Accuracy of Noninvasive Estimated Continuous Cardiac Output (esCCO) Compared to Thermodilution Cardiac Output: A Pilot Study in Cardiac Patients

作者：Ball Timothy R^*; Tricinella Anthony P; Kimbrough Alex; Luna Sarah; Gloyna David F; Villamaria Frank J; Culp William C Jr

来源：Journal of Cardiothoracic and Vascular Anesthesia, 2013, 27(6): 1128-1132.

DOI：10.1053/j.jvca.2013.02.019

• cardiac output
• noninvasive monitoring
• pulmonary artery catheter
• cardiac surgery

Objective: To compare the noninvasive estimated continuous cardiac output (esCCO), device-derived cardiac output (CO) to simultaneous pulmonary artery catheter (PAC) thermodilution (TD) CO.
Design: A prospective study comparing pulse wave transit time (estimated continuous cardiac output, esCCO; Nihon Kohden, Tokyo, Japan) to intermittent TD CO.
Setting: One academic hospital.
Participants: Patients presenting for cardiac surgery.
Interventions: Intraoperative CO measurements at 4 distinct time points (after induction, after sternotomy, after cardiopulmonary bypass, and after chest closure).
Measurements and Main Results: The study population consisted of American Society of Anesthesiologists (ASA) IV subjects, 27 (77%) males and 8 (23%) females, with a mean age of 64.6 +/- 12.2 years. Data points from esCCO and TD were collected simultaneously and means per time point compared using Bland-Altman, Pearson R coefficient, and percent error. Mean TD CO for the study was 5.4 L/min. The Pearson R coefficient, percent error, and bias in L/min were: 0.57, 44%, 0.66 (after induction); 0.54, 51%, 0.88 (after sternotomy); 0.60, 60%, 0.95 (after cardiopulmonary bypass); and 0.57, 60%, 0.75 (after chest closure) respectively.
Conclusions: esCCO is easy to use and provides continuous CO measurements, but has wide limits of agreement and large percentage errors with a consistently positive bias in comparison to TD.

• 出版日期2013-12