Electrical cardiometry for non-invasive cardiac output monitoring: a method comparison study in patients after coronary artery bypass graft surgery.

Cardiac output can be estimated non-invasively by electrical cardiometry with the ICON® monitor (Osypka Medical GmbH, Berlin, Germany). Conflicting results have been reported regarding the cardiac output measurement performance of electrical cardiometry. In this prospective method comparison study, we compared cardiac output measured using electrical cardiometry (EC-CO; test method) with cardiac output measured using intermittent pulmonary artery thermodilution (PATD-CO; reference method) in patients after coronary artery bypass graft (CABG) surgery. We calculated the mean of the differences with 95%-limits of agreement (95%-LOA) and their corresponding 95%-confidence intervals (95%-CI) using Bland-Altman analysis and calculated the percentage error. We also analyzed trending using four-quadrant plot analysis. We analyzed 157 paired cardiac output measurements of 41 patients. Mean ± standard deviation PATD-CO was 5.1 ± 1.3 L/min and mean EC-CO was 5.3 ± 1.3 L/min. The mean of the differences ± SD between PATD-CO and EC-CO was -0.2 (95%-CI -0.5 to 0.2) ± 1.2 L/min with a lower 95%-LOA of -2.6 (95%-CI -3.1 to -2.0) L/min and an upper 95%-LOA of 2.3 (95%-CI 1.6 to 2.9) L/min. The percentage error was 47% (95%-CI, 37 to 56%). The concordance rate for cardiac output changes was 48%. In this study, the agreement between EC-CO and PATD-CO was not clinically acceptable in patients after CABG surgery. The trending ability of EC-CO was poor.
Competing Interests: Declarations. Competing interests: GG, RS, AH, NN and PT have no conflicts of interest to declare. BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA). BS is a consultant for Philips North America (Cambridge, MA, USA) and has received honoraria for giving lectures from Philips Medizin Systeme Böblingen (Böblingen, Germany). BS has received institutional restricted research grants and honoraria for giving lectures from Baxter (Deerfield, IL, USA). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from GE Healthcare (Chicago, IL, USA). BS has received institutional restricted research grants and honoraria for giving lectures from CNSystems Medizintechnik (Graz, Austria). BS is a consultant for Maquet Critical Care (Solna, Sweden). BS has received honoraria for giving lectures from Getinge (Gothenburg, Sweden). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Pulsion Medical Systems (Feldkirchen, Germany). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Vygon (Aachen, Germany). BS is a consultant for and has received institutional restricted research grants from Retia Medical (Valhalla, NY, USA). BS has received honoraria for giving lectures from Masimo (Neuchâtel, Switzerland). BS is a consultant for Dynocardia (Cambridge, MA, USA). BS has received institutional restricted research grants from Osypka Medical (Berlin, Germany). BS was a consultant for and has received institutional restricted research grants from Tensys Medical (San Diego, CA, USA). BS is an Editor of the British Journal of Anaesthesia. MF is a consultant for and has received honoraria for giving lectures from Edwards Lifesciences (Irvine, CA, USA). MF has received honoraria for consulting and giving lectures from CNSystems Medizintechnik (Graz, Austria). MF is an Editor for the Journal of Clinical Monitoring and Computing. Informed consent: Informed consent was obtained from all individual participants included in the study. Ethical approval: This method comparison study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethics committee (Ethikkommission der Ärztekammer Hamburg, Hamburg, Germany) on March 16, 2020.
(© 2024. The Author(s).)