Comparison of a non-invasive with two minimally invasive cardiac output monitors during off-pump coronary artery bypass surgery

Thomas Scheeren, P. Buisman, J.P. Van Der Berg, E. Visser, J. Brommundt, W. Rietman, Marieke Poterman, A.F. Kalmar

Research output: Contribution to conferencePosterAcademic

Abstract

Title
Comparison of a non-invasive with two minimally invasive cardiac output monitors during off-pump coronary artery bypass surgery.

Background
Cardiac index (CI) can be measured using arterial pressure curve analysis, which can be derived either minimally invasive from the radial artery (e.g. FloTrac/Vigileo™ (CIFTV) or ProAQT-Pulsioflex™ (CIPA)) or completely non-invasively with a finger cuff (e.g. ccNexfin™ (CINF)). Assuming that CIFTV and CIPA are clinically interchangeable, we compared CIFTV and CIPA with each other and the average of the minimal invasive CIFTV and CIPA (CIAVR) with non-invasive CINF.

Methods
In 70 patients undergoing off-pump coronary artery bypass surgery, CI was compared at predefined events during anesthesia (before and after induction of anesthesia, before and after sternotomy). Values were compared by Bland-Altman analysis for repeated measures. Four-quadrant plots and polar plot methodology were used to evaluate CI trending ability.

Results
Agreement analysis of CIFTV versus CIPA showed a bias of -0.2 l min-1 m-2, limits of agreement (LOA) of ± 1.5 l min-1 m-2 and percentage error (PE) of 103% (fig A). CINF slightly underestimated CI compared to CIAVR with a bias of 0.6 l min-1 m-2, LOA of ± 1.6 l min-1 m-2 (p<0.001), PE of 102% (fig. B). Polar plot analysis revealed moderate concordance to track CI changes comparing CIFTV to CIPA and CIAVR to CINF (83% and 90% within 30º limits of agreement) (fig. C, D).

Conclusions
The arterial pressure curve derived CIFTV and CIPA reveal a similar agreement and trending ability with each other as with noninvasive CINF. Therefore, noninvasive CINF can be considered as interchangeable with the minimal invasive arterial pressure curve based CI monitors.
Original languageEnglish
PagesP-46
Publication statusPublished - 18-Sep-2014
Event30th International Congress of Cardiothoracic and Vascular Anaesthesia - Florence, Italy
Duration: 17-Sep-201419-Sep-2014
Conference number: 30
http://www.eacta.org/congress-events/

Conference

Conference30th International Congress of Cardiothoracic and Vascular Anaesthesia
Abbreviated titleEACTA ICCVA 2014
CountryItaly
CityFlorence
Period17/09/201419/09/2014
Internet address

Cite this