Inaccuracy of the FloTrac/Vigileo™ System in Patients With Low Cardiac Index

Maeda, Takuma; Yoshitani, Kenji; Inatomi, Yuzuru; Ohnishi, Yoshihiko

doi:10.1053/j.jvca.2014.04.013

Cited by 22 publications

(10 citation statements)

References 29 publications

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“…Кроме того, отдельный анализ пар данных с нормальным (≥3,5 л/мин) и низким СВ ТПТД выявил значительно более высокую процентную ошибку (89%) сис-темы esCCO при низком значении референтного показате-ля СВ в сравнении с 48% в подгруппе с нормальным СВ ТПТД . Высокую процентную ошибку выявили и среди пациентов с низким СВ при оценке других малоинвазивных методов изме-рения сердечного выброса [13,14].…”

Section: Discussionunclassified

Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

Смёткин¹,

Хусcейн²,

Захаров³

et al. 2016

Patol krovoobrashch kardiokhir

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Aim: The study was designed to evaluate the accuracy of cardiac output (CO) measurements based on pulse wave transit time (PWTT) as compared to transpulmonary thermodilution (TPTD) in perioperative off-pump coronary artery bypass grafting (OPCABG). Methods: 20 patients scheduled for elective OPCABG were enrolled for a prospective study. Parallel measurements of CO by using PWTT (COPWTT) and TPTD (COTPTD) were carried out at five stages intraoperatively and at three stages postoperatively. Also analyzed was the agreement between CO absolute values and its ability to monitor cardiac output dynamics. Results: All in all, 153 pairs of CO data were obtained. According to Bland–Altman analysis, the mean intraoperative difference between the methods was 1.2 L/min, with boundaries of agreement reaching ± 2.9 L/min and a percentage error amounting to 64%. The intraoperative analysis of a polar plot revealed an increased angular difference of 6.9º and radial boundaries of agreement of ± 70.4º, and a decreased polar concordance rate (55%). The postoperative analysis of the data showed better agreement between the methods: mean difference was 0.4 L/min with boundaries of agreement of ± 2.3 L/min and percentage error of 41%. The postoperative trending ability was also more accurate (angular difference of 3.2º, angular boundaries of agreement ± 39º, polar concordance rate 81%). Conclusion: Poor accuracy and reproducibility of non-invasive COPWTT and its insufficient trending ability to monitor cardiac output during off-pump coronary artery bypass grafting makes it impossible to recommend this technology to be used intraoperatively as an alternative to transpulmonary thermodilution technique. The calibration and trending ability of COPWTT improved after OPCAB.

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Section: Discussionunclassified

Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

Смёткин¹,

Хусcейн²,

Захаров³

et al. 2016

Patol krovoobrashch kardiokhir

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“…In comparison with PAC the FloTrac/Vigileo was proved to be a reliable method for CO assessment both during CABG surgery [54] and after elective cardiac surgery [55] but remains sensitive to changes in vascular tone [56]. Newer studies have emphasized that the system is not accurate in cardiac surgical patients with low CO (especially when CI < 2.2 l/min/m 2 ) and in those with low ejection fraction (< 40 %) [57][58].…”

Section: Flotrac/vigileo (Edwards Lifesciences -Usa)mentioning

confidence: 99%

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Hendy

Bubenek

2016

Rom J Anaesth Int Care

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Hemodynamic monitoring has evolved and improved greatly during the past decades as the medical approach has shifted from a static to a functional approach. The technological advances have led to innovating calibrated or not, but minimally invasive and noninvasive devices based on arterial pressure waveform (APW) analysis. This systematic clinical review outlines the physiologic rationale behind these recent technologies. We describe the strengths and the limitations of each method in terms of accuracy and precision of measuring the flow parameters (stroke volume, cardiac output) and dynamic parameters which predict the fluid responsiveness. We also analyzed the place of the APW monitoring devices in goaldirected therapy (GDT) protocols in cardiac surgical patients. According to the data from the three GDTrandomized control trials performed in cardiac surgery (using two types of APW techniques PiCCO and FloTrac/Vigileo), these devices did not demonstrate that they played a role in decreasing mortality, but only decreasing the ventilation time and the ICU and hospital length of stay.

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“…[ 4 ] Noninvasive CO monitoring devices have some desirable properties but have been found to be variably reliable. [ 5 6 7 8 ] Several recent trials have evaluated the efficacy of arterial waveform analysis monitoring using the FloTrac/Vigileo™ (FV™) (Edwards Lifesciences, Irvine, CA, USA) monitoring system. [ 9 10 11 12 13 ] FV™ data are extrapolated from the arterial pressure waveform after correction for body height and weight, age, and gender.…”

Section: Introductionmentioning

confidence: 99%

Comparison of pulmonary artery catheter, echocardiography, and arterial waveform analysis monitoring in predicting the hemodynamic state during and after cardiac surgery

Power

Bone

Simpson

et al. 2017

Int J Crit Illn Inj Sci

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Objective:The aim of this trial was to determine whether Flotrac Vigileo™ (FV™) provides a reliable representation of the hemodynamic state of a cardiac surgical patient population when compared to pulmonary artery catheter (PAC) and echocardiography in the peril-operative period.Design:This was a prospective observational trial comparing perioperative hemodynamic states using transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), FV™ and PAC during and post cardiothoracic surgery.Setting:Tertiary regional hospital Intensive Care Unit (ICU).Participants:50 consecutive adult cardiothoracic patients with written consent provided.Intervention:Comparison of the perioperative hemodynamic states using echocardiography, FV™ and PAC was performed. Evaluation of the hemodynamic state (HDS) was performed using TEE, TTE, PAC and FV™ during and after cardiac surgery. Data were compared between the three hemodynamic assessment modalities.Main Outcome Measure:Predicted hemodynamic state.Results:FV™ and PAC were shown to correlate poorly with TEE/TTE assessment of the hemodynamic state. Both PAC and FV™ showed significant discordance with echocardiographic assessment of the hemodynamic state.Conclusions:In this trial, FV™ and PAC were shown to agree poorly with TTE/TEE assessment of the HDS in an adult cardiothoracic population. Agreement between the FV™ and PAC was also poor. Caution is recommended in interpreting isolated hemodynamic monitoring data. All hemodynamic monitoring devices have inherent sources of error. Caution is advised in interpreting any single device or measurement as a gold standard. We suggest that hemodynamic measuring devices such as FV™/PAC may act as triggers for a global hemodynamic assessment including consideration of TTE/TEE.

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Inaccuracy of the FloTrac/Vigileo™ System in Patients With Low Cardiac Index

Cited by 22 publications

References 29 publications

Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Comparison of pulmonary artery catheter, echocardiography, and arterial waveform analysis monitoring in predicting the hemodynamic state during and after cardiac surgery

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