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Journal of Clinical Monitoring and Computing

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01-06-2013 | Original Research

Cardiac output monitoring in septic shock: evaluation of the third-generation Flotrac-Vigileo^®

Authors: Sophie Marqué, Antoine Gros, Loic Chimot, Arnaud Gacouin, Sylvain Lavoué, Christophe Camus, Yves Le Tulzo

Published in: Journal of Clinical Monitoring and Computing | Issue 3/2013

Abstract

Continuous cardiac index (CI) monitoring is frequently used in critically ill patients. Few studies have compared the pulse contour-based device FloTrac/Vigileo^® to pulmonary artery thermodilution (PAC) in terms of accuracy for CI monitoring in septic shock. The aim of our study was to compare the third-generation FloTrac/Vigileo^® to PAC in septic shock. Eighteen patients with septic shock requiring monitoring by PAC were included in this study. We monitored CI using both FloTrac/Vigileo^® and continuous thermodilution (PAC-CI). Hemodynamic data were recorded every hour or every 2 min during fluid challenges. The primary endpoint was the global agreement of all CI-paired measurements determined using the Bland–Altman method adapted to replicated data. We tested the linearity of the bias by regression analysis, and compared the reactivity of the 2 techniques during fluid challenges. A receiver operating characteristic (ROC) curve analysis tested the ability of FloTrac/Vigileo^® to detect concordant and significative CI changes, using PAC-CI as the reference method. Overall, 1,201 paired CI measurements were recorded. The Bland–Altman analysis for global agreement of the 2 techniques showed a bias of −0.1 ± 2.1 L min⁻¹ m⁻² and a percentage error of 64 %. The overall correlation coefficient between PAC-CI and FloTrac/Vigileo^® CI was 0.47 (p < 0.01), with r² = 0.22. The area under the curve of the ROC curve for detecting concordant and significant changes in CI was 0.72 (0.53; 0.87). In our study, third-generation Flowtrac-Vigileo^® appears to be too inaccurate to be recommended for CI monitoring in septic shock.

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Title: Cardiac output monitoring in septic shock: evaluation of the third-generation Flotrac-Vigileo®
Authors: Sophie Marqué
Antoine Gros
Loic Chimot
Arnaud Gacouin
Sylvain Lavoué
Christophe Camus
Yves Le Tulzo
Publication date: 01-06-2013
Publisher: Springer Netherlands
Published in: Journal of Clinical Monitoring and Computing / Issue 3/2013
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-013-9431-z

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Cardiac output monitoring in septic shock: evaluation of the third-generation Flotrac-Vigileo^®

Abstract

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Abstract

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