thermodilution CO [16]. OPCAB surgery results in the geometry of the heart being incompatible with effective ejection and venous return due to obstructions caused by torque cardiac positioning during anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, OPCAB patients had unique intraoperative periods (in particular, the period of coronary artery graft surgery), which is characterized by rapid changes in vascular volume and compliance. These factors can have a marked influence on APCO accuracy [16,20,21]. UCCO measurements give true pulse-wave signals from the descending aorta [22], and these factors do not influence UCCO accuracy.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of cardiac output measurements during off-pump coronary artery bypass grafting: according to the vessel anastomosis sites

Park

Kim

Joe

et al. 2012

Korean J Anesthesiol

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BackgroundDuring beating heart surgery, the accuracy of cardiac output (CO) measurement techniques may be influenced by several factors. This study was conducted to analyze the clinical agreement among stat CO mode (SCO), continuous CO mode (CCO), arterial pressure waveform-based CO estimation (APCO), and transesophageal Doppler ultrasound technique (UCCO) according to the vessel anastomosis sites.MethodsThis study was prospectively performed in 25 patients who would be undergoing elective OPCAB. Hemodynamic variables were recorded at the following time points: during left anterior descending (LAD) anastomosis at 1 min and 5 min; during obtuse marginal (OM) anastomosis at 1 min and 5 min: and during right coronary artery (RCA) anastomosis at 1 min and 5 min. The variables measured including the SCO, CCO, APCO, and UCCO.ResultsCO measurement techniques showed different correlations according to vessel anastomosis site. However, the percent error observed was higher than the value of 30% postulated by the criteria of Critchley and Critchley during all study periods for all CO measurement techniques.ConclusionsIn the beating heart procedure, SCO, CCO and APCO showed different correlations according to the vessel anastomosis sites and did not agree with UCCO. CO values from the various measurement techniques should be interpreted with caution during OPCAB.

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“…64,[66][67][68] The accuracy of these devices generally decreases during periods of hemodynamic instability; 59,60,64,[69][70][71] thus, there appears to be a tradeoff between convenience and reliability, especially in situations in which loading conditions are expected to change.…”

Section: Technological Assessmentmentioning

confidence: 99%

Inter-device differences in monitoring for goal-directed fluid therapy

Thiele

Bartels

Gan

2014

Can J Anesth/J Can Anesth

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Comparison of Uncalibrated Arterial Pressure Waveform Analysis with Continuous Thermodilution Cardiac Output Measurements in Patients Undergoing Elective Off-Pump Coronary Artery Bypass Surgery

Cited by 16 publications

References 20 publications

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

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

Accuracy of cardiac output measurements during off-pump coronary artery bypass grafting: according to the vessel anastomosis sites

Inter-device differences in monitoring for goal-directed fluid therapy

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