1. Accuracy of Cardiac Output Measured by Fourth-Generation FloTrac and LiDCOrapid, and Their Characteristics Regarding Systemic Vascular Resistance in Patients Undergoing Cardiac Surgery.
- Author
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Takei Y, Kumagai M, Suzuki M, Mori S, Sato Y, Tamii T, Tamii A, Saito A, Ogata Y, Kaiho Y, Toyama H, Ejima Y, and Yamauchi M
- Subjects
- Adult, Humans, Cardiac Output, Vascular Resistance, Hemodynamics, Thermodilution methods, Reproducibility of Results, Monitoring, Intraoperative methods, Cardiac Surgical Procedures methods
- Abstract
Objectives: The clinical use of less-invasive devices that calculate the cardiac output from arterial pressure waveform is increasing. The authors aimed to evaluate the accuracy and characteristics of the systemic vascular resistance index (SVRI) of the cardiac index measured by 2 less-invasive devices, fourth-generation FloTrac (CI
FT ) and LiDCOrapid (CILR ), compared with the intermittent thermodilution technique, using a pulmonary artery catheter (CITD )., Design: This was a prospective observational study., Setting: This study was conducted at a single university hospital., Participants: Twenty-nine adult patients undergoing elective cardiac surgery., Interventions: Elective cardiac surgery was used as an intervention., Measurements and Main Results: Hemodynamic parameters, CIFT , CILR , and CITD , were measured after the induction of general anesthesia, at the start of cardiopulmonary bypass, after completion of weaning from cardiopulmonary bypass, 30 minutes after weaning, and at sternal closure (135 measurements in total). The CIFT and CILR had moderate correlations with CITD (r = 0.62 and 0.58, respectively). Compared with CITD, CIFT, and CILR had a bias of -0.73 and -0.61 L/min/m2 , limit of agreement of -2.14-to-0.68 L/min/m2 and -2.42-to-1.20 L/min/m2 , and percentage error of 39.9% and 51.2%, respectively. Subgroup analysis for evaluating SVRI characteristics showed that the percentage errors of CIFT and CILR were 33.9% and 54.5% in low SVRI (<1,200 dyne×s/cm5 /m), 37.6% and 47.9% in moderate SVRI (1,200-1,800 dyne×s/cm5 /m), 49.3% and 50.6% in high SVRI (>1,800 dyne·s/cm5 /m2 ), respectively., Conclusions: The accuracy of CIFT or CILR was not clinically acceptable for cardiac surgery. Fourth-generation FloTrac was unreliable in high SVRI. LiDCOrapid was inaccurate across a broad range of SVRI, and minimally affected by SVRI., Competing Interests: Conflict of Interest Y. Takei reports grants from the Japan Society for the Promotion of Science, received during the conduct of the study; grants from the Japan Agency for Medical Research and Development and Japanese Society of Anesthesiologists, received outside the submitted work. H. Toyama reports grants from the Japan Society for the Promotion of Science, received outside the submitted work. M. Yamauchi reports grants from the Merit Medical, Eisai Co., Philips Japan Ltd., Shionogi, Japan Society for the Promotion of Science, and Japan Agency for Medical Research and Development, received outside the submitted work. All authors have read the journal's authorship agreement and policy on disclosure of potential conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2023
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