Accuracy of Vigileo/Flotrac monitoring system in morbidly obese patients

作者：Tejedor Ana^*; Rivas Eva; Rios Jose; Arismendi Ebymar; Martinez Palli Graciela; Delgado Salvadora; Balust Jaume

来源：Journal of Critical Care, 2015, 30(3): 562-566.

DOI：10.1016/j.jcrc.2015.01.015

• Cardiac output
• Pulmonary artery catheter
• Obese patient
• Vigileo/FloTrac

Purpose: Our goal was to assess the accuracy of measuring cardiac output (CO) by the FloTrac/Vigileo (COV) device in comparison with thermodilution technique through pulmonary artery catheterization (PAC(TD)) in morbidly obese patients.
Material and methods: Cardiac output in 8 morbidly obese patients was assessed twice at upright and lying position breathing ambient air. At least 4 consecutive CO measurements with 10 mL of ice-cold saline injections were performed each time. Simultaneous CO measurements were recorded with both single-bolus thermodilution and COV.
Results: One hundred thirty-two CO data pairs were collected. The overall mean single-bolus thermodilution 6.2 +/- 1.1 L/min was lower than the overall mean COV 7.8 +/- 1.6 L/min (P < .001). Lin concordance coefficient indicated that overall agreement between PAC(TD) and COV was poor, 0.29. Lin concordance coefficient in sitting position was 0.29, 95% confidence interval (0.17-0.40) and in lying position was 0.30, 95% confidence interval (0.15-0.44). The Bland-Altman plot analysis showed systematically higher values from COV in comparison with PAC(TD). These differences increased in presence of high CO measurements. In 3 of 8 patients, the percentage error was lower than 20%, whereas in the other 5, it was higher than 20%. Of these 5, in 2 cases, the percentage error was greater than 50%.
Conclusion: Data obtained using COV vs PAC(TD) measurements showed poor correlation. The results were not interchangeable.

• 出版日期2015-6